Update on dementia treatments and research

After decades of research, the developments of the first treatments that can delay the onset of Alzheimer’s disease have been met with excitement and an outpouring of hope.

The immunotherapy drugs lecanemab and donanemab, which have both been approved for use in the USA (although not in Australia), can slow the progression of symptoms of Alzheimer’s disease for people in the early stages of the condition.

They also come with possible side effects that need to be carefully monitored by health professionals.

Complexity of dementia research

These and other immunotherapy drugs are just one avenue of potential treatment options for dementia that research teams in Australia and around the world are investigating.

Dr Janet van Eersel, who leads one such team at Macquarie University’s Dementia Research Centre, said dementia was such a complex and varied condition that we’re unlikely to find a “silver bullet” treatment that would be effective for everyone.

“What we likely need is a range of treatment options like we have for cancer and other conditions,” Dr van Eersel said.

“One promising potential treatment we are working on is gene therapy,” she said.

“We are aiming to deliver genetic material into brain cells using specially modified safe viruses to cross the blood-brain barrier.

“This genetic material can hopefully make the brain cell more resilient to the development of dementia.”

Dr van Eersel, who received research funding from the Dementia Australia Research Foundation, said in addition to her project there were hundreds of gene therapy clinical trials being run globally.

“It’s a very exciting field that has exploded in the past few years and I think this is a very promising avenue for treating hard-to-tackle diseases such as dementia.”

Developing drug treatments for dementia

As well as gene therapy, Dr van Eersel’s team is working to develop drug treatments for dementia.

“There are many questions to answer when you’re looking at drug treatments,” Dr van Eersel said.

“Firstly, what do you want to target? And what combination and doses are most effective? Testing must start with cell models, then in mouse models before you get anywhere near any human testing. It’s a slow process,” she said.

“One advancement in recent years that is speeding this up however is the use of artificial intelligence computer modelling.

“What this enables us to do is to narrow down the most promising drugs for further testing. Like any modelling, it can be very useful but it always needs to be validated in the real world.”

Brain boosting bread?

Another potential treatment that Dr van Eersal’s team is working on is trying to prevent the proteins that are associated with Alzheimer’s disease from binding with each other and becoming toxic.

“When these proteins bind with each other in the brain, it sets off a cascade of horrific events that cause the neurons to become overexcited and die,” Dr van Eersal said.

“We are hoping to use peptides, which are themselves a type of mini protein, to prevent these proteins from binding in the brain and becoming toxic.

“What is potentially really cool about this is that we may be able to modify yeast to express these peptides, meaning we may one day be able to bake bread that can help protect you from dementia.”

Vital improvements in early detection of dementia

St. Vincent's Institute of Medical Research Professor Michael Parker said that while progress towards a treatment for dementia had been frustratingly slow in recent decades, vital improvements in early detection had been made over the period.

“Not only do we urgently need treatments for dementia, we also need to be able to detect the condition as early as possible so we can deliver those treatments to the people who need them and before the disease progresses too far,” Professor Parker said.

“There have been major leaps made in identifying biomarkers that can detect dementia in the early stages of the disease.

“This is very important because the new treatments that are currently being developed seem to be most effective when administered to people in the early stages of dementia.”

Want to know more?

To learn more about dementia research visit the Dementia Australia Research Foundation website.

For support, advice and expert information, contact the National Dementia Helpline on 1800 100 500.

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