Exploring perspectives on new disease-modifying therapies for Alzheimer’s

Professor Iracema Leroi, Associate Professor of Geriatric Psychiatry, School of Medicine and Global Brain Health Institute is one of four new Irish Research Council New Foundations 2022 awardees for the School of Medicine.

The project, led by Professor Leroi entitled: Scoping public and professional perspectives of the new disease-modifying therapies (DMT) for Alzheimer’s disease (AD) in Ireland willexplore the views of people at risk of or diagnosed with, Alzheimer's or other dementias, and the wider public and professionals on the new disease-modifying therapies (DMTs) for Alzheimer disease.A DMT is as an intervention that produces an enduring change in the clinical progression of AD.

Until 2021, there was no licensed treatment to delay or slow the progression of Alzheimer’s disease which has significantly limited treatments offered to people at risk of, or diagnosed with, Alzheimer's or other dementias. However, over the past five years, the emergence of a pipeline of drug treatments targeted at disease modification (DMTs), and the growing evidence for dementia prevention through risk reduction, has made the prospect of slowing or preventing dementia a reality at last.

To embrace this progress, our current approach to the diagnosis and management of Alzheimer's through Memory Clinics in Ireland, as well as our health system overall, must radically change.

The mode of drug administration (i.e. infusion not oral), side effect monitoring (i.e. serial brain scans), cost of the drug, and the need to verify a diagnosis using complex biomarkers in the very earliest stages of the disease, will all differ from current practice. Thus, health system readiness must be urgently addressed. To support this, we aim to survey public and professional stakeholders in Ireland regarding their perspectives on DMTs, since such views are critical to health developments.

This project represents the first ever public exploration of perspectives and attitudes about this critical change in Alzheimer treatment, and has several potential benefits at a national as well as international level, which have significant implications for care recipients and their families.

The potential benefits are:

Improving the brain health of Irish residents and reducing the incidence of dementia in Ireland’s aging society. A wide-ranging national survey about Alzheimer’s DMTs and the need for very early diagnosis will increase national engagement and public health literacy regarding brain health/dementia, which is essential for future dementia prevention.
Informing critical health system changes by providing the critical groundwork for the introduction of Alzheimer's DMTs in Ireland by informing the health system about the views of public stakeholders regarding the necessary changes in memory clinic provision, national brain health policy, and the National Dementia Strategy.
Informing policy regarding older person’s brain health in Ireland: Understanding the views of lay stakeholders regarding new Alzheimer's therapies is vital for upcoming health policy formulated by partners ASI (i.e. critical advocacy work including Pre Budget Submissions), and the National Dementia Office (i.e. architects of the National Dementia Strategy). This work has the potential to significantly improve/enhance ASI’s services and communications ensuring the needs of people at risk/affected by dementia are met.
Raising dementia research awareness and participation: By directly involving the Irish public as study participants, we will foster an awareness of dementia research in Ireland, and the crucial need for Ireland to be part of the global research agenda for Alzheimer’s. DMTs are a core part Ireland’s dementia clinical trial program supported by partner Dementia Trials' Ireland and public perception of DMTs will be important to ensure successful recruitment and uptake of participants in DMT clinical trials to move the field forward and ensure new drugs are licensed for Alzheimer's and the other dementias.

Professor Leroi said:

“This award provides us with an important opportunity to understand how critical new treatments for Alzheimer’s disease may be implemented in Ireland. Without such an understanding, we risk inequitable access to new therapies across the state.”

The collaborators on this project are: