Living with dementia magazine August 2010

The latest international conference in dementia research was a mixed bag, says the Society's Research Communications Officer Anne Corbett, who brought us the latest news from Honolulu.

Once a year in the height of summer, dementia researchers from around the world come together for the International Conference on Alzheimer's Disease (ICAD). The conference is hosted by the American Alzheimer's Association, and for 2010 they pulled out all the stops, choosing to hold the event in Honolulu, Hawaii.

Between 10 and 15 July, thousands of scientists descended upon the tropical island in the Pacific to share their research. ICAD is an important event in the dementia research calendar, a conference of gigantic proportions with hundreds of oral presentations and thousands of scientific posters ranging from basic science through to clinical trials and research into care.

The search for a treatment continues

The Holy Grail for dementia research is of course a new drug or treatment that could halt dementia in its tracks. This year, research into new treatments was thin on the ground. Hopes that had been pinned on drugs such as Dimebon are now sadly proving to be unfounded. However, there are some interesting developments in the pipeline. Immunotherapies such as vaccines are beginning to emerge as a promising approach. In particular, a therapy called Bapineuzumab, currently in phase III clinical trials, has been shown to remove both of the important Alzheimer's proteins - amyloid and tau - from the brain.

There may also be potential for the return of Desferoxamine, which performed well in initial human trials but was halted a few years ago. New research with animal models of Alzheimer's disease has shown the drug improves memory, reduces amyloid in the brain and boosts important biological pathways in nerve cells. This study involved administering the drug as a nasal spray, which delivers the drug directly to the brain.
A new drug is only as good as the trial in which it is tested. A key theme at ICAD this year was the need for better diagnostic criteria for clinical trials. Many trials are thought to fail because the participants are not suitable for the trial. A new updated set of criteria was unveiled at ICAD and has now been posted online so scientists worldwide can review it before the final version is produced.

A plethora of genes

The search for dementia genes has stepped up a gear in the last few years as a result of advances in genetic screening techniques. Many newly identified genes were described that may be important in Alzheimer's disease. However, all of this research is still in the initial stages. The genes have been found, but we don't yet know what they do. Although this is frustrating, it is an important step, as in another couple of years we can expect to learn more about these genes and how they affect the risk of Alzheimer's disease.

Preventing dementia

Research into lifestyle factors dominated a number of the ICAD sessions this year. The overriding message from all of this research is the importance of a healthy lifestyle. The link between dementia and obesity cannot now be refuted. The spotlight was on exercise in particular as the most positive way to avoid dementia. Clinical trials have shown that exercise improves the symptoms of dementia and can actually reduce the amount of amyloid in the brain.

Elsewhere, studies provided more evidence of dietary factors that may help reduce the risk of dementia. These included vitamin D, walnuts, and further proof of the benefits of tea and coffee.

There were mixed results around the benefits of brain training activities. The results seem to show that brain training is not beneficial for preventing dementia but may be a good way to help people with dementia stay mentally active and manage behavioural symptoms.

Issues in care

An important message that emerged this year in the field of care research was the need to consider the general health of people with dementia. Studies showed a greatly increased risk of seizures and anaemia in people with Alzheimer's disease, highlighting the importance of regular health checkups.

A number of care interventions were presented, including an internet-based activity centre for people in care homes that allows people with dementia to plan physical activities, play games and interact with friends and family through Skype. A second internet intervention was a trial entitled Mastery Over Dementia. This cognitive behaviour therapy has already shown positive benefits for managing symptoms of depression and anxiety, and is now being tested with people with dementia.

In summary

Overall, ICAD this year was something of a mixed bag. Expectations of exciting new findings have not yet been met, and much of the research is at too early a stage for us to anticipate the outcome. However, the real feeling this year was one of looking to the future. New genetic techniques, approaches to treatments and standards for clinical trials mean that the next few years promise to be full of fascinating new research. The work presented this year is paving the way for the next generation of dementia research.