DEMENTIA could be treatable in the same way as breast cancer detected at the earliest stages as  experts hailed “real progress” in treatment and screening.

Professor Craig Ritchie, a world-leading authority in dementia based at the University of Edinburgh, said advances in blood-based biomarkers are opening the door to “reliable and effective screening and early treatment” for neurodegenerative disease.

He said screening for the earliest stages of Alzheimer’s Disease is about five to 10 years away but could be piloted earlier if plans to launch four new dedicated brain health clinics are able to progress.

The first has been launched in Edinburgh but the pandemic is said to have “severely curtailed its implementation”.

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The latest research suggests 40 per cent of the incidence of dementia is due to 12 “modifiable” lifestyle risk factors; high blood pressure, obesity, smoking, physical activity, diabetes, social isolation, hearing loss, depression, low education, traumatic brain injury, excess alcohol consumption and air pollution.

Scientists believe the remainder of disease risk is probably attributable to a complex interplay between abnormal tau- and beta-amyloid proteins.

Mr Ritchie, who is leading more than 30 drug trials, likened the period of mid-life among people likely to develop dementia later as a “silent period” for brain disease.

“But it’s only silent because we are not listening,” he said.

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He said he expected a future where networks of clinics being developed by Brain Health Scotland would play a central role in early detection, individualised risk reduction and ongoing disease management. 

He said: “There is good evidence emerging that the diseases we know in later life as dementia, or late stage neurodegenerative disease, are really evident from mid-life onwards.

“My argument is it is time to really start focusing our attention on detection in these populations as early as possible and this is the best chance of impacting on the course of the disease.

“Early detection of dementia, or neurodegenerative disease, could become like breast cancer where mammograms can detect pre-cancerous or early tumours and at that point the disease can be effectively managed with the best treatments.

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"I think screening for the earliest stages of Alzheimer’s Disease – not necessarily dementia – is about five to 10 years away but could be piloted earlier as and when we get Brain Health Clinics established.”

He said early detection would have the added benefit of creating a growing group of people available for phase IV trials of new disease modifying treatments. 

Mr Ritchie said that while charitable funding for research had been “pulled back significantly” funds have been put in place by the Scottish Dementia Research Consortium to help mitigate losses.

He said the next phase of treatment will be in emerging secondary prevention where individuals detected early through screening to be at high risk of cognitive impairment and dementia can benefit from emerging disease modifying anti-amyloid and anti-tau drugs. 

In 2019 there were six such disease modifying drugs undergoing phase III trials and their results are eagerly awaited.  

One of them Aducanumab – administered by an infusion every four weeks – has been filed for fast-track review with the US Food and Drug Administration with a decision expected by March 2021.  

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According to Mr Ritchie another role for the brain health clinics would be to target an estimated one-third of patients with functional cognitive disorders other than dementia who get wrongly diagnosed with the disease. 

He said they may live for 10 or 15 years believing they have dementia but experience no cognitive decline.

“We are doing these people a massive disservice by giving them a false positive,” he said. 

Henry Simmons, chief executive of Alzheimer Scotland and associate director of Brain Health Scotland, said: “A world where some forms of dementia are preventable has always been a goal for Alzheimer Scotland. 

"We look forward to creating Scotland’s first brain health strategy, and Alzheimer Scotland will play a crucial role in its implementation.”

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The Herald is campaigning for improved care standards for people affected by dementia.