Cardiff University hosts five leading researchers in dementia and alzheimers to showcase their current findings
By Holly Giles
Last week the Royal Society of Biology returned to Cardiff University’s School of Biosciences for a panel event of five of Wales’ top researchers in dementia and alzheimers. The event highlighted current understanding of the condition but also how far we have to go to understand it fully and completely support patients. There are currently 850,000 people in the UK living with dementia meaning 1 in 75 of us are living with the condition but it currently consumes 20% of the NHS’ budget annually. This highlights the need for drastic research and remedies to cut back the millions spent by the NHS each year.
The first talk was from infection and immunology specialist Dr Matthew Clement. He provided background to the condition and explained that alzheimers occurs when the brain is inflamed. Unlike inflammation after a cut on your hand, the brain is unable to swell as the cranial space traps the brain and means it cannot grow in size. This increases the pressure in the brain and leads to an increased permeability in the Blood Brain Barrier (BBB). This BBB is normally tightly controlled meaning substances in the blood cannot travel to the brain but in cases of neuroinflammation pathogens can freely travel across the BBB and into the brain to alter brain activity. It is Clement’s belief that infections can influence the protein levels in the brain and alter cognitive decline. He showed this through behavioural studies with mice which when given a specific infection they were unable to recognise new objects as have cognitive impairments; it is not the infection that directly causes the disease but it speeds up the cognitive decline. This changes our perspective on treating Alzheimers as means we need to emphasise treating infections and using over the counter drugs to minimise the spread of infections; these pharmacy drugs could drastically decrease the strains on the NHS for specific dementia medication.
We then heard from Dr Tim Hughes who specialises in the microbiome of the gut and its link to alzheimer’s disease. Recently the scientific community have noticed a link between a healthy gut and a healthy brain. They tested this through using a probiotic on mice given a fatty diet and saw that probiotics improve inflammation and return cognition to normal levels. He was quick to emphasise this is “not a magic bullet” but that “the take home message is that diet is incredibly important but that probiotics help maintain a healthy gut”.
These investigations have all used mice as mammalian animal models but Dr Owen Peters, from Cardiff University, encouraged the use of Drosophila Fruit Fly as model organisms instead. They are cheaper to use and easier to manipulate and have 80% of human genes associated with disease are conserved in the drosophila genome. This provides a new opportunity for research into the genetic links behind the condition. They have been able to show a group of genes that contribute to the development of alzheimers through the accumulation of the protein amyloid beta in the brain. With new technology they can turn on these disease genes and see the change in neuronal function; here an instantaneous neuronal process changes to take ten seconds, reflecting the decline in cognitive function. Although flies cannot tell us everything and cannot reflect cognitive behaviour they can be used to identify risk genes for dementia and as a guide for more expensive mammalian experiments.
An example of these experiments can be seen in the lab of Professor Andrea Tales from Swansea University who specialises in ophthalmology. She was keen to emphasis that “memory is not the only brain function that is abnormal in dementia” and that other side effects, including vision, concentration and attention, should not be overlooked (no pun intended). She explained that a key challenge in dementia research is the difficulty in defining attention but it is widely recognised that visual attention is important in brain function; “if you don’t attend to it then you don’t remember it” explained Tales. Healthy people are able to selectively process and filter out unnecessary information but for patients with dementia they cannot inhibit irrelevant information to focus their attention. This shows why patients with dementia interact with their environment in the way that they do and shows the importance of understanding the wider effects of dementia in providing the best possible care to patients.
Patient care was also emphasised by the final speaker Mrs Lesley Butcher from Cardiff University’s School of Healthcare Sciences. Butcher is passionate about changing the current problems in patient care and “shifting culture form a task-centred attitude to a person-centred attitude”. This will be tackled in her new research campaign which was launched last week (Friday 15th) where care homes across Wales will undergo a training program to tackle the human rights of people with dementia and how they can be better met. The main principle of the campaign, titled A Person Like Me, is that people with dementia are still people and that we need to aim to find our similarities and not our differences in order to empathise with patients and improve our interactions with them. Butcher explained “there are problems in care” but that many centres volunteered to be in the project showing they are keen to improve and help their patients. The campaign starts in South Wales but aims to be across Wales by 2020 and subsequently to be a national campaign by 2021. Through this she aims to transform patient care and ensure their human rights are not only met but exceeded.
The event highlighted the steps that are being made by the scientific community in understanding and alleviating dementia from our society but also showed how far we still have to go. As Dr Owen Peters explained, “that with more old people so there will be more alzheimers”. With an ageing population predicted to be composed of 20% of Uk residents being over 65 by 2030 it shows that without research the costs of dementia treatment will only increase, a fact that our NHS simply cannot handle. These key progresses though show that we are starting to understand this condition and through it can offer hope for patients through improving patient care, medication and understanding.