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04 February 2011
A poll from Alzheimer’s Research UK this week has revealed that dementia has overtaken cancer, and even death, as the nation’s biggest fear. While this is an interesting finding in itself, the poll has helped draw attention to the charity’s core concern: the startlingly low levels of funding for dementia research.
How can a condition that strikes such fear into the public, affects nearly a million of us, and carries a £23 billion cost to our economy every year, remain the Cinderella disease in terms of research funding?
Our attitudes to dementia are changing, and while the level of public fear is startling, the flipside is that awareness of the condition must also be improving. While acknowledging the existence of dementia does not inspire action in itself, it might nevertheless mark the dying moments of a stigma that has too long surrounded dementia.
The only answer to dementia, or any serious disease, lies in research, which makes public decisions on the apportionment of research funding so crucial. Unhelpfully, the motivations of the purse-holders remain sometimes ambiguous, so we can’t be sure why, in the face of mounting evidence of dementia’s impact, investment remains so low.
It could be that a legacy of misunderstanding around dementia - too many write it off as inevitable "battiness" - is undermining its ability to attract research funding. The same could not be said for cancer, heart disease or stroke, all of which enjoy publicly funded advertising campaigns, and all of which are well recognised as life-ending conditions.
Whatever the motivations, the funding decisions are still not recognising the reality of how serious diseases impact on society.
Last year’s Dementia 2010 report examined the impact of cancer, heart disease and dementia in terms of economic impact and research investment. It revealed that dementia costs the UK economy £23 billion each year, whereas cancer costs £12 billion and coronary heart disease £8 billion. Combined charity and government investment amounted to £590 million for cancer, £169 million for heart disease and just £50 million for dementia. A new study by Thomson Reuters for Alzheimer’s Research UK has revealed that dementia research capacity is bottom of the pile in comparison to cancer, heart disease and stroke. For every scientist working on dementia, at least six are working against cancer.
There is no suggestion that funding should be displaced from one disease protection effort to another, but it would be remiss not to make the case a more proportionate response. Dementia research has also long been a victim of short-termism. Why invest in finding causes and treatments, when we won’t see the benefits of this research for ten years? Or perhaps more accurately, why would one Government invest in solving it, when they can leave it to the next?
Yet the evidence shows that sustained investment in serious disease research brings results, with breakthroughs in cancer being the best example. Successful research also inspires more action, in a snowball effect that can make such a positive impact on public health. The bottleneck in dementia research at the moment is in understanding the causes, so investment in these areas will help move us on towards treatments. If this can happen now, there is a belief in the dementia research sector that Alzheimer’s will be a tractable disease by 2025.
One of the main problems is that diagnosis of dementia is elusive, with an estimated two thirds of people never receiving an accurate diagnosis. It means that the course of the illness is played out over many more years than the official line suggests. This long, drawn-out trauma doesn’t share the shock and immediacy of other serious diseases, and fails to attract attention and investment as a result. Sir Terry made the point well that we need to react to dementia in the same way as we did to HIV and AIDS in the Eighties. He appealed for "aggressive action" against dementia; this is the kind of language we need to use more.
The further tragedy of this situation is that the UK boasts some of the world’s leading dementia scientists. We have an enviable track record of successful dementia research in the UK. Our scientists produce crucial findings at a fraction of the cost of the US, Germany and France. We have the talent to continue driving towards new treatments, but we must create an environment that fosters young neuroscience researchers and encourages the growth of the dementia research sector. We need talent from other areas of research to turn their attention towards defeating dementia.
Dementia research is now making significant breakthroughs, which could be more quickly realised with greater investment. We have now discovered 10 genes that contribute to the development of common Alzheimer’s, responsible for two thirds of dementia cases, some 500,000 people. Nine of the 10 have been discovered in the last three years.
What these genetic discoveries offer are genuine new targets for the development of novel treatments that must be exploited. For example, several genes point to an abnormality in our immune response, contributing to disease development. Examining this abnormality is a new idea and one that hints at real progress.
There has rarely been such a gulf between potential and the means to deliver as there is in UK dementia research today. We have made strides forward in the face of underinvestment, but the reality is that we continue to let down the 820,000 people in the UK today with dementia. With concern at an all time high, an economic burden that dwarves other diseases, and numbers with dementia spiralling towards a million, there really isn’t an argument against action now.
Investment today will avert a crippling social and economic burden tomorrow.
This article first appeared in The Daily Telegraph on Wednesday 9th February 2011: www.telegraph.co.uk/health/8314354/Funding-for-dementia-research-is-dangerously-low.html
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