As we live longer and there are more people living into old age, there is an increasing number of people developing dementia with more than 400,000 people currently living with the condition in Australia.
Dementia is now the leading cause of death in Australia, and Alzheimer’s disease is the most common cause of dementia.
Dementia Australia warns that in the absence of a significant medical breakthrough, more than 6.4 million Australians will be diagnosed with dementia in the next 40 years, at a cost of more than $1-trillion.
Whilst there is still uncertainty about the cause of Alzheimer’s disease, there is hope for new drugs that may be effective in slowing the progress of the disease.
The Therapeutic Goods Administration has recently approved the use of two monoclonal antibodies targeting the amyloid protein that is present in the brains of people with Alzheimer’s disease. These two drugs, donanemab and lecanemab, are approved for the treatment of mild cognitive impairment and early Alzheimer’s disease.
Alzheimer's results from genetic, environmental, and lifestyle factors and is characterised by amyloid plaque in the brain. These sticky clumps of protein build up between nerve cells, blocking communication and eventually killing cells, leading to memory loss and confusion.
Donanemab is administered with a monthly intravenous infusion and lecanemab as a fortnightly intravenous infusion. Both drugs work to clear the amyloid plaque in the brain.
Trials have demonstrated that these drugs can reduce the amyloid plaque and potentially improve quality-of-life and functional independency.
Leading clinician/researcher Professor Sue Kurrle said the impact of the drugs is not straight forward.
“Donanemab is not a cure, but studies over 18 months show that it does slow the progress of dementia by several months when compared with a placebo drug,” said the clinical director of the Northern Sydney Local Health District Rehabilitation and Aged Health Network.
“These drugs are for the management of very early Alzheimer's and they do not have the same effect in people with moderate Alzheimer's disease, so are only suitable for a limited number of people,” she warns.
“These drugs are not currently subsidised by our pharmaceutical benefits scheme, so they are expensive and require regular MRI brain scans due to the side effects of brain swelling or bleeding.”
With each infusion costing around $4,700, an 18-month course will cost about $80,000. The Federal Government is currently reviewing an application to list the drug on the pharmaceutical benefits scheme.
In the meantime, Professor Kurrle is encouraging the community to do what it can to reduce the impacts of the disease.
“There is no single solution to preventing Alzheimer’s disease and other forms of dementia, but there are lots of small things you can adopt to greatly reduce your risk,” she said.
“These include, looking after your physical and mental health, regular exercise, and health checks to capture in any changes.”
Your local doctor can monitor the following key areas:
- blood pressure and cholesterol, especially if you have a family history of cardiovascular conditions
- blood glucose levels, especially if you have a family history of diabetes
- weight
- hearing and vision
- cognitive function and memory
- mood and mental health
- any other conditions that need regular medical attention.
Professor Kurrle said there are many resources available detailing specific diets and tips for brain health, and I would encourage the community to visit the Dementia Australia website for more information at: www.dementia.org.au