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International Clinical Trials

Early Detection for Invisible Patients

Dementia is a devastating condition that has grown into a major public health issue, particularly due to our increasingly aging populations. Despite the push for new and better treatments, no exciting breakthroughs have emerged so far. However, evidence is building in support of tangible benefits from treatments able to prevent or reduce the risk of dementia before it takes hold. New approaches to improving brain health in mid- and late life offer a real possibility for adults to manage their own risk many years before any symptoms emerge. This new perspective also raises the opportunity to conduct innovative trials of treatments to prevent dementia in people who are known to be at risk.

Opportunities for Dementia Prevention

Where previously there was scepticism about the preventability of dementia, now there are options for improving brain health and reducing risk. Even delaying the onset of dementia by just six months could have an enormous impact on health and costs at both an individual and population level, but current ambitions are far more optimistic. Several preventative strategies carry strong evidence. These include a number of lifestyle approaches known to reduce the risk of dementia, including physical exercise, maintaining a healthy weight, and stopping smoking (1). There is also strong evidence for other lifestyle approaches such as the regular use of cognitive training and games that engage the brain, both of which have been shown to improve brain function (2-3). A recent large-scale study that used data from 200,000 people showed that lifestyle factors could overcome the increased risk conferred by known Alzheimer’s disease (AD) genes (4). This represents a tangible ‘call to arms’ for all older adults to take control of their own risk through changes to lifestyle.

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About the authors

Professor Clive Ballard at the University of Exeter Medical School specialises in the psychiatry of older adults. Throughout his career, his research has ranged from prevention of dementia and the study of biological mechanisms and drug discovery to understanding the needs of people with more severe dementia living in care homes and the overuse and harms of anti-psychotic medications in these individuals. Clive is a Fellow of the Academy of Medical Sciences, and he won the Weston Brain Institute International Outstanding Achievement Award in 2019. He has published more than 600 research papers, including multiple clinical trials, and has played a major role in changing dementia care policy in the UK and further afield.

Dr Dawie Wessels is Chief Medical Officer at AES, a PPD business. From a clinical research background, Dawie moved into a succession of operational roles where he has always advocated and embraced the use of scientific expertise to better serve the research community.
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