A simple but revolutionary approach to early Alzheimer’s diagnosis is being pioneered, in a breakthrough that could pave the way for improved outcomes for individuals who develop the disease in the future.
The research uses a new method to passively measure brain activity. It involves participants looking at a series of flashing images on a computer over two minutes, whilst their brain waves are measured using an EEG cap.
New research on this, published today on World Alzheimer’s Day, shows that the technique is highly effective at picking up small, subtle changes in brain waves which occur when a person remembers an image.
Crucially, the technique is completely passive, meaning the person doing the test doesn’t need to understand the task or respond, and may not even be aware of their memory response.
The team behind the ‘Fastball EEG’ technology – led by psychologists at the University of Bath and funded by the dementia charity BRACE – say the approach is cheap, portable and relies on pre-existing technology already available in hospitals, making it easily scalable.
They are now beginning to use Fastball EEG in a study of the earliest stages of Alzheimer’s disease in collaboration with the Research Institute for the Care of Older People (RICE) and the Bristol Brain Centre at Southmead Hospital.
Alzheimer’s is the underlying cause of approximately 60 per cent of dementia, with an estimated prevalence rate in Europe and North America of 5 to 7 per cent of the population. Estimates suggest the disease costs the UK economy around £26 billion a year, with costs expected to rise as an ageing population will see numbers increasing.
Alzheimer’s disease is currently diagnosed using a combination of subjective and objective reports of cognitive decline, often involving memory tests administered in a clinic.
These tests are prone to various biases, including assessment anxiety, but also require verbal and written communication abilities which make them ineffective for certain people.
By knowing more about people’s disease at an earlier stage, drugs can be prescribed earlier when they may be more effective, such as the recently-approved Aducanumab, the first disease modifying treatment for Alzheimer’s disease.
Lifestyle interventions can also be implemented to help slow disease progression. Current diagnosis for Alzheimer’s typically occurs late in the progression of the disease.
In the near future, the researchers hope that Fastball EEG could help lower the age of diagnosis by up to five years. Longer-term, they say it may offer opportunities to expand this further. They liken their future aspirations for its application to current screening tools used to test for high blood pressure in middle age.
Lead researcher and cognitive neuroscientist Dr George Stothart, of the Department of Psychology at the University of Bath, explains: “Fastball offers a genuinely novel way of measuring how our brain is functioning.
“The person being assessed doesn’t need to understand the test, or even respond, they simply watch a screen of flashing images and by the way we manipulate the images that appear we can learn an enormous amount about what their brain is, or is not, able to do.
“The tests we currently use to diagnose Alzheimer’s miss the first 20 years of the disease, which means we are missing huge opportunities to help people.
“For decades now we have had tools in scientific research that have been able to probe how the brain is working, but we have never made the leap to a viable clinical tool for the objective assessment of cognition. We hope that Fastball may be that leap.
“We are at a really exciting stage in its development. We are testing the tool in earlier and earlier stages of Alzheimer’s and expanding the type of brain function it can measure, to include language and visual processing.
“This will help us to not only understand Alzheimer’s but also the many other less common forms of dementia.
“Ultimately the Holy Grail of a tool like this would be a dementia screening tool used in middle age for everyone, regardless of symptoms, in the same way we test for high blood pressure. We are a long way from that, but this is a step towards that goal.”
Mark Poarch, chief executive of BRACE, added: “We were delighted to be able to fund Dr Stothart’s research, which clearly has exciting potential.
“It could result in an early diagnostic tool with benefit for innumerable people and help turn the tide against dementia. More generally, we have seen in the last year what happens when the world ploughs resources into medical research to find a vaccine for a dangerous virus, and we now need to give dementia researchers the resources they need to achieve comparable breakthroughs.”
Dr Stothart and colleagues will soon start work on a significant £100,000 longitudinal study of early dementia funded by the Academy of Medical Sciences. The study will involve testing patients with Mild Cognitive Impairment using the new Fastball tool.
Support at your fingertips – new resources for family dementia carers
Dementia Carers Count (DCC) is a national charity offering free, life-changing, practical support for families living with dementia.
The charity has just launched its new Virtual Carers Centre and runs regular online learning sessions, enabling carers to access essential support wherever they are.
DCC gives family carers the opportunity to understand more about dementia, to connect with others in a similar situation and to look after themselves while navigating the highs and lows of caring for someone with dementia.
It’s the ideal place to signpost carers to, for information and resources to help them with their day to day challenges.
Here is Stuart’s story.
Stuart met Roger in 1985, they’ve been in a registered partnership since 1995. Roger was diagnosed with young-onset Alzheimer’s when he was 57.
Roger has deteriorated considerably since his diagnosis and, as well as caring for him full time, Stuart has had to take on more and more at home.
Although Roger’s interests have changed his mood has remained good. He’s always smiling, and people tend to be drawn to him.
Stuart feels a bit frustrated now that he’s increasingly having to do more and more for Roger. He didn’t choose to be a carer and thought that by now, he would be enjoying my retirement and living happily ever after.
At the start of the pandemic Stuart began using technology like Zoom. He first found out about Dementia Carers Count (DCC) in an online, young-onset support group. He registered for some of DCC’s online learning sessions.
“The online courses have been like gold dust and have increased my knowledge of dementia and Alzheimer’s. The people leading the sessions are easy-going, supportive and understanding…. They’ve been a lifeline for people like me during the pandemic.”
“DCC’s digital services are fantastic. They are very informative, accessible, and the content is presented in a way that is easy to understand. During the sessions, you can talk about your specific challenges and connect with the other people attending. “
Stuart says that the support DCC provides him has helped him immensely and is extremely useful to anyone in a caring situation.
“The information comes from people with experience and knowledge. It will help you understand what is going on for the person you care for and develop a better caring strategy. Everyone running the sessions is very patient and nurturing towards the people attending.”
DCC is here to help families living with dementia.
DCC’s Virtual Carers Centre is a brand new resource for family or friends who are looking after someone with dementia. It’s accessible any time; day or night, complete with articles, videos, presentations and more.
Carers will find all the support they need, including:
✔️ Practical information about carers’ rights and benefits
✔️How to manage everyday emotions and changes in behaviour
✔️Wellbeing strategies for carers and for the person they are supporting
✔️The opportunity to book on to Live Online Learning sessions covering various topics
T: 020 3096 7895 E: email@example.com
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De-cluttering ‘may not help’ with dementia
People with moderate dementia performed better when surrounded by their usual clutter, a new study has revealed
A clutter-free environment may not help people with dementia carry out daily tasks in the way that has traditionally been thought, a new study has revealed.
Researchers at the University of East Anglia (UEA) studied whether people with dementia were better able to carry out tasks, such as making a cup of tea, at home – surrounded by their usual clutter – or in a clutter-free environment.
And they admit to being “surprised” to find that participants with moderate dementia performed better when surrounded by their usual clutter.
But the different environments made no difference to people with mild and severe dementia, who were able to perform at the same level in both settings.
Professor Eneida Mioshi, from UEA’s School of Health Sciences, said: “The majority of people with dementia live in their own home and usually want to remain living at home for as long as possible.
“So it’s really important to know how people with dementia can be best supported at home – one possible route would be by adapting the physical environment to best suit their needs.
“As dementia progresses, people gradually lose their ability to carry out daily tasks due to changes in their cognitive, perceptual and physical abilities. Participation in daily tasks could then be improved by adapting the person’s environment.
“To this end, we wanted to investigate the role of clutter in activity participation, given the potential to use de-cluttering to support people with dementia to continue to be independent.
“Environmental clutter has been defined as the presence of an excessive number of objects on a surface or the presence of items that are not required for a task.
“It is generally assumed that a person with dementia will be better able to carry out daily tasks when their home space is tidy and clutter free.
“However, there has been very little research to really test this hypothesis.
“We wanted to see whether clutter was negatively affecting people with dementia. So we studied how people at different stages of dementia coped with carrying out daily tasks at home, surrounded by their usual clutter, compared to in a clutter-free setting – a specially designed home research lab.”
Occupational therapist and PhD student Julieta Camino carried out the study with 65 participants who were grouped into those with mild, moderate and severe dementia.
They were asked to carry out daily tasks including making a cup of tea and making a simple meal, both at their own home and at UEA’s specially-designed NEAT research bungalow – a fully furnished research facility that feels just like a domestic bungalow.
The researchers evaluated performance of activities in both settings, and also measured the amount of clutter in the participants’ homes. Meanwhile, the NEAT home setting was completely clutter free.
Julieta, also from UEA’s School of Health Sciences, said: “We thought that the complete absence of clutter in our research bungalow would play a beneficial role in helping people with dementia with daily living activities. But we were wrong.
“We were surprised to find that overall, people with moderate dementia, in particular, performed daily tasks better at home – even though their homes were significantly more cluttered than our research bungalow.
“And it didn’t seem to make any difference how cluttered the participant’s home was. The only factor that contributed to how well they could carry out tasks at home was their level of cognition – with those with severe dementia encountering the same difficulties to perform the tasks at home and in the research bungalow.”
This research received funding from the Alzheimer’s Society and National Institute of Health Research (NIHR) Applied Research Collaboration East of England (ARC EoE) programme.
New drug design could yield Alzheimer’s treatments
The breakthrough could have the potential to create superior new drugs to improve cognitive function in Alzheimer’s disease patients
A breakthrough ‘bench to bedside’ discovery, ten years in the making, has been made in the quest to advance the future treatment of Alzheimer’s disease in patients.
The research illustrates – for the first time – the process of designing a new molecule to selectively target a specific receptor protein in the brain and demonstrating, through laboratory preclinical and human clinical studies.
The breakthrough has been hailed as having the potential to create superior new drugs to improve cognitive function in Alzheimer’s Disease patients.
The study – conducted at the University of Glasgow with Sosei-Heptares Ltd – was focused on new molecules, designed by the biotechnology company, that selectively target a protein called the M1 muscarinic acetylcholine receptor (or M1 receptor, a G protein-coupled receptor or GPCR) in the brain, which is known to play a central role in memory and cognition.
Subsequent translational medicine studies tested the hypothesis that such molecules will retain cognitive benefits and lack dose-limiting side effects.
The international research team demonstrated that an exquisitely selective modulator could be successfully designed using detailed knowledge of the M1 receptor’s 3D structure, despite its very close similarity to other types of muscarinic receptor. This approach is known as structure-based drug design or SBDD.
Subsequent pre-clinical studies confirmed the designed molecule retained optimal properties for improving memory while minimising side effects associated with previous attempts to target the M1 receptor.
Finally, clinical studies demonstrated that the M1-selective clinical candidate HTL9936, at meaningful doses in healthy volunteers, showed greatly reduced side effects relative to many non-selective predecessors from programmes spanning a generation of traditional drug discovery approaches.
These ground-breaking results substantiate the hypothesis and the power of novel approaches using 3D structures of receptors developed by the team can be applied to the M1 receptor to create a potential new medicine for Alzheimer’s Disease patients, and also have broader implications highlighting a new approach to address other GPCRs linked to a wide range of diseases.
Prof. Andrew Tobin, professor of molecular pharmacology and director of the newly-built Advanced Research Centre at the University of Glasgow, said: “This is a true bench-to-bedside discovery, many years in the making, and we are thrilled that this hugely important and global collaboration with our partners at Sosei Heptares and others has resulted in a highly sophisticated drug design approach that offers huge potential to improve the treatment of Alzheimer’s Disease, by activating memory and cognitive centres within the brain.
“We are extremely encouraged by our findings so far and are very hopeful that this could lead to new treatment options for patients with this devastating disease.”
Dr Miles Congreve, chief scientific officer at Sosei Heptares, added: “We are delighted that this pioneering drug design work in collaboration with Prof. Tobin and others has been published in such a highly acclaimed journal.
“The precision SBDD technology that we have developed is core to our approach at Sosei Heptares and has been extremely effective for designing new and superior drug molecules that we are progressing through preclinical and clinical development as potential new treatments for a wide range of neurological, immunological and gastrointestinal diseases.”
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