Alzheimer's prevention highlighted
By JULIAN SHEA in London
China Daily
1575027849000

A caretaker at Beijing Intech Nursing Home, a private facility, looks after an Alzheimer's patient in March 2011. (Photo: China Daily)

Simple steps could help China deal with growing medical problems

In 2019, the People's Republic of China celebrated its 70th birthday, and for its age, it is in good health.

Figures from the National Health Commission reveal that in 2018, average life expectancy had risen to 77 years. The National Bureau of Statistics reports that between 2012 and 2018, the number of people in poverty in rural areas fell from nearly 100 million to 16.6 million and the Belt and Road Initiative is boosting China's profile worldwide.

But there is one unavoidable, more alarming side to ageing. China has the world's biggest Alzheimer's disease problem. In 2017, the South China Morning Post reported that there were at least 9.5 million diagnosed sufferers on the Chinese mainland, and if numbers continue to grow at the current rate, by 2050 China will have around 45 million cases, almost half the world's total.

The implications could be devastating, but recently hopes were raised when the country granted conditional approval to its first self-developed treatment, a product called Oligomannate, which uses extract from marine brown algae as its raw material.

Shanghai Green Valley Pharmaceuticals, which developed the drug, said "trial results demonstrated … statistically improved cognitive function in mild-to-moderate patients as early as week four, and the benefit was sustained at each follow-up assessment visit".

The news came shortly after companies including Pfizer and Johnson and Johnson abandoned projects because of unsatisfactory data, and publication European Scientist reported that Green Valley must still submit evidence of the substance's long-term safety and effectiveness to China's National Medical Products Administration.

So, what is the outlook for sufferers, and how might the disease's impact on the next generation be managed?

The Dementia Research Centre at University College London, also known as UCL, is an international treatment hub, and its work will increase further when its new 281-million-pound ($359 million) neuroscience facility opens.

Professor Alan Thompson, dean of faculty of brain sciences at UCL, said it will "transform our ability to tackle the devastating global health challenge of neurological diseases such as dementia … we aim to create the most comprehensive, coordinated translational neuroscience research hub in the world".

A significant donor is UCL alumna Cathy Lee, wife of Hong Kong-based Henderson Land Vice-Chairman Martin Lee Ka-shing, who saw her grandmother succumb to the disease.

"It's almost like this disease is invisible," she told the South China Morning Post. "It's not something you really hear about on the news because it is not shocking enough."

Professor Claudia Cooper is a UCL Alzheimer's specialist with almost 20 years of experience in the field. She told China Daily that, as understanding has increased, talk has moved from finding a cure to reducing risk.

"Dementia is an umbrella term for a variety of scenarios where you develop cognitive problems, such as memory loss, that are sufficiently severe that they impact on daily life," she explained.

"The most common form is Alzheimer's. As you age, you are at increased risk, but there is evidence that lifestyle changes make this less likely. A study on prevention, treatment and care identified nine modifiable risk factors associated with Alzheimer's. One is being less educated — it's called cognitive reserve, which in simple terms means the bigger your brain is at the start, the more you have to lose before you develop symptoms. Other pointers include if you have a hearing impairment, a less active lifestyle, mental health issues, or diabetes."

She said a global problem needs a global solution.

"If anyone in the research community finds anything that works, it's likely to be adopted by others," Cooper added. "The United Kingdom and United States have done a lot of research but the mindset now is moving away from the attitude of 'we're ahead and have things to teach others'. It's all about seeing what we can learn from one another. You'd never embark on a new study without checking international research first."

Different societies have their own way of interpreting things, but some things cut across boundaries, such as the importance of being active.

"Alzheimer's pathology can build up for 15 years before you actually get a diagnosis, so earlier intervention is needed. Understanding of what you can do to prevent dementia has really grown too," she said.

"Each country has its own take on what being active means. In China, they've looked at things like using the creative arts, storytelling, tai chi and dumbbell exercises. They're coming up with similar findings to ours but we don't have the strength of evidence yet to widely implement an adaptable intervention program."

While Oligomannate may give some hope, the long-term outlook for sufferers remains unclear. Until that changes, prevention seems more likely than cure. And there are several simple ways in which, for China and the rest of the world, that is largely already within reach.