Finding drugs to manage bladder and bowel control in people with Alzheimer's disease

Research project: Treating gastrointestinal dysmotility symptoms in Alzheimer's disease

Lead investigator: Dr Jerome Swinny
Institution: University of Portsmouth
Grant type: PhD studentship
Duration: 36 months
Amount: £84,863

Why did we fund this project?

Comments from members of our Research Network:

"An important project because the effects of gastrointestinal symptoms in people with dementia causes tremendous emotional upset to both the person with dementia and their families/carers. If the issue of continence can be solved it would improve quality of life for everyone involved."

"An excellent proposal. The expected outcome addresses an important day to day issue people with Alzheimer's disease and their carers attempt to manage."

"This is promising research with the potential for finding drug treatments to prevent loss of bowel control in people with Alzheimer’s disease."

What do we already know?

As well as the well documented symptoms of impaired memory and thinking skills, people with Alzheimer’s disease may also have a range of other symptoms. One of these is loss of bowel and bladder control, resulting in incontinence or constipation. The unpredictable nature of these symptoms can increase the stress associated with Alzheimer’s disease, felt both by the person who has Alzheimer’s and their family or carers. This can limit the ability of people with Alzheimer’s to maintain regular day to day activities both in the home and in public, impacting on their quality of life.

In order to understand why these conditions are more common in people with Alzheimer’s disease we need a better understanding of the basic way the body controls the movement of waste through the intestine. Within your intestine, there are muscles, which squeeze and relax, in order to ensure that the contents are moved through in a way which allows time for the absorption of nutrients, and the removal of waste products. Controlling these muscles is a network of nerves which is often called the brain of the gut. It is capable of functioning without information from the brain, and regulates all aspects of gut function.
The researchers have previously found that mice that have been genetically changed to develop Alzheimer‚Äôs disease also show changes in this ‚Äėgut brain‚Äô making it weaker than normal. They also found changes in some of the chemical messengers (neurotransmitters) that are important for sending and receiving signals through the system. 

What does this project involve?

The researchers in this study want to build on their previous findings, to determine how the signals transmitted in the gut are changed in Alzheimer‚Äôs disease. They aim to identify drugs that can reverse these altered signals, and hopefully result in better bowel and bladder control for people living with Alzheimer‚Äôs disease. 

Using the mice that develop symptoms of Alzheimer‚Äôs, they will first determine how the disease alters the amounts of the different types of neurotransmitters in the system. They will then use this information to choose specific drugs try to turn these signals on or off. After some initial testing in the lab, the best drugs will be given to the Alzheimer‚Äôs disease mice, and the strength of their intestine will be measured. The researchers will be looking for a drug or combination of drugs that strengthen the response of the muscles in the intestines of the Alzheimer‚Äôs disease mice. 

How will this benefit people with dementia?

The loss of bladder and bowel function in people with Alzheimer‚Äôs disease is very common. These symptoms can be quite debilitating and isolating, resulting in reduced confidence of the person with Alzheimer‚Äôs disease and their support system to continue with their day to day activities. 

Currently, the only medical intervention that is available is general symptomatic relief, simply because we know so little about what causes these issues.  We need to know precisely how Alzheimer‚Äôs disease alters the function of the intestine before we can develop new treatments.

This project aims to find out the specific cause of the reduced ability to control the movement of waste through the intestine in people with Alzheimer‚Äôs disease. This will hopefully allow the researchers to identify medical interventions that can reduce these problems and return normal intestinal control to people who have those symptoms. 

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