My Lords, as a neuroscientist I welcome the consideration of mental health in the gracious Speech and declare an interest as the founder of a biotech, Neuro-Bio, working towards an effective treatment for Alzheimer’s disease. However, in this capacity I was sadly disappointed that no mention was made of addressing the urgent issues relating to such a devastating health problem.
This debate is taking place during Dementia Action Week, so it is an especially pertinent time to highlight the needs of people living with this condition. Alzheimer’s is a neurological disease characterised by memory loss, disorientation and general cognitive impairment. It presents typically, though not exclusively, in older people: one in six over the age of 80 and as many as 70% of residents in care homes. The spectre of Alzheimer’s is one of the cruellest potential scenarios awaiting us in later life. While heart disease and cancer are serious, often disabling and sometimes terminal, you can still reminisce over old photographs and spend meaningful and precious time with your grandchildren. These life-enhancing moments are gradually closed off to an individual with dementia.
There are currently around 900,000 individuals living in the UK with dementia, a figure projected to rise to 1.6 million by 2040. The cost of care in the UK is currently £34.7 billion, and this is set to rise sharply over the next two decades to £94 billion by 2040.
Many noble Lords have spoken about carers, and this is particularly important with respect to Alzheimer’s. Imagine the impact of Alzheimer’s on the family, specifically the financial and mental health repercussions of giving up a job to care for a loved one—perhaps the love of your life—who then no longer even recognises you; that is a scenario I have heard described, on more than one occasion, as a living death.
Two other main issues could have been addressed in the gracious Speech and were omitted. One is the issue of obtaining a diagnosis. The reaffirmed commitment to invest £2.3 billion to increase diagnostic activity, with ambitions to roll out up to 160 community diagnostic centres, is obviously to be welcomed. However, this must include a specific commitment to improve dementia diagnoses. These are currently at a five-year low, with more than 30,000 additional people now living in England not formally diagnosed. The Alzheimer’s Society estimates that it would take four years to clear the current backlog without extra help. There are national strategies to deal with the backlog in elective care and cancer diagnosis, but nothing to fund or plan to deal with the specific backlog for Alzheimer’s. It will not go away on its own.
Memory assessment services are vastly overstretched due to the pandemic. This is largely caused by workforce pressures. Individuals are being referred to services, but the services cannot deal with referrals at the same rate. Memory services are seeing people come to them with much more advanced symptoms than previously. Just £70 million would allow the NHS to address the backlog in secondary care while making allowance for increasing primary care costs. Up to 65% of emergency hospital admissions for people living with dementia could be avoided if they had the right support.
The individual patient could then become more actively involved in personal decisions, including healthcare. They could use treatments more effectively, focus on what is important and make empowering choices. They could take advantage of resources and help advance research, perhaps by joining clinical trials. With more than 150 such programmes worldwide currently examining potential dementia treatments, it is more pressing than ever that we can identify suitable participants.
This brings us to the third issue: research and the development of new drugs. The Government need to deliver on their manifesto commitment and fund the dementia moonshot as soon as possible. As a scientist on the front line of research, I was saddened to see no mention of this in the gracious Speech, but such funding is urgently needed to deliver on our ambitions for dementia research and, crucially, to deliver new treatments. In parallel to increased research funding, the forthcoming national dementia strategy must set out a bold and ambitious approach from government to create new momentum and help push us over the finish line to the first wave of new treatments.
For example, Alzheimer’s Research UK is leading calls for the Government to apply lessons learned from the Covid-19 Vaccine Taskforce by establishing a dementia medicines task force. The task force would act as a catalyst to accelerate the development of new treatments. It would harness the existing strengths and leading initiatives in the UK, minimising gaps and tackling any duplication in current approaches. The goal would be to ensure that new treatments reach those who need them as soon as possible. It would drive progress in research and speed up clinical trials, as set out in the dementia moonshot manifesto. This would ultimately benefit current patients, while also creating a powerful offering for global life science investment.
Any one of us here could succumb to Alzheimer’s, and a significant number of us are likely to do so. It is one of the biggest health challenges we face, and as such it cannot, as it was in the gracious Speech, be ignored.