Community-based programs supported by the Davos Alzheimer’s Collaborative, each adapted to the local country and culture, are testing new ways of managing dementia care. Learn more in our special report, The New Age of Alzheimer’s.
It’s never too early to start maintaining good brain health. That is the message Alzheimer Scotland is sending to children as young as eight, with advice on diet, exercise and keeping up a social life, packaged in online material with eye-catching graphics—and, indirectly, to their parents as well. “The children can be a very good catalyst for conversation in the home and so raise awareness,” says Jim Pearson, the nonprofit’s policy director.
The imaginative approach is typical of Scotland, which increasingly sees itself as a world leader in the field of dementia care, prevention and research. Thirteen years ago, the Scottish government brought out its first national dementia strategy. Since then, it has followed with three more, the latest in 2023. The Brain Health Scotland initiative, which distributes the brochures to schoolchildren, has the support of the government, prominent academics and Alzheimer Scotland.
In its dementia strategy, Scotland promises every person who has Alzheimer’s a minimum of one year’s support from a named caregiver after diagnosis. A network of dementia resource centers spans the country. And an Alzheimer’s phone helpline has been running since 1989. With an eye to publicity, last year Brain Health Scotland launched a clinic at Murrayfield, the home ground of Scotland’s rugby team in Edinburgh, where former players go to get regular brain checkups. The National Health Service (NHS) hopes to set up a chain of similar clinics nationwide by 2025.
About 90,000 people in Scotland have dementia. It is one of the country’s leading killers, with a death rate similar to coronary heart disease. Government authorities have come to recognize the role of lifestyle factors in contributing to the disease, as well as the importance of early diagnosis. Together with a new generation of drugs that slow the progress of Alzheimer’s, experts reckon that reducing exposure to 12 key risks, such as diabetes or alcohol consumption, can delay or prevent 40 percent of dementia cases.
Researchers have access to a vast pool of anonymized data in the centralized healthcare system of the NHS. Scotland can also lay claim to its own particular tradition of medical record-keeping. As far back as the 1930s, it launched a unique survey testing the intelligence of the nation’s children. The performance of almost all those born in 1921—more 80,000 in total—was logged, creating a useful reference resource for population studies.
The spirit of cooperation among the main stakeholders is crucial. For instance, the University of St Andrew’s, the country’s oldest university and the alma mater of Prince William, has twice in the last two years hosted international brain-health summits, bringing together leading figures from what’s called the “triple helix” of universities, healthcare providers and the commercial life sciences sector. “What is unique in Scotland is the level of collaboration,” says Pearson.
Such joint efforts hold out the promise of commercial dividends. Frank Gunn-Moore, an expert in neurodegeneration at St Andrew’s—whose recent work on the brains of stranded dolphins made headlines by revealing that their brains showed some of the classic markers of human Alzheimer’s—is seeking to create a government-backed fund that would help form spin-out companies from all Scottish universities working on Alzheimer’s and dementia. “Drug companies really want to work in Scotland because it’s manageable,” says Gunn-Moore. “We are ambitious: we really want to go big scale.”
It’s happening already. Earlier this year the healthcare giant Roche Diagnostics announced a partnership with Scottish Brain Sciences (SBS), an Edinburgh-based research institute, to explore the earliest biological signs of neurodegenerative disease using blood-based biomarkers. “Early diagnosis will be transformative in the way we assess, manage and conceptualize clinically Alzheimer’s disease,” says Craig Ritchie, the firm’s founder and CEO, who has emerged as a central figure in the world of Alzheimer’s research and prevention. The selection of SBS for the project was a “huge vote of confidence in the Scottish life sciences sector.”
Disillusioned by the bureaucracy of the NHS and the lengthy delays facing patients waiting for appointments at memory clinics, SBS is now rolling out its own network of dementia-prevention research centers across Scotland. On offer will be free access to the latest diagnostic tests and medication through big drug trials funded by the pharmaceutical industry. In Ritchie’s words: “We are ready for this next generation of treatments to start. The problem is the infrastructure is not in place to do it.”
Scotland is one of six countries participating in a pilot program, funded by the Davos Alzheimer’s Collaborative, that is making new blood tests and digital cognitive assessments available to Alzheimer’s patients. “We have a proud history of being at the forefront of dementia policy, of being half a step ahead of others, so it follows naturally that there’s interest in research,” says Wendy Chambers, a dementia consultant working on the trials.
Who knows where that will ultimately lead? Chambers says: “It might not change much for my generation, but it certainly starts to change what the progression of the disease looks like for future generations.”
This article is part of The New Age of Alzheimer’s, a special report on the advances fueling hope for ending this devastating disease.