Insight into the fight against Alzheimer’s

Prof Alison Murray

It is an occupational hazard that when I meet new people, while I am genuinely interested in what they are saying, a small part of my thoughts stray into wondering what their brain looks like. Thankfully, it’s not as gruesome as it sounds. As director of Aberdeen University’s Biomedical Imaging Centre, my job is to scan brains using techniques such as MRI to better understand how the brain works and, crucially, what factors contribute to the onset of conditions such as Alzheimer’s disease.

Last summer I attended the European Prevention of Alzheimer’s Disease (Epad) Consortium in Aberdeen along with hundreds of other similarly brain-obsessed individuals, as all Scottish scientists involved in the major £58 million Europe-wide research project to tackle the disease come together.

But what do we mean by “tackle”?

My guess is that most people assume scientists like me are trying to cure Alzheimer’s – to create wonder pills which reverse or halt the effects of this cruel disease.

That is certainly where the focus used to be. About 10 years ago a number of drugs designed to reduce a protein in the brain called amyloid were held up as our best hope.

However, while they showed great promise in laboratory tests, they ultimately failed when tested on human patients.

Tests with other compounds continue and may well prove to be effective for some specific sub-groups of patients, but the harsh truth is it does not seem likely that there is a miracle cure on the horizon.

Does that mean scientists have thrown in the towel? Not a bit of it.

In recent years there has been a shift in emphasis from treatment of the disease to prevention. We know things such as being diabetic, having high blood pressure, an unhealthy diet and lack of exercise can make some people more likely to develop Alzheimer’s.

There is more awareness that this is a degenerative condition of the brain that we need to try to prevent by getting people to lead healthier lives.

But if it is that simple, why do we need a multi-million-pound research project?

Of course, the problem, though, is that it’s not that simple. Broadly speaking, a healthier lifestyle could toughen your body’s resilience to the disease, but our understanding is superficial.

We don’t yet understand what combination of factors have “good” or “bad” outcomes when it comes to Alzheimer’s. We need to understand what combination of elements make people most vulnerable, versus what things make people more resilient.

At Aberdeen University’s Biomedical Imaging Centre we are specifically interested in what helps contribute or detract from this cognitive reserve and resilience.

We have access to patients that have been scanned earlier in their lives and can compare their readings from then with new scans to look for common biomarkers. When these are shared with the other scientists in the Epad project, we will hopefully have a much better idea about which lifestyle factors affect your chances of developing Alzheimer’s.

Our team are undertaking a project in India, where we will compare brain scans of locals there with people from Aberdeen we’ve studied over the years. We hope to see if the differences in education, multilingualism, nutrition, lifestyle and other health factors in the different countries play a role in how the brain ages.

Epad has designed a platform that enables pharmaceutical and biotechnology organisations, academic researchers, and funders to have an efficient, adaptive proof-ofconcept trial designed to deliver early, accurate results in the most efficient way.

The project aims to recruit 24,000 people across Europe. To be eligible, participants must have been studied earlier in their lives, so we have data we can compare over time.

In this regard, Aberdeen is well placed, as we have a number of cohorts we can call upon. We also have a track record in excellence in medical imaging and great strength in our NHS, university and industry partners, with the ability to carry out PET scans to gather even more detailed information.

The fight against Alzheimer’s may have changed focus, but it is being attacked with no less force. People in the north-east of Scotland can be proud that Aberdeen University is playing a key role and, with the help of our volunteers, together we are getting closer to understanding how to prevent this disease.

A healthier lifestyle could toughen your body’s resilience