C: Robina Weermeijer via Unsplash

Thousands in Ireland to have access to dementia trials under new initiative commencing this week

Tens of thousands of people living with dementia in Ireland will have access to clinical trials aimed at improving their quality of life and/or lifespan under a new initiative set to begin on Tuesday.

Dementia Trials Ireland (DTI) is funded by the Health Research Board, and aims to significantly increase the provision of clinical trials for those living with the neurological condition and those at risk of dementia within a period of five years. In Ireland, clinical trials activity in dementia has been at a low level, but DTI aims to dramatically improve the situation.

The trials range from complex drug interventions to social and arts interventions such as dance therapy. The trials will be aimed at those at different stages of dementia, from preclinical to advanced, as well as those suffering from different forms of dementia, including Alzheimer’s disease and vascular dementia. DTI aims to ensure that every person that is at risk of, or living with, dementia in Ireland has access to clinical research. The network, which is supported by the Health Research Board (HRB), will be officially launched on Tuesday at the Naughton Institute, Trinity College Dublin.

Co-lead of DTI, Prof Iracema Leroi, told Medical Independent.ie that participation in trials can give people a “sense of empowerment”, and, in some instances, access to potential new therapies. She noted that access to research was identified as a priority in the Irish National Dementia Strategy and was an objective of investment in memory assessment clinics across Ireland.

Over the course of the next 60 months, the organisation aims to co-develop and support an internationally recognised dementia trials infrastructure, significantly increase Ireland’s capacity to conduct dementia trials, and support the delivery of national strategic policies for dementia. It insists that on a national and global scale, there is an urgent need for new therapies and interventions because of the fact there are no disease-modifying drugs with proven effectiveness in the treatment of Alzheimer’s disease and other types of dementia.

Internationally, researchers in dementia have struggled to make the same progress as scientists developing treatments for cancer. More than 99% of clinical trials for new dementia drugs have failed in the past 25 years, according to DTI lead Prof Leroi.

Roughly 64,000 people in Ireland live with dementia, and that figure is predicted to double by 2046. By 2050, some 153 million people across the world are expected to be living with dementia – an increase from 57 million in 2019 – largely because of population ageing and population growth, according to estimates published in The Lancet Public Health in January 2022.

The paper also looked at four risk factors for dementia—smoking, obesity, high blood sugar, and low education—and highlighted the impact they will have on future trends. For example, improvements in global education access are projected to reduce dementia prevalence by 6·2 million cases worldwide by 2050. But this will be countered by anticipated trends in obesity, high blood sugar, and smoking, which are expected to result in an additional 6·8 million dementia cases.

The authors highlighted the urgent need to roll out locally tailored interventions that reduce risk factor exposure, alongside research to discover effective disease-modifying treatments and new modifiable risk factors to reduce the future burden of disease.

Dementia trials are offered to under 1 per cent of the 64,000 people living with the condition in Ireland, compared to 20 per cent in the UK. In direct contrast, Irish cancer patients have a one-in-five chance of being enrolled in a trial. DTI co-lead Prof Leroi insists that Ireland needs to see “more trials, more interventions to trial, and more people volunteering to participate in trials” in order to arrest the progression of dementia here.

The trials commencing this week will seek to recruit healthy volunteers between 60 and 80 years of age who might be concerned about dementia due to their family history; people with symptoms who have not yet been diagnosed; people living with a diagnosis; and those with advanced dementia.

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