Health experts have hailed major advances in dementia research for providing “real hope” to millions of patients around the world, but warned key hurdles must still be overcome to unlock the potential of promising treatments.
The latest report on dementia – released to mark World Alzheimer’s Day on Monday – points towards a new era of care that could mirror the rapid developments in cancer treatment.
The Alzheimer's disease International report shows 158 potential therapies are under trial, but several roadblocks could yet delay their arrival.
“This is a moment of real hope for dementia research,” said Chris Lynch, acting chief executive of Alzheimer’s disease International.
“After decades of frustration, clinical trials have shown for the first time that new treatments can slow the progression of Alzheimer’s disease, and a burgeoning pipeline of treatment trials brings real hope.
“We are on the cusp of a revolution in dementia diagnostics and treatments, but major barriers to recruiting trial participants risk slowing progress.”
Trial data
Active trials need around 55,000 participants, but, as not all volunteers are suitable, an estimated pool of 350,000 participants is required to meet regulatory and scientific requirements.
Low awareness of the value of dementia trials, limited GP referrals, travel costs and a high bar for eligibility have made recruitment a considerable challenge that could derail progress.
“The advancement in blood-based biomarkers could revolutionise the way trials are recruited, drastically reducing screening costs and enabling recruitment on a scale that previously hasn’t existed,” said Mr Lynch.
“There is a lot here to be learnt from the oncology space, where information and the referral pathway for clinical trials is much better developed.”
A key challenge facing dementia trials is that many of them are held in high-income countries like the US.
Participants are predominantly white, so trials lack the diversity required to offer scientific robustness.
Many factors, including genetics, vascular health, education level and socioeconomic status, can all influence the risk of developing dementia, the likelihood of diagnosis, and the response to treatment.
Researchers in the UAE are pressing on with local trials that could reach a new benchmark for how dementia is treated in the Arab world.
Under the Emirati Genome Programme, a million Emiratis have offered their genetic data to accelerate the development of new dementia drugs.
Africa is also a continent desperately in need of localised clinical dementia research.
In Kenya and other areas of sub-Saharan Africa, the majority of the population still lives in rural areas, and yet most clinical trials take place in urban or metropolitan zones.
Care for all
Improved targeting of these rural populations, along with practical logistics like transportation to and from clinical trials, could significantly improve recruitment and participation in trials among underserved communities.
“Better targeting of these populations, alongside practical support such as transportation to urban clinical trial centres, could significantly increase the recruitment and participation of appropriate populations,” said Zul Merali, founding director of the Aga Khan University Brain & Mind Institute.
Elsewhere in Cuba, researchers working with the Global Brain Health Institute recently completed a cluster-randomised trial involving primary care clinics across the country.
Instead of relying on expensive specialist infrastructure, the programme trained ordinary family doctors to recognise dementia earlier and more confidently.
Over 12 months, diagnosis rates rose significantly in the intervention clinics, suggesting a few truisms remain about how doctors spot early warning signs.
Blood tests and symptoms such as mild confusion or brain fog, paired with a family history of dementia, should lead to further investigation.
By knowing the risks, patients can slow down disease progression and even delay the onset of more serious symptoms.
Dr Derk Krieger is a neurological specialist at Fakeeh University Hospital and leads the Brain Health Programme at Recognition Health (RCH), part of M42 and Mubadala Health Dubai.
“We are witnessing a sea change in Alzheimer’s care,” he said.
“For the first time, we have treatments that can slow the underlying disease, not just relieve symptoms.”
“Research must reflect the patients we actually treat. The Middle East has distinctive genetic, metabolic, cultural, and lifestyle characteristics that deserve to be studied.”
“We need to move from treating dementia late in life to protecting brain health throughout life.” Dr Krieger is set to lead the UAE’s first brain health clinic, due to open in Dubai later this year.
It offers a suite of new preventive measures to keep pace with the healthcare demands of an ageing population.
“This clinic is the first in the Middle East, but we need more of those that take dementia before it actually happens, it is as serious as a cardiology prevention clinic,” said Dr Krieger.
“At age 40, you should start treating your blood pressure, your cholesterol, and all of this in order to avoid a stroke or heart attack at age 60.
“This is very similar for Alzheimer, as it takes two to three decades to fully develop.”
Brain clinics
The clinic will call on those with a family history of dementia, those experiencing symptoms or those wanting to have a blood test or health check to assess their lifestyle.
Poor sleep, lack of exercise, smoking, alcohol and a poor diet can all contribute to a greater risk of neurodegenerative disorders.
National dementia plans are the bedrock on which a successful dementia care pathway can be built.
In Japan and South Korea, people living with dementia are placed at the heart of the countries' responses to community health care.
In 2026, South Korea implemented its fifth national dementia plan, which enables people living with dementia to continue living within their communities and to access medical and social support services.
In Japan, implementation of a long-term care insurance scheme is compulsory, and the scheme applies to everyone aged 65 and over.
It features a care needs certification that is determined by a person’s physical and mental health.
It means people living with dementia are eligible for support if they have a formal diagnosis.
Dr Mohammad Ghatali, consultant neurologist at Mubadala Health Dubai, said the UAE is moving towards a more preventive model of dementia care.
“Over the past five years, we have seen an important shift in Alzheimer’s disease care from managing symptoms after cognitive decline towards earlier diagnosis,” he said.
“Historically, many patients presented only when memory problems had become obvious and were beginning to interfere with daily life and independence.
“This remains a challenge. What is changing is our ability to identify Alzheimer’s disease earlier and more accurately.
“Ultimately, an ageing population requires us to think about brain health in the same proactive way that healthcare systems already approach cardiovascular disease, diabetes and hypertension.
“The objective is identifying those at increased risk, recognising meaningful changes earlier and ensuring that patients reach appropriate specialist care.”
