Dementia care has waited a long time for a piece of good news, and some good news has finally arrived. According to a new report from Alzheimer’s Disease International, nearly 160 potential therapies are now in trials worldwide, and experts say the field is on the cusp of a revolution, much like the one that is transforming cancer care. After decades of frustration, such treatments could loosen the grip of this distressing and debilitating cognitive illness.
Nevertheless, much work remains to be done. For the Middle East, home to one of the world’s fastest-ageing populations, a relative lack of such international trials – which are often focused on western, mostly white populations – clouds the picture. Genetics, vascular health, education and income all influence who develops dementia, who is diagnosed with it and how patients respond to treatment. Results from one population cannot be assumed to hold for another.
The UAE is extraordinarily well placed to correct this imbalance. Through its Emirati Genome Programme, close to a million UAE citizens have offered their genetic data to help with research and studies. In July, The National reported how Abu Dhabi was already using this information to identify people at high risk of Alzheimer’s for a trial of a preventive therapy. The value of local data is clear; earlier this month a major international study into Parkinson’s disease revealed significant blind spots in meeting the needs of the Middle East, despite people from the region carrying a key genetic variant associated with the condition.
As well as supplying vital data, the UAE’s genome project also reveals that people in the Emirates are willing to take part in scientific experiments or data collection, when it is well explained. This participatory goodwill is vital if research gaps are to be plugged. Active dementia trials need about 55,000 participants globally, and because many volunteers prove unsuitable, a pool of roughly 350,000 is required.
This is where the UAE could step in. As well as providing key data on its Arab population, the Emirates, which is home to more than 200 nationalities, is one of the most diverse places in the world in which to run such trials. That is a scientific asset as much as a social one.
Right now, dementia trials suffer from low awareness, limited doctor referrals and strict eligibility criteria. Oncology, where referral pathways for trials are much better developed, offers a model for future progress. Hospitals, clinicians and governments should make it easier to join a trial, with clear referral routes and plain explanations of what taking part involves. The UAE has the potential to lead the region by promoting participation as a civic contribution.
In this way, the Gulf can become a region where medical trials are designed for the people who live here. At the same time, it can harness its diverse population to make scientific discoveries of international importance. That would be another piece of good news, especially for those whose lives are personally touched by complex diseases.
