According to the World Health Organization, 55 million live with dementia globally, with 10 million new cases arising yearly. Unfortunately, at this rate, it is likely that by 2030 there will be 78 million dementia cases worldwide.
However, recent assertions by the World Economic Forum indicate that there is hope on the horizon as the clinical trials of a new treatment unveil positive results.
Dr. Ashok Bharucha, MD, MA, a highly-trained geriatric psychiatrist with years of experience, offers his insight into these recent developments: the opportunities they present, as well as the necessary considerations that need to be taken before spouting them as a cure.
What are possible solutions according to the WEF?
The World Economic Forum is hopeful about a potential treatment for Alzheimer’s and dementia. They propagate a sense of hope for those who have these diseases.
Unfortunately, the WEF indicates that seeing as dementia tends to be diagnosed after significant symptoms have already arisen, the patients who take part in the clinical trials have advanced conditions of the disease. Regrettably, this means that the development of drugs is impeded.
According to Dr. Ashok Bharucha, “it is essential that practitioners identify symptoms as early as possible so that treatment options are more effective. Recent studies in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association suggests that doctors may be able to identify the potential development of Alzheimer’s as early as nine years before the onset of the disease through recognition of possible indications of brain impairment. This study is an immense development and is likely to improve the possibility of effective treatments.”
The WEF indicates that Lecanemab may be able to mitigate the impact of Alzheimer’s. Lecanemab is a monoclonal antibody being developed by Biogen as a potential treatment for Alzheimer’s disease. It is designed to target and inhibit the activity of an enzyme called BACE1, which is involved in the production of amyloid beta protein. High levels of amyloid beta protein in the brain are a hallmark of Alzheimer’s disease, and it is thought that inhibiting BACE1 may help to reduce the production of amyloid beta and slow the progression of the disease. Lecanemab is currently in clinical development, and its safety and effectiveness have not yet been established; however, clinical trials have indicated that Lecanemab slows the decline of cognitive function in those who suffer from the disease.
Should this give hope to those who have Dementia?
“Even though these developments are hopeful, we must be cautious. There are numerous side effects, and the drug mainly works in the beginning stages of the disease. Unfortunately, as we know, most patients are diagnosed when the disease has progressed significantly,” says Dr. Bharucha.
Prof Bart De Strooper, Director of the UK Dementia Research Institute and Group Leader at the UK Dementia Research Institute at UCL, corroborates some of Dr. Bharucha’s assertions, “…it is extremely encouraging to see positive effects of Lecanemab in a trial of just 18 months…this is the first drug that provides a real treatment option for people with Alzheimer’s. While the clinical benefits appear somewhat limited, it can be expected that they will become more apparent if the drug is administered over a longer period.”
However, he continues to say that “the benefits of the drug need to be balanced against the side effects. ARIA is a known side effect that involves a bleed or build-up of fluid in the brain…Further follow-up is needed to understand whether ARIA in the context of anticoagulation therapy in certain patients is life-threatening. It may be that patients receiving such treatments need to be excluded. Further studies will be able to identify the patients at risk and those patients who will maximally profit from the treatment. “
Despite this, Bharucha believes that this development is a major leap in finding appropriate treatments. As with all medical breakthroughs, extensive research and trials must be undertaken, but the results of this 18-month trial are immensely positive.
Some common examples of Dementia:
a) Disorientation to time and place: Although this can happen for a number of reasons, that jetlagged appearance or sense of being a bit lost or “far away” look you spot in a relative could very well be related to dementia. A more common example can be when people revert to another time of their life – let’s say a relative speaks to you in the present time as if you are in the city they lived in 10 years ago.
b) Impaired judgment: The types of decisions people make with dementia can at times be dangerous, for example making poor decisions when driving. In another example, an aging policeman asked for the mobile number of a lady who smiled at him, however she actually went to the police for advice on a matter related to sexual assault – which led to a very unpleasant situation for the police officer.
c) Memory loss: We all may forget things from time to time, however as dementia sets in it is common to hear old people repeat the same story 3 times within a week as if they never told it, which can be frustrating over time. In another example, someone who got accused of a crime they did not commit, actually admitted to being guilty of it as they simply forgot the facts. Evidence later revealed that they were completely innocent.
d) Constantly misplacing things: Many people are forgetful and disorganized. But with dementia, people can frequently misplace and forget things at the same time. These can be important things with consequences – for example misplacing car keys and leaving the car on while going into the house, walking around with their wallet in their pockets while searching for their wallet and so forth.
Clearly the consequences of dementia take a heavy toll on both families and those who suffer with it. It is therefore an important area of research where breakthroughs will be welcome.
Conclusion
Although it is prudent to consider the drug’s limitations and possible side effects, that does not mean that practitioners, patients, and their families should not start seeing the light at the end of the tunnel – no matter how dim nor how unclear it may be.
