Research bites

We have found a trove of new and interesting articles for you

3 July 2024

A new drug has been approved in the US for treatment of MCI and early Alzheimer’s disease

FDA Approves Eli Lilly’s Donanemab for Early Symptomatic Alzheimer Disease

“Less than a month following a positive recommendation from the FDA’s Peripheral and Central Nervous System Drugs Advisory Committee, the agency has approved Eli Lilly and Company’s donanemab, a 350 mg/20 mL once-monthly injection for IV infusion, for the treatment of adults with early symptomatic Alzheimer disease (AD). Marketed as Kisunla, donanemab is available to patients with mild cognitive impairment (MCI) as well as those with the mild dementia stage of AD, with confirmed amyloid pathology.¹

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Considered the third approved antiamyloid therapy, donanemab is the first and only medication with evidence to support stopping treatment when amyloid plaques are removed, which can result in lower therapy costs and fewer infusions.

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In the low/medium tau population, LSM change from baseline in the iADRS score at 76 weeks was –6.02 (95% CI, ­–7.01 to –5.03) in the donanemab group and ­–9.27 (95% CI, –10.23 to ­–8.31) in the placebo group, resulting in a 35.1% (95% CI, 19.90-50.23) slowing of disease progression. The impacts were less pronounced in the overall population, with between-group score differences of 2.92 (95% CI, 1.51-4.33; P <.001), representing a 22.3% (95% CI, 11.38-33.15) slowing of disease progression.”

IN SHORT:

The Phase 3 trials of donanemab also included Australian patients.  It has been described as a ‘game changer’ because not only does it slow progression like the two other drugs in this class, it can be discontinued after the amyloid deposits are removed.  It does raise the question of when/if it will be approved by the Therapeutic Goods Administration, noting that it also has significant side effects.

1 July 2024

Commonwealth Government puts up $20M to commercialise AI to unlock neurocognitive secrets

Commercialising A.I. to unlock the mystery of multiple sclerosis

“The Australian Government is investing $20 million to commercialise digital health research, taking it from the lab and putting it in the hands of patients and their health team, like using artificial intelligence to unlock the secrets of neurological disorders like multiple sclerosis and dementia.

To realise the potential of Australia’s world-class digital health research, ANDHealth+ received $19.75 million through the Medical Research Future Fund’s (MRFF) Medical Research Commercialisation initiative.

Each company is awarded a share of $3.75 million in equity-free funding, alongside hands-on support by a network of experts to help them to scale their businesses.

The MRFF investment has now supported 21 companies to turn their research into real treatments and products for Australians.”

Minister Mark Butler stated “The potential of Australian researchers and our digital health technology sector is unlimited…Investment is important, but so too is expert guidance to navigate the pathway from discovery to delivery for Australian patients.”

IN SHORT:

Neurocognitive disorders are at the cutting edge of research that uses artificial intelligence (AI).  Australia is getting behind innovation in the field.  Keep an eye out for results that could deliver practical improvements for people with neurocognitive disorders.

1 July 2024

Dementia UK calls out gaping hole in dementia nursing care in British hospitals

Open letter calls for increased access to dementia nursing in hospitals

“Access to specialist dementia nursing in hospitals must increase to ensure people with the condition receive appropriate care, a leading charity has urged.

Dementia UK has delivered an open letter calling on the next government to address the ‘huge gaps’ in health and social care which it says are leaving people with dementia ‘isolated and unsupported’.

The letter, addressed to all political parties and signed by 13,000 people, echoes demands from the charity’s recently published manifesto ‘Put dementia on the agenda’.”

IN SHORT:

Along with other concerns about the UK National Health Service (NHS), now comes the call for urgent action to lift the quality of dementia nursing care in British hospitals.  This comes after recent reports about hospital care for people with dementia in Australia.

13 June 2024

A healthy diet in childhood may protect against cognitive decline

Associations Between Dietary Pattern and Global Cognitive Ability Trajectories Across the Life Course: Longitudinal Analysis of the 1946 British Birth Cohort

A study has identified links between dietary patterns from childhood and later cognitive ability using longitudinal data. “Our results suggest dietary patterns in midlife, before age 50, may be most predictive of cognitive trends up to age 69. Future research should follow younger cohorts and plan earlier diet interventions.”

IN SHORT:

These researchers looked at the diets of people at five time points and their cognitive ability at seven time points. Perhaps not surprising, the quality of the diet was closely linked with cognitive ability.  The results are pretty stark.  For example, only 8% of people with low-quality diets had sustained high cognitive ability, and only 7% of individuals who had high-quality diets had low cognitive ability over time compared with their peers.

If you needed another reason to eat a balanced diet of fresh wholefoods – look no further.  And it’s never too late – see this easy to digest write up.

12 June 2024

New study shows that diabetes accelerates cognitive decline

Diabetes accelerates Alzheimer’s disease progression in the first year post mild cognitive impairment diagnosis 

A new study shows a link between type 2 diabetes and development of Alzheimer’s disease.  Specifically, the study found:

• Diabetes mellitus (DM) accelerates mild cognitive impairment (MCI)-to-Alzheimer’s disease (AD) progression within the first year after MCI diagnosis.
• DM leads to sharper cognitive decline within 12 months of follow-up.
• There is notable nucleus accumbens atrophy observed in MCI patients with DM.
• DM causes significant reductions in gray matter volume and sulcal depth.
• There are stronger correlations between cognitive decline and brain changes due to DM.

IN SHORT:  

Those people with mild cognitive impairment (MCI – the first stage of dementia) and type 2 diabetes appear to progress to Alzheimer’s disease more rapidly than those who do not have diabetes.  This aligns with other studies which highlight the role of role of glucose control in the development of dementias.  It may surprise you to learn that Alzheimer’s disease is sometimes referred to as type 3 diabetes (see this explanation by Diabetes Australia).

April 2024

Low cost, high quality dementia care in Thailand is drawing Australians living with fatal condition

Australia’s failing aged care is driving dementia patients overseas

“It’s never easy losing someone you love, but what’s even worse is having to grieve for them while they’re still alive.

That’s the cruel reality of dementia.

And like so many Australians, I’m living it.

My mum, Lorraine, has had the disease for more than 10 years and now lives in a nursing home in Sydney.

With no cure and no effective treatment, watching mum slowly surrender to her failing mind has been excruciating.It makes you think there must be a better way.

And it turns out, there is – in Thailand.

The town of Chiang Mai is full of luxury resorts, where people with dementia can have their own carer 24 hours a day.”

IN SHORT:

This 60 Minutes story showcases the development of a new form of health tourism.  Enclaves in Thailand are marketing to Australians and their families who have dementia, including those with young onset dementia.  The attraction is easy to see – lower cost personal care, resort style living and an accepting community.  However, the decision to move to Thailand also means that you are leaving behind your friends and community, giving up access to the Australian health system, assuming that you will die before the money runs out, and living without the protection of citizenship or permanent residency.

Perhaps some would say it’s not a bad bargain if the quality of care is what is shown in the marketing material.  But it does highlight the significant way we have to go in Australia in care  for people with dementia – both young and old.