A national screening programme to pick up Alzheimer’s disease is on the horizon, experts have said, after insisting that drugs to fight dementia will be ready within 10 years.
Scientists who are working on treatments said medicine would be available in time to meet a pledge made by David Cameron to slow down or cure Alzheimer’s by 2025.
And once drugs were able to treat the disease, a programme to find those at most risk will almost certainly follow, experts told a briefing in London.
When asked if widespread national screening was likely, Dr Nick Fox, Professor of Neurology at University College London, (UCL) said: “Definitely. If we have something that really makes a difference and really slows onset there will be a very strong case for screening.
“First we have to show benefit, then we will be working out if we can give it earlier.”
Around 850,000 people in Britain are living with dementia, and some half a million have Alzheimer’s disease. But it is the only disease to have no treatment options.
Last week it was announced that a widely anticipated drug for Alzheimer’s disease - solanezumab - had failed in final trials, in a setback which charities said was hugely disappointing for sufferers and their families.
However the panel of experts said it was possible that pharmaceutical company Eli Lilly had simply tested it on the wrong patients. The drug was designed to clear out the sticky amyloid plaques which cluster in the brains of Alzhiemer’s patients and kill brain cells.
But it was given to people with early Alzheimer’s disease, and scientists now think that may have been too late, because irreversible damage to the brain had already occurred.
John Hardy, Professor of Neuroscience, UCL, who was the first to propose that the build-up of amyloid caused Alzheimer’s, said: “I was disappointed when solanezumab didn’t work. I would have said the chance of it working was better than evens.
“My concern is that is was given too late. We now know amyloid deposition starts a long time before the disease symptoms, and you could ask whether (the drug) was appropriate for a later stage.
“You wouldn’t take statins for a stroke and the same analogy may hold true for Alzheimer’s. It one is going to attack amyloid then we need to attack earlier.”
Asked it a treatment was still likely by 2025 he added: “I would say yes. This is one of the few David Cameron promises that is likely to be still on the road.”
In Iceland some people are born with a genetic mutation which prevents them making amyloid, and they never develop Alzheimer’s disease, so scientists believe starting treatment, before any damage is done, could be the key.
Prof Fox added: “I think it is perfectly reasonable to say we may well have a better chance earlier, and a drug may work earlier. There is no disease where it’s better to wait and treat later.
“We now have a way of tracking Alzheimer’s progression and it seems to start 10 to 20 years before symptoms. So giving drugs at a mild to moderate stage is a bit like giving treatments for cancer when they are already in the hospice.”
However pharmaceutical companies are often reluctant to embark on lengthy preventative trials because they can take decades to show a benefit.
The panel said that one way of speeding up trials would be to test preventative treatments on people at the high risk of developing Alzheimer’s disease, such as those with Down’s Syndrome or a genetic predisposition.
If the drugs proved effective it would be difficult to argue why they should not be prescribed to large numbers of the population, perhaps from middle age, said the scientists.
“I think the pressure will be unstoppable,” added Prof Hardy.