The Future of Dementia

Published on 25/10/2018

By Julian Hughes, RICE Professor of Old Age Psychiatry

Where is dementia going?

The truth is we don’t yet know.

But there are reasons to be positive. The prevalence of dementia, at least in the UK and several other Western countries, has gone down. In other words, there are fewer people than we would have expected with dementia given the ageing of the population.

We suspect that this improvement reflects a variety of factors: people doing more exercise and eating better, fewer people smoking, and better control of some of the things that put us at risk of dementia, such as high blood pressure and cholesterol in middle age. As we advocate, what’s good for the heart is good for the brain.

On the other hand, we still don’t have a cure and the drugs we do have only produce a modest effect, and there are still no drug treatments for a number of types of dementia.

New research at RICE

At RICE we are taking the fight to dementia. We are pushing forward on all levels; continuing to take part in treatment trials and conducting research that pushes at every door.

Cure or care, both things are worthwhile.

When we consider care, it’s important to remember that dementia doesn’t always come on its own.

A study in Newcastle showed that people 85 years or older had on average 4 separate diseases.

The good news was that most (77.6%) rated their health compared with others of the same age as good, very good, or excellent. So, having a disease in itself doesn’t make things bad. But other diseases can complicate the impact of dementia and family, friends and other people around you can also make a difference.

Similarly, dementia also involves behaviours beyond the straightforward memory problems we usually associate with it.

For instance, some people get agitated with their dementia. Others develop hallucinations or false beliefs (delusions). But the main point is that, even when the dementia cannot be cured, life can be improved by managing and treating the symptoms and issues which we can get to grips with.

There’s a clear message: we can make things better by looking at the person as a whole and treating as many problems as we can. And at RICE we’re involved in trials that look at agitation, hallucinations and delusions, as well as blood pressure.

What’s more, research on dementia has moved on apace. We can never be sure which avenue might be successful and we never know when a new approach might emerge.

Will we find a cure?

We may never find the magic bullet that cures Alzheimer’s disease or Lewy body dementia, let alone vascular dementia. (I say “let alone” because “vascular dementia” involves all sorts of things going wrong with the brain’s blood vessels and it seems unlikely that there is one possible cure for all of these things!)

But – like cancer – there will be a variety of treatments that chip away at the problem. So we are focusing on finding different approaches which might work together. And, of course, other, non-drug, approaches may also help.

The message is that we need to keep working on many fronts at once. RICE is in a position to do this. But we’ll do it especially well if we work with others. Hence, our collaborations with the Royal United Hospital, with the Universities of Bristol and Bath, and increasingly with care homes.

Dementia won’t go away – but we can keep on chipping at it from every side.

With persistence we will make a difference.

Find out more about supporting research at RICE

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