As scientists in Aberdeen announce a potentially life-changing breakthrough in the treatment of Alzheimer’s disease Morag Lindsay examines how an ageing population has made finding a cure for dementia all the more urgent

Race to find a cure

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Typical. You wait 100 years for a breakthrough in Alzheimer’s disease research and then two come along at once.

Yesterday’s announcement that scientists at Aberdeen University had created a new drug to dramatically slow the progress of the disease was the first to target the so-called protein tangles in the brain since they were discovered by German neuropsychiatrist Alois Alzheimer in 1906.

The Aberdeen breakthrough coincided with a report from researchers in Chicago suggesting cholesterol-reducing drugs, known as statins, could halve the chances of vulnerable patients developing Alzheimer’s.

Dementia research, for a long time the poor relation of more high-profile diseases, has been gathering pace in recent years as the reality of an ageing population makes finding a cure all the more pressing.

Alzheimer’s accounts for around two-thirds of all cases of dementia, which costs the NHS in Scotland around £1.7billion a year.

There are around 63,000 people with dementia in Scotland at present – 1,600 of them under the age of 65 and two-thirds of them female. As the population ages the number of people with dementia in Scotland is expected to rise by 75% to as many as 114,000 by 2031, taking the cost of caring for them to £2.9billion a year.

In most cases the key symptom of dementia is serious memory loss. Patients might also lose track of time, get lost in familiar places and go through marked changes of behaviour. People with dementia are also likely to lose their ability to reason clearly or make decisions. Personality changes can occur, which can be particularly difficult for families and carers to come to terms with.

In the 100 years since the disease was identified by Alois Alzheimer, research has largely ignored the role of protein tangles, and focused on the effects of a build-up of amyloid plaque on the brain cells.

It is now thought this plaque is more a feature of normal ageing than a signal of dementia.

Around £100million a year has been spent on research into this aspect of the condition over the last 20 years, resulting in a group of drugs known as “cognitive enhancers”, which work by preventing the breakdown of acetylcholine – a chemical which carries messages between brain cells.

These drugs – Aricept (launched in 1997), Exelon (1998) and Reminyl (2002) – have been found to be effective in around half of patients in the mild to moderate stages of the disease, but while they can temporarily improve or stabilise symptoms, they don’t stop the death of brain cells and so don’t represent a permanent cure.

The world market for these acetylcholine enhancers is about £3billion a year.

A drug called Ebixa, which may help people in the moderate to severe stages, was also licensed in 2002. As with the cognitive enhancers, it is not a cure for Alzheimer’s but may improve the symptoms, although it is not widely available throughout the NHS.

The study unveiled yesterday is just one aspect of research being carried out at Aberdeen University. The department of psychology has been looking at issues such as quality of life and decision-making capacity. A brain bank has also been established to collect Alzheimer’s tissue for research.

Elsewhere in Scotland, Dundee University has established the Dundee Alzheimer’s Disease Research Centre, a multi-disciplinary project taking in pharmacology, psychiatry, psychology, neurology, social work and computing. Current activity ranges from research into the link between diabetes and Alzheimer’s and the role of stress to the creation of a multimedia reminiscence based system.

At Stirling University the focus is on improving services for dementia sufferers. Edinburgh and Glasgow universities also have their own Alzheimer’s programmes.

On a practical basis, the charity Alzheimer Scotland advises patients to seek help at the earliest possible opportunity to gain access to the widening range of services available to them and make important decisions about their future.

As well as drug treatments, patients can seek rehabilitation, counselling, education and advice on topics such as welfare benefits and powers of attorney.

Research suggests early intervention can reduce depression in people with dementia and stress in carers.

Information and advice is available on the 24-hour freephone helpline 0808 808 3000 or at the website www.alzscot.org