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Dementia research isn’t just about the brain

Activities at a dementia group (Copyright: Department of Health*)

Activities at a dementia group (Image copyright: Department of Health)

Studying how the brain changes as part of neurodegenerative diseases is crucial, but there’s growing evidence that the way the rest of our body changes as we age is important too. As we launch the UK Dementias Research Platform, the Chair of our Neurosciences and Mental Health Board Professor Hugh Perry tells us why we need to be taking a more holistic approach to research into dementias.

There was a time when we would have considered diseases of the brain in isolation of other body systems. But to put it crudely, 75-year-old brains are part of 75-year-old bodies, and these 75-year-old bodies tend to have various physiological problems.

There’s now growing evidence that as we age changes in physiology such as arthritis and diabetes are associated with changes in our mental processes such as memory, language and decision-making.

The number of people with neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease is increasing as the population ages, and we need to find new ways of addressing them. Despite an enormous amount of research over the past 25 years, developing drugs to treat or prevent dementias has been hugely challenging.

We need new strategies, and some of these will involve understanding more about not just the disease itself in the brain, but what happens elsewhere in the body to lead to the disease. In Alzheimer’s disease, for example, we know a fair amount about the build-up of misfolded proteins which characterises the diseased brain, so called plaques and tangles, but remarkably little about what the early stages of the disease look like, and why one person gets the disease while another’s brain ages healthily.

To do this we need to take a more holistic view of dementias and look ‘beyond the brain’. By taking this approach we hope to find processes early in the disease that are easier to target than those in the brain in the later stages.

For example, there is growing evidence that inflammation ― the way the body responds to stimuli such as injury or irritation ― in other parts of the body contributes to disease in the brain. If this is the case then treating or blocking the molecules involved might have some benefit.

These are the kinds of interventions that we hope will come from the new UK Dementias Research Platform that we’ve announced today. The platform is a public-private partnership in which researchers from academia and industry will work together on a holistic approach to dementia. For example, the pharmaceutical company GSK is the first industry partner to commit to funding the platform, which will help drive forward the first stage of development.

Added to the platform is a new study that the MRC is funding along with the National Institute for Health Research. This will carry out frequent detailed studies of the physiology of a group of 24 early stage Alzheimer’s patients, and assess whether it’s feasible for such intensive assessments to be carried out on larger groups of patients.

One of the fantastic things about the UK is that we have many groups of people and patients who are already involved in research. Researchers have ‘followed’ these cohorts for many years, recording information about their health and behaviour, as well as taking biological samples such as blood.

The first stage of the platform involves collecting together information from across a number of cohort studies, so that we can observe who develops a dementia and who doesn’t. The biggest of these cohorts, UK Biobank, has 500,000 members, so vast amounts of data will be involved. The analysis of this amount of data from many different types of measurement is not simple: the MRC will be working with the new Farr Institute to ensure that we are capable of dealing with this data. We then hope that researchers in both academia and industry, in the UK and internationally, will access it for their research into dementias.

In the longer term, we hope that members of these cohorts will be willing to take part in experimental studies that will improve diagnosis, for example. Later still, we hope there’ll be scope to test new treatments and preventative strategies. I firmly believe that it is by widening the way that we look at dementia, the more strategies we’ll have to test.

Hugh Perry

The UK Dementias Research Platform was announced today with £5m in core funding from the MRC. The platform will launch in April 2014. For more details see our news story

*The image used in this article has not been released under our Creative Commons Attribution 3.0 Unported Licence.

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