Why is it so hard to treat dementia?

It is with a really heavy heart when I say devastatingly, there is currently no cure or medical treatment for dementia and I often get asked why?

My heart could not go out further for someone who receives a diagnosis of a condition, and then is told that very little can be done to cure it or halt the progression.

Dementia receives A LOT of publicity these days – from press features, government campaigns, research, documentaries etc. I do think this is amazingly positive and the fact that Alzheimer’s Society and Alzheimer’s Research UK have joined together for the #DementiaRevolution and become the 2019 London Marathon charity partner of the year is FANTASTIC. I couldn’t honestly be more pleased 🙂

So back to the question, why is it so hard to treat dementia?

Despite the vast number of people affected by dementia globally and an estimated 850,000 people currently living with dementia in the UK, there are only treatments that can help to manage symptoms and the latest drug to be approved was in 2003!

Here are a few reasons why:

  1. Dementia is caused by various diseases of the brain

Part of the difficulty in finding treatments for dementia comes from the fact it’s not a single disease, but a complex health condition with more varying underlying causes.

However, most drug treatments in development have and are targeting Alzheimer’s Disease because it accounts for around 60-70% of people living with dementia.

  1. We still do not know enough about the causes of dementia

For example, we don’t know what exactly regulates the toxic build-up of plaques and tangles in the brain which inevitably kill brain cells. (which is found in people with Alzheimer’s Disease). We also don’t know why the disease progresses at different rates in different people.

Why don’t we know? I hear you ask …. well part of the reason is the symptoms of dementia can progress gradually and slowly and affect people very differently. For example, it could be that Alzheimer’s disease is made up of a number of different but related conditions, making it even more difficult to find a treatment that works for ‘most’ people with the condition.

  1. Blood-brain barrier

The blood-brain barrier (sounds gory hey!) provides a defence (imagine superhero shield) against disease-causing viruses and toxins that may be present in the blood. Because mother nature designed our body structures so cleverly, the barrier actually exists to keep out nasty substances from the brain. However, the clear downside to this is that it also keeps the vast majority of potential drug treatments from reaching the brain.

  1. The brain is so complex

The brain is beyond fascinating and is by far the most complex organ in the body. Because of this, it’s still pretty difficult to see what is fully going on in there. This makes it even more challenging for researchers to understand and thus how to treat it.

  1. Timing

In recent years, it has been noticed that by the time significant changes are noticed within a person living with dementia, the brain has often been dramatically impaired, being too advanced to be positively impacted with drugs (i.e. brain cells cannot be recovered once they have died). The changes in the brain can sometimes begin 10 – 15 years before symptoms appear to the person and loved ones.

So, what’s next?

It’s abundantly clear that dementia drug development is no easy task. However, the future is bright … a new dementia research centre has been implemented through government funds and the two leading dementia charities which is great. The new treatment development is now focused on slowing and/ or reversing the disease process itself, by targeting the underlying biology, which again I think is good news 🙂

Hope that helps

x Rebecca x

 

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