Modelling progression of dementia to improve treatment

September is World Alzheimer’s Month. Alzheimer’s disease is the most common cause of dementia and is one of the largest health concerns in the UK. It is a progressive mental deterioration that can occur in middle or old age, due to generalized degeneration of the brain.

Approximately 46 million people living with dementia worldwide forget daily appointments, basic activities in their daily lives, friends and family. Alzheimer’s disease cannot be cured, but the symptoms of dementia can be delayed with currently available treatments.

With the launch in August 2016 of the MRC/NIHR-funded Deep and Frequent Phenotyping study (D&FP) in Alzheimer’s disease, scientists at the MRC Biostatistics Unit are now involved in three interlinked major collaborations in dementia research. The other two collaborations are the Dementias Platform UK (DPUK) and the European Prevention of Alzheimer’s Disease Consortium (EPAD).

The D&FP study is a UK multi-centre, non-interventional repeated measures observational study which involves the most thorough and rigorous series of tests to detect Alzheimer’s disease ever performed on approximately 250 volunteers whose time and effort will make a huge difference in the future diagnosing and treating of the disease. It is designed to generate a biomarker set (combining both novel and more established markers) for proof of concept in prodromal Alzheimer’s disease, with the hope of dramatically improving the success rate of clinical trials for Alzheimer’s disease. It leverages the existing infrastructure and resources of DPUK and is nested within EPAD’s combined registry, cohort and adaptive trial programme.

At present there is a high rate of failure for treatments being tested for Alzheimer’s disease. This is probably because these treatments were tested on those who already have irreparable damage to the brain. By identifying persons in the very early stages of disease through use of biomarkers present then, it is likely that treatments will be more effective in slowing or arresting further progression of the disease to dementia.

The MRC Biostatistics Unit’s involvement in all three projects is focused on the modelling of the progression of the disease through use of the biomarkers and cognitive function outcomes. It is hoped that through our work a better understanding of the natural history of the disease will result and that identification of novel biomarkers will be realised. This will be used to inform clinical trial design and recruitment, as well as for treatment management and monitoring of patients with dementia. Our involvement is led by our director, Professor Sylvia Richardson (in DPUK), and Programme Leaders Professor Fiona Matthews (DPUK), Dr Adrian Mander (in DPUK and EPAD) and Dr Brian Tom (in DPUK, EPAD and D&FP).

 

Image credit from Flickr