The suffering and costs of dementia would be reduced by preventative measures if the Group of Eight nations adopt a model that has worked in fighting heart disease, a group of doctors and scientists said.
“About half of Alzheimer’s disease cases worldwide might be attributable to known risk factors,” they said in a statement before a G-8 meeting in London tomorrow to coordinate responses to the condition. “Taking immediate action on the known risk factors could perhaps prevent up to one-fifth of predicted new cases by 2025.”
The costs of dementia were estimated at $604 billion for 2010, the group said, and the number of cases is set to more than triple by 2050. The 111 signatories from 36 countries called on governments to back more research into prevention, and policies such as promotion of healthier diets. The G-8 are the U.K., U.S., Germany, France, Canada, Italy, Russia and Japan.
“The choice is stark,” said Zaven Khachaturian, a signatory and editor-in-chief of U.S. journal Alzheimer’s & Dementia. “Either you invest money in creating this infrastructure for preventing or delaying dementia, or continue along the way. If we continue with the current trends, no country’s health-care system will be able to provide care.”
Alzheimer’s Disease International estimates that 44 million people worldwide have dementia, which will rise to 76 million in 2030 and 135 million by 2050, according to data from the group of Alzheimer’s associations.
About $40 billion has been invested in drug development efforts that haven’t produced effective new medicines, the researchers said in today’s statement. Even so, recent research suggests there may be cheap options to help tackle the problem.
A cocktail of vitamins B6 and B12 and folic acid would cost pennies a day and slowed atrophy of gray matter in brain areas affected by Alzheimer’s disease, according to a study published in May by the Proceedings of the National Academy of Sciences.
About half the fall in deaths from conditions such as heart disease and stroke in the past 50 years resulted from modifying risk factors, according to the scientists advocating prevention. Taking a similar approach to dementia by encouraging middle-aged people to adopt healthy lifestyles may ward off the condition as it does other diseases and save “huge sums,” they said.
A healthy lifestyle includes exercising; not smoking; following a diet rich in fruit, vegetables and fish; avoiding obesity, diabetes and excessive alcohol; and treating high blood pressure, the researchers said.
Other research is helping to identify people at risk. A person’s chance of getting dementia before age 65 may develop as early as adolescence, according to a study that suggests teens with high blood pressure or who drink excessively are at risk.
Other risk factors include stroke, use of antipsychotics, father’s dementia, drug intoxication, as well as short stature and low cognitive function, according to the study of Swedish men published by the journal JAMA Internal Medicine in August.
G-8 governments should set goals, stimulate more collaborative research, coordinate policies and establish consistent rules for data sharing, intellectual property and ethics, Khachaturian said in a telephone interview.
The U.S. Food and Drug Administration hasn’t cleared new drugs for memory loss conditions in a decade. Approved medicines such as Eisai Co.’s Aricept ease symptoms without slowing or curing dementia.
A joint U.S.-European Union task force in 2011 found that all disease-modifying treatments for Alzheimer’s in the previous decade failed late-stage trials “despite enormous financial and scientific efforts.” Since then, at least four more experimental treatments have failed.
Eric Karran, director of research at the charity Alzheimer’s Research UK, who wasn’t among the signatories to the statement, said that failed trials can provide useful lessons. One of the four medicines, Eli Lilly & Co.’s solanezumab, is undergoing further tests to determine if it helps people with mild Alzheimer’s disease, Karran said.
“If we could just get efficacy in one approach, we will unlock so much else, we will get so much more understanding,” Karran said at a press conference on Dec. 4. “If solanezumab is shown to work in mild Alzheimer’s disease, the pathway will be to take that earlier and earlier.”