Dementia is one of the greatest health challenges of our generation. Currently 50 million people world-wide are diagnosed with dementia and approximately 500 000 Australians. Without major advancements in treatment, dementia prevalence is estimated to increase to 1 million Australians by 2050. This number does not capture the broader impacts of dementia, such as it’s impact on the health and wellbeing of family carers.

SMS has well established ties to research institutions. We are able to provide further information to patients and family who are interested in research participation and can then facilitate referral onwards. The research centre would then be able to provide further in-depth information.

In the below video Dr Chris Kyndt, in his role as a principle investigator at the RMH cognitive trial unit, outlines some of the reasons why patients may want to participate in dementia treatment trials.

Treatment trials have certain common inclusion and exclusion criteria. These take into consideration the patient’s cognitive screening scores, any recent unstable medical issues, medication history, ability to complete further imaging such as MRIs and the availability of a reliable study partner supporting participants during the study.
Many randomised control treatment trials have two groups: an active treatment group where participants receive the active trial medication, and a placebo group where participants receive inactive medication. This allows the study researchers to work out if the medication is having any treatment effect over the time of the study. Neither the staff involved in the study visits nor the participants know who is in the active or inactive groups and this stops any bias in completing assessment. The chance of being placebo varies amongst studies but can range between 25-50 %.
Trials are rigidly structured for safety with regular monitoring through clinical assessment, blood tests and imaging. This allows any side-effects to be detected and action to be taken by the study team.

This is a time of renewed investment in research and development in dementia. SMS has great optimism that this research drive will be reflected in advancements in diagnostics and therapeutics in the years to come. Further breakthroughs are just around the corner.

In diagnosis we expect advancements in both imaging and blood test markers allowing better diagnostic accuracy. This will provide the basis for identifying patients earlier in the disease including at the asymptomatic (without symptom) stage. The earlier stages of these conditions may provide the greatest window for treatment response.

We also expect that, similar to other areas of medicine such as cardiovascular disease, there will be improved tools to predict future dementia risk. Risk stratification will enable targeted preventative strategies based on lifestyle measures (exercise, social interactions and diet) and vascular health strategies (blood pressure control, cholesterol and diabetic management) that can be provided in middle life to reduce future dementia risk in the future.

For patients with established dementia, improvement in treatments that both slow disease progression and ameliorate symptoms is required, ultimately with the aim to preserve patients’ independence at home and delay nursing home admission.

At the same time there needs to be a move away from collective “one fit” approach to dementia management, towards a more individualised patient-centred approach. This individualised approach should use cognitively trained multi-disciplinary teams to focus on individual specific care needs – physical, cognitive, behavioural, psychological, social and functional.

A major revamp to social provisions for people living with dementia is required, including improved government funding and dynamic policy. We support residential home enterprises such as the dementia specific villages that seek to both provide supported safe environments while maintaining a degree of independence, environmental familiarity, stimulation and social connection.

Finally, there is an urgent need for age appropriate community and residential care and support options tailored for people living with younger onset dementia, noting the specific and differing care needs of younger people compared to the older population.