Living with dementia magazine August 2010

The Society's Head of Research Dr Susanne Sorensen gives her perspective on her fifth ICAD trip, and introduces the Society-funded researchers who presented their results at the conference.

This was my fifth international conference on Alzheimer's disease and related dementias. I have come back with a clear sense that the reality of communities having to support families and look after many more people with dementia in the coming years is hitting home.

The focus of the conference has broadened considerably since the early years, when it was mostly about the basic science of molecular and cellular changes in the brain that lead to dementia. Topics would typically include psychosocial interventions, prevention, and how to provide relevant services.

However, the big discussion this year centred on why clinical trials of promising drugs have not been able to prove they are effective in people with dementia. It is now clear that the diseases that lead to dementia start ten to 15 years before symptoms become apparent.

The time to treat people is before the symptoms start, but we still don't really know how to identify the people who will go on to develop dementia at this stage. And these are the people the researchers need to include in clinical trials in order to demonstrate that new drugs work.

Brain activity

Many sessions in the conference were devoted to detailed discussions about the merits of new techniques for measuring what is happening in the brain, and how reliable the measurements may be. Researchers are searching for 'biomarkers' of the disease. These can either be scans that reveal what is taking place in the brain, or chemicals that can be measured in blood or cerebrospinal fluid (liquid that can be tapped from the bone marrow).

Towards the end of the conference the American Alzheimer's Association announced new criteria for diagnosis of Alzheimer's disease that included recommendations for a spinal tap.

Alzheimer's Society researchers

Excitingly, two of Alzheimer's Society's PhD students were invited to present their research at the conference. The Society is very keen to support the development of younger researchers to increase the numbers of scientists working in the field.

Clare Garwood is a PhD student at Kings College London who is working on a potential drug for Alzheimer's disease which is being tested in a mouse model.

Manja Lehman is identifying the differences between Posterial Cortical Atrophy (PCA) and Alzheimer's disease that can be seen on MRI scans, and linking them to symptoms. This may be helpful for diagnosis of this condition in the longer term.

Alzheimer's Society research fellow Jill Fowler presented more data from her project on head injury as an early event that may lead to Alzheimer's disease.

Madhav Thambisetti is a former Alzheimer's Society fellow who completed his research fellowship some years ago. Now working in the USA, he has built on the work he did at Kings College London whilst funded by the Society, and continues to work with old colleagues as well as building a research base in his new institute.

At the conference, Madhav spoke about his latest results on Clusterin, a protein that is now also linked to Alzheimer's disease through genetic studies. This makes it a very good candidate for further studies. Not only could it help us to understand the processes in the brain that lead to disease, but it can also be detected in blood. It is one of a group of proteins that may eventually form the basis of a blood test for Alzheimer's disease.

Another former Alzheimer's Society research fellow who has gone on to build her own research group in Southampton University, Amrit Mudher, spoke at a special session dedicated to the tau protein. Amrit explained her latest hypothesis on how modified tau proteins interfere with the proper workings of the cells in the brain. Better understanding of the molecular changes that happen early in the disease may lead to new treatments.

It is great to see the younger scientists we funded in the beginning of their careers going on to attract larger research grants and gain influence in dementia research.

Our Director of Research, Clive Ballard, presented more data from the brain training clinical trial, which is still ongoing and will report in full next year. There is still a great deal of controversy about whether mental stimulation improves general cognitive function, so Clive's presentation generated a lot of interest.

Biomedical research moves forward in many small steps. Each research project leads to a little bit more knowledge, and it is important for researchers to meet frequently and have the opportunity to challenge each other. Scientists do not fully accept findings before they have been corroborated by other research. It will be interesting to see how the discussion of new diagnostic criteria and how to find the people we need to take part in clinical trials will develop in the UK.