Lancet: Volume 384, Issue 9948, 20–26 September 2014, Pages 1072
On Sept 11–12, 2014, the pharmaceutical and biotechnology industries met with academics and politicians at Global Action Against Dementia, an event hosted by Canada and France. Following on from the 2013 G8 Summit on Dementia—which set an ambitious goal to find a dementia cure by 2025—their focus was to maximise “academia–industry synergies”.
Yet, in the same week, researchers from King's College London and the London School of Economics emphasised the reality on the ground for people living with dementia. They estimated not only that the prevalence of dementia in the UK was 7·1% in people older than 65 years (816 000 individuals), but also that 42 000 younger people have the disorder. Overall, dementia costs the UK £26·3 billion each year, mostly borne by private spending on social care (22%) and by 670 000 unpaid carers of people with dementia (44%).
Moreover, Alzheimer's UK reports that 42% of people living with dementia have a poor quality of life and that up to two-thirds are undiagnosed in some areas; a planned government cap on the cost of residential care, due in 2016, will limit costs only beyond £72 000 per year and will not include living expenses. If the UK (a high-income country with free-to-access universal health care) cannot provide affordable and comprehensive dementia care, then what hope have the low-income and middle-income countries in which 62% of people with dementia live?
Despite the ambitions of the summit on dementia to find a cure, at best there is hope for a therapy that slows onset or limits cognitive decline to a small extent, probably only in the early stages of disease, and probably available more than a decade from now. Meanwhile, modifiable risk factors (such a physical activity) and disease mechanisms are under-researched. In terms of research funding, dementia lags far behind other chronic diseases; in the USA, the National Institutes of Health is due to spend just US$666 million of its $30 billion budget for 2014 specifically on dementia. A dementia cure without affordable care or action on prevention is not the legacy that patients deserve.