Great expectations for dementia research

Abstract

Worldwide, the prevalence of dementia is projected to increase from about 46·8 million, in 2015, to about 74·7 million by 2030. Most of the estimated increases in prevalence are predicted to occur in low-income and middle-income countries. However, these countries are unlikely to have adequate funding to invest in the dementia research that is urgently needed to tackle this large-scale problem. Even in high-income countries, dementia research has not been given priority and therefore its fair share of funding. For example, in the UK, only 11% of £856 million in funding from charities and government was spent on dementia research in 2012, versus 64% on cancer research, despite the higher financial burden associated with dementia. The prevalence of dementia in the UK is projected to increase from an estimated 850 000 people in 2015 to more than 1 million by 2025, according to the 2014 Dementia UK: Update. The financial burden of dementia is a staggering £26·3 billion per year (at 2012–13 prices). In an attempt to address the increasing burden of dementia in the UK, on Nov 24, the Prime Minister David Cameron announced funding for the first national dementia research institute. The research done with this funding will eventually benefit people not only in the UK but also in other countries. The UK Government is following through on a commitment to dementia research that began in December, 2013, at the G8 Summit in London and continued at the WHO Ministerial Conference in Geneva in March, 2015. At these meetings, for the first time in history, dementia became a high political priority globally. Now, in the UK, an investment of up to £150 million for a dementia research institute will link to existing research initiatives, such as the National Institute for Health Research's Translational Research Collaboration and Alzheimer's Research UK's Drug Discovery Alliance. The dementia research institute will be led by the UK Medical Research Council (MRC) and will be fully functional by 2020. This UK initiative is similar to that of Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Germany's dementia research institute. Founded in 2009, DZNE now has more than 70 research groups and brings together scientific expertise from all over the country with the aim to quickly translate knowledge gained in laboratories into treatment through the collaboration between basic, clinical, and health-care researchers. The UK's new dementia research institute will hopefully strengthen the move towards much greater collaboration and networking. It will aim to unify dementia research with a main hub, based at a university, and by forging links with other universities and centres of research and clinical excellence in the UK. Importantly, the institute will need to work in tandem with existing initiatives to expedite progress towards desperately needed new treatments for dementia. £150 million—a paltry amount compared with the estimated £26·3 billion yearly burden—cannot replace input from the pharmaceutical industry; therefore, an effective pharmaceutical industry component would be desirable to expedite the process of bringing new treatments to the clinical assessment stage. A main hub with links to universities and centres should not only increase the facilitation of collaboration but should also enable the dissemination of a programme for integrated research. Another important function of the UK institute would be to educate clinicians and to assist in the implementation of clinical trials. The MRC is expected to open a competitive process in 2016—the closing date is likely to be announced by the end of January or early February—so that universities can bid to host the dementia research institute. Careful attention will need to be given to the breadth of the institute's research programme and translation of existing knowledge into clinical practice. The success of the institute will be determined by the vision and leadership skills of its director, who should have a broad knowledge of dementia research. The appointment of the director should be sought through an open and competitive international process. On Dec 18, another G8 country—the USA—announced a proposal for the 2016 federal budget that would increase funding for Alzheimer's research by 60%, raising the total to US$936 million. The budget has earmarked an additional $85 million for Brain Research through Advancing Innovative Neurotechnologies Initiative and has increased the US Department of Defense's budget for Alzheimer's research by $15 million. These long-awaited funding initiatives pave the way for a more optimistic outlook for dementia research. What is important now is to maintain momentum and ensure that the funding is sustainable.