Brain Degeneration

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An inevitable consequence of growing old is the gradual slowing of the cognitive and mental faculties that people come to rely upon during their working lives. For many people, growing old is associated with an annoying decline in the ability to recall names or dates or places, or an inability to recall a word that is well known to them but just doesn’t seem to want to surface as they sit staring at crossword puzzle. This dulling of mental acuity, although potentially frustrating, is a natural part of the ageing process. Main biologists believe that our bodies begin to degenerate from the third decade of life.

However, in a percentage of the population, the decline in cognitive abilities and abilities goes well beyond that associated with normal ageing. In such individuals, it is usually the existence of an underlying neurodegenerative disease that brings about a gradual but insidious destruction of brain cells and a consequent acceleration in an individual’s inability to function normally.

Once an underlying pathological cause for cognitive decline has been recognised, the individual now becomes classified either as cognitively impaired, or in most severe cases, as “demented” and, at least in the developed world, is likely to receive some form of medical treatment. By far the most common cause of dementia is Alzheimer’s disease although there are a number of other diseases that cause similar symptoms. What all these diseases have in common is that by and large, they are age related.

With the baby-boomer generation processing towards retirement age, the issue of age related disorders is rapidly growing in importance. In general, the prevalence of Alzheimer’s disease is less than 1% at age 65, but increases to 35% above 90. With improving healthcare standards, an increasingly greater proportion of the population are reaching their 70th, 80th, and even 90th birthday and beyond. Given the high financial costs of caring for demented patients together with the high personal and emotional costs (i.e. for family careers), there is a ticking socio-economic time bomb in the developed world that cannot be ignored.

As would be expected, patients with clinically diagnosed dementia only represent the tip of an iceberg. Floating below the surface is a whole raft of individuals, ranging from the normal but eccentric, through the well but worried that their mental abilities are beginning to decline, to the individuals that have declined to the point where they have seen fit to visit a “memory clinic” and emerged with a clinical diagnosis of “mild cognitive impairment” (MCI) or “cognitive impairment, no dementia”(CIND). The prevalence of cognitive impairment grows significantly with age, with rates increasing by about 10 percent for every 10 years of age after age 65. CIND is almost 5 times more common than dementia (23,4 percent CIND to 4,8 percent dementia for people 65 and older). It is now fairly well accepted that patients with MCI have an increased risk of developing Alzheimer’s disease, cited to be between 5% to 25%.

Currently, only those with a clinical diagnosis of Alzheimer’s disease., or another dementia, receive medical treatment. There are currently no specific treatments for MCI or CIND although some clinical studies are beginning to test the effects of treatments developed by Alzheimer’s disease on these earlier pre-conditions. Thus, there is a significant gap in the market for new products developed for MCI and CIND patients. Any product that could slow the rate of cognitive decline, particularly in the early days when maintaining the status quo is most desirable, could have a significant socio-economic effect. The audit Commission in the UK has calculated the annual cost of dementia care to be around £6.1 billion. According to the association of British Pharmaceutical Industries if the onset of Alzheimer’s disease could be delayed by just 5 years the number of people developing the disease, and hence the cost, could be halved.