What is involved in dementia research?

Alzheimer’s Research UK funds biomedical research into the causes, diagnosis, prevention, and treatment of dementia. But what does this mean?

When dementia research hits the headlines, it tends to be about results from late-stage clinical trials where a new treatment or diagnostic tool is close to a breakthrough. While this type of research is particularly exciting, many other stages of research have taken place behind the scenes to get that study to the last crucial phase.

Research usually starts with a hypothesis –an untested theory – that can be proven or disproven by a series of experiments. For example, scientists may want to know whether having a particular gene increases our chance of developing Alzheimer’s disease. Finding out whether this hypothesis is true helps us understand more about the diseases that cause dementia, opening the door for research into potential new treatments.

Here we have a look at different types of research used to investigate new treatments, diagnostic tools, and how to prevent dementia.

What is biomedical research?

Basic biomedical research studies give us a detailed understanding of how diseases like Alzheimer’s develop and cause dementia. This research provides the building blocks for new treatments and ways of diagnosing dementia.

In these important laboratory-based studies brain cells, blood, genetics, or bacteria are investigated (referred to as in vitro). Using pioneering techniques scientists can replicate what happens in a brain affected by dementia, in a specific group of cells or an animal model. By doing this, they are able to closely analyse what goes wrong at a cellular level to cause a disease.

Stem cells are particularly useful in dementia research as we can grow many different types of cells from them, including neurons. When neurons die in the brain it causes the symptoms of dementia, and so by studying these specific cells we can identify what causes their death.

For example, Alzheimer’s Research UK is funding researchers at King’s College London who are using cutting-edge stem cell techniques to look at how a protein called TDP-43 is involved in frontotemporal dementia. Frontotemporal dementia is a less common type of dementia where changes in behaviour, ability to speak and communicate are common because TDP-43 builds up in toxic clumps in areas of the brain known as the frontal and temporal lobes.

In this study, the researchers grow neurons in the lab and look at the changes that occur when they interfere with the regulation of TDP-43. This will help in the search to find treatments that could reverse or prevent some of these changes.

 

 

What are clinical trials?

Clinical research often involves giving an ‘intervention’ to one group of people and comparing them with another group who do not receive the intervention to determine whether it’s effective or not. An intervention could be a new method of diagnosis, a medicine, or something like an exercise or diet programme.

These research trials are often time and cost intensive and take many years to complete. As a result, clinical research, particularly into new treatments, is often run by large pharmaceutical companies who have the resources to fund the trials. There are three key phases to clinical trials for new medicines.

New treatments tested in dementia research are often given alongside a dummy drug, known as a placebo. This is because even the act of taking part in a clinical trial can have some clinical benefit to the participant, due to things like extra medical care or the belief that they are getting better. Using a dummy drug allows researchers to compare the actual clinical benefit: the drug’s ability to tackle the disease or alleviate symptoms.

New treatments to manage dementia symptoms are also crucial for people living with dementia. Alzheimer’s Research UK is funding a clinical trial investigating a cannabis-based medicine for the treatment of agitation and anxiety in people with dementia in care homes.

 

Epidemiological research

This type of research measures health and lifestyle factors and the rate of disease in a population, to identify patterns overtime. This helps scientists to identify those who may have a higher risk of developing a particular condition, and what factors may contribute to that increased risk. In dementia, this may involve looking at factors such as exercise, diet, blood pressure and other lifestyle factors over time to determine how they interact with our age, gender, and genetics to increase or decrease our risk.

Having a greater understanding of risk factors for disease allows scientists to create screening to identify those at risk, and interventions designed to help people reduce their risk. It also helps policy makers and healthcare professionals to develop public health campaigns and targeted messaging to inform people how to lower their own risk by changing factors within their control.

Based on extensive research of this type, Alzheimer’s Research UK launched the Think Brain Health campaign in 2021. This campaign aims to inform people in midlife about three ways they can reduce their own risk of developing dementia:

1. Love your heart: what’s good for your heart if good for your brain. Keeping active and eating a balanced diet are all shown to lower your risk of developing dementia.
2. Stay sharp: keeping mentally active and regularly challenging your brain can also help to keep your brain healthy!
3. Keep connected: staying socially active and maintaining your connections with others particularly in later life, is very important.

 

Secondary research

Many research projects often set out to investigate the same thing, and so there are overlaps in the study design and data collected. While this may seem like a doubling of time and effort, comparing such data helps researchers draw conclusions. By comparing study outcomes, we can see if results can be replicated and therefore trusted. Secondary research does just this, it compares both data of many similar studies and reports the results as a summary of all the research in that area. There are a couple of key types of secondary research:

• Reviews and systematic reviews: these reviews provide an in-depth analysis of the data available to answer a broad topic area or question. These involve extensive literature searches and reviews of the strengths, short-comings, and reliability of specific studies.
• Meta-analysis: this looks at numerical data from a number of studies to look for overall patterns and trends in the data.

Sometimes a systematic review and meta-analysis can be combined. An important example of this in dementia research is the report produced by the Lancet Commission in 2020. This report provided an in-depth analysis into 12 modifiable risk factors for dementia that had been identified by previous research, and summarised that these risk factors could be responsible for up to 40% of all dementia cases worldwide. This type of analysis is incredibly important as it provides a readily accessible and reliable summary of findings from the field and can be used to inform future healthcare policy and initiatives like our Think Brain Health campaign.

If you would like to find out more about dementia research or sign up as a research volunteer, contact our Dementia Research Infoline on 0300 111 5 111 (Mon-Fri 9am-5pm) or email infoline@azheimersresearchuk.org with any questions you may have.