Dementia is caused by diseases, not ageing – funding work like mine can help find a cure
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Dr Cara Croft wanted to be a medic when she was younger. A spell of work experience at a hospital in Wigan around the time she left school changed her mind.
“I met someone for the first time with one of the diseases that causes dementia and it was just heartbreaking when the doctor said, ‘There’s nothing we can do’,” she says. That meeting was pivotal in her decision to study neuroscience instead of medicine, a field where she felt she could “try and make a difference” to change the outcome.
“We don’t know that much about the brain, let alone when the brain goes wrong, and I thought that was fascinating,” she says.
We’re standing in a tissue culture facility in the Blizard Institute at Queen Mary University of London, where Dr Croft is now a senior lecturer in neuroscience – and where she is trying to make a difference by finding a way to prevent dementia.
After stepping off the busy streets of Whitechapel, where the winter daylight is fading, the brightly lit institute is quiet and futuristic-looking. Here, you can imagine discoveries being made; scientific understanding being advanced.
Suspended above the main atrium hang supersized models of a fly embryo and a mammalian embryo. Below, lies a vast, open-plan laboratory, where scientists in white lab coats beetle around between the benches, engaged in a variety of projects. Every surface is covered in white and clear plastic bottles, boxes, scales, funnels and the other paraphernalia of medical research.
Down a corridor leading from the lab is Dr Croft’s facility: a small, windowless room full of fridges and cabinets. It is here that she and her two colleagues keep mouse brain tissue alive so they can study it. Their aim? To see how the 75 genetic changes that can lead to Alzheimer’s disease in humans (the most common type of dementia) influence the build-up of molecules, or protein clumps, in the brain. It is this build-up of proteins called amyloid and tau in and around brain cells that is thought to cause the condition.
In our ageing society, a great many of us are already watching a loved one suffer with dementia, or will be in the future. Yet the progress made in tackling it has lagged behind what has been achieved with other illnesses – and we’re still without a cure.
Dr Croft is researching whether the genetic changes found in those with dementia could eventually be targeted with preventive treatment. Between 10 and 20 per cent of these changes have been studied a lot, she says. The rest have not been examined in any great detail.
“We want to see how they feed into those molecules or clumps building up, because if we understand more about that, then we think that’s probably what we’d want to treat with drugs,” she says.
The “pipe dream” is to catch the disease before it has even started, by genetically screening younger adults to find out whether they’re at risk. “If you know they’ve got this risk, that’s when you’d step in with the drugs to prevent the knots from happening.”
In this hoped-for future, those with genetic markers for dementia could start taking preventive drugs as early as their 40s, much like statins are taken now by those whose cholesterol levels put them at higher risk of heart attacks and stroke. Such preventive drugs for dementia are yet to be developed, but Dr Croft is optimistic that more drugs that can slow dementias down for longer will be possible in the next 10 years.
Her research is made possible by Race Against Dementia, which has funded her entire project for the past four years. It is among the charities the Telegraph is supporting.
Without it, those like Dr Croft might struggle to carry out their search for a way to stop in its tracks a disease that around 900,000 people in the UK currently suffer from – a number expected to rise sharply in the years to come. Despite its prevalence (an estimated one in 14 over-65s has some form of dementia) research has been relatively underfunded.
“In the UK, over half of medical research is funded by charities but in terms of dementia, it’s even more difficult,” says Dr Croft. “It’s important we treat cancer and other diseases, but in terms of cancer, there’s about four scientists for every dementia scientist.” Dr Croft says that the relatively fewer numbers dedicated to the condition has contributed to progress being “so far behind” advances seen in other areas.
For sufferers, she believes there’s an enduring stigma surrounding dementia that isn’t present with other illnesses. “I think people are quite open to saying, ‘I’ve got cancer’, but when it comes to these diseases that cause dementia, I think people are less open in their diagnoses,” she says. “A few years ago I met a gentleman with Alzheimer’s who said for two years he held it from his family.”
Has this lack of openness hampered the ability of researchers to raise awareness of dementia as a problem and attract the funding needed to cure it? “I think so,” says Dr Croft. “I think people have kind of accepted it’s a part of ageing, but it’s not. It’s caused by diseases, and other diseases have cures so why can’t we have cures for the diseases that cause dementia?”
She and her small, all-female team are working on it. Dr Croft, who is from Manchester, spent time at the University of Florida learning genetic editing techniques. Race Against Dementia also sponsored her spell in the US.
So, has her team’s efforts led to any breakthroughs yet? “Yes,” she says, in her usual calm tone. “We’ve been able to see, for the first time, these protein clumps building up and irritating cells… at first the brain cells can handle this… That would be the window where you’d need to go in with a drug.” Dr Croft says that these findings potentially indicate that “new medicines could interfere to stop the clump renewal process so that a cell remains healthy and not irritated”.
She shows me a vial of cells used to generate the non-infectious viruses that help the neuroscientists change the genetic code of the mouse brain tissue they experiment on. It looks like a red liquid sitting at the base of a container. The mice are kept in a different building. “There’s a long-standing funny history with animal research,” says Dr Croft, with some understatement. “I think it’s good to be open about it because ultimately, testing drugs in mice or other animals will lead to therapies for us.”
Genetic changes associated with dementia are not the only factor in its occurrence. Some 60 per cent of Alzheimer’s cases are thought to have a potential genetic component. The other 40 per cent are understood to be linked to lifestyle factors – research suggests smoking, obesity, diabetes, high cholesterol and high blood pressure can increase the risk – and possibly environmental factors, such as air pollution. There is still a great deal of uncertainty around the extent to which you can mitigate genetic risk by making lifestyle changes.
Despite this, Dr Croft encourages healthier choices – there is evidence that regular physical activity, drinking less alcohol and stopping smoking can all reduce your risk. “Generally what’s good for your heart is good for your brain, so it’s worthwhile.”
I wonder whether her passion for curing this disease that brings such anguish to so many is fuelled by any personal, family experience?
“Yeah,” she says quietly, without elaborating. “Not when I started; but most people end up being affected by it.”
Race Against Dementia is one of four charities supported by the Telegraph Christmas Charity Appeal. The others are Go Beyond, The RAF Benevolent Fund and Marie Curie. To make a donation, please visit telegraph.co.uk/2023appeal or call 0151 284 1927