ANALYSIS

WE have a large dementia population. These are people with frank symptoms, struggling day-in day-out.

The UK DRI is not a care support organisation – we are all about research. What is missing in our efforts to treat and prevent dementia is basic understanding.

There is a knowledge gap. We don’t know enough about the root causes and that really is what the institute is about.

In the UK we now have almost one million people who are typically going to be dealing with dementia for about a decade. That’s why we are really worried. We are standing on the beach, looking at this wave. It’s getting bigger and bigger and it hasn’t really hit us yet – but it is going to and it’s like that around the world.

If you think of cancer 30 years ago it was the thing we didn’t want to say – the C-word terrified us – but now it’s more approachable and it’s almost as if it’s become much more acceptable to talk about it.

But we are only just getting there with dementia. We’re just coming out of that phase where it’s terrifying, because there’s very little we can do about it.

There’s a good analogy here with cardiovascular disease. If someone comes in with a heart attack, you really struggle to fix that damaged heart.

But we now monitor cholesterol and blood pressure years before we expect that it may result in a heart attack – and when we identify someone with the wrong balance of cholesterol, or very high blood pressure, we treat it.

The idea is you are preventing the heart attack, not waiting for it to happen then fixing it.

For dementia, we estimate the first triggering events, that very gradual cascade of events, is probably 20 to 30 years before symptoms and we want to get to the point where we can use some new technology to identify those very early triggering points and then tackle them at source. And that goes to the very heart of the institute. We want to understand what those events are, how you detect them and how you might interfere with them in the same way as preventing a heart attack.

The gold standard for all diseases is to prevent them. HIV 25 years ago was a death sentence. It was frightening and there was nothing you could do about it.

But now it can be managed. So could we get to the point where we identify people who were at risk or in very early stages of dementia and then manage it? Yes, maybe.

Even with this institute and our ambitions to make a real dent in dementia, we are not investing nearly enough. It’s not crazy to think the UK over the next 10 years should invest £1billion in this, because we know the tidal wave is building.

‘The gold standard for all diseases is to prevent them’