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Dementia Prevention: Imaging risk in primary care and catalysing behaviour change

Periodic Reporting for period 1 - DEMPREV (Dementia Prevention: Imaging risk in primary care and catalysing behaviour change)

Période du rapport: 2019-09-01 au 2020-02-29

CONTEXT

Dementia is a leading global health challenge. In EU28, it costs approximately €200 billion/year and brings distress and heartbreak to 8.7 million people diagnosed and cared for by 16.9 million unpaid carers. It is the leading cause of death in some countries, such as England. Radical change is needed as one in three people born today are expected to develop dementia in their lifetime.

PROBLEMS BEING ADDRESSED

- Dementia prevention is practically non-existent. 59% of the public believes that dementia is an inevitable part of ageing and that you cannot do anything to lower your risk
- People are diagnosed with dementia once they are symptomatic. By this stage, significant and irreversible death of brain cells has occurred. Even if novel pharmacological or stem cell treatments were discovered in future decades, this late detection would severely limit their effectiveness
- There are very few treatments of limited benefit available for clinicians to prescribe: 99.6% of dementia treatment clinical trials have failed, and no new drugs have been developed for 15 years

Solutions are needed to reduce incidence of dementia in the next elderly generation by:
- Identifying at-risk individuals before the cycle of irreversible neuronal death occurs
- Helping these individuals reduce the chance that this cycle begins
- Developing drugs to help delay or slow down the progression of dementia in those people who do develop symptoms.

Mind over Matter (MoM) is developing two technologies to enable this reality: 1. A low-cost, portable, simple-to-use and non-invasive neuroimaging headband able to determine dementia risk at least a decade before symptoms appear with high sensitivity and specificity. 2. Intelligent behaviour change app to help individuals reduce their individual risk by up to 50% through lifestyle changes.

IMPORTANCE TO SOCIETY

Through its technologies, MoM aims to:
- Ignite a dementia prevention movement by increasing awareness and understanding of dementia and its risk factors
- Improve health through early intervention. With dementia being the most-feared disease for 68% of people in the west, it could be the most effective vehicle for catalysing healthier lifestyles. It could also support development of effective pharmaceutical solutions to prevent or slow down the disease
- Close the health and wellbeing gap by being low enough cost and operable by non-specialists to be used in community settings
- Control health and care costs by delaying onset if not preventing dementia, with very significant and much-needed cost savings for public acute healthcare, residential care and home care commissioners and providers, and society at large

PROJECT OBJECTIVES

Technical Question: “Does the unique information about an individual’s risk for developing dementia available from measuring brain inflammation using the headband (as compared to the information available from knowing clinical risk factors only) increase predictive power sufficiently for clinicians to prescribe a dementia prevention strategy?”

Commercial Question: “Could the total solution be manufactured for a price that potential customers would be willing to pay?”
WORK PERFORMED IN THIS PROJECT

During this H2020 SME Instrument Project we have:
- Built prototype neuroimaging headband
- Designed and prepared the technical feasibility trial to collect signals using the prototype
- Collected neuroimaging signals and other trial data from volunteers
- Collected feedback from potential customers about route to market, willingness to buy and price point
- Assessed technical feasibility to develop a productised version of the headband within the willingness to pay envelope
- Refined subsequent product development technical and commercial plans

MAIN RESULTS

Technical Question

Preliminary findings indicate there are differences in the average brain electrical activity and blood flow signals between people aged 65+ with mild cognitive impairment or dementia compared to people aged 65+ without mild cognitive impairment or dementia. Analyses of the data collected from individuals aged 50-65 with healthy cognition so far find that CBF shape features vary but ERP shape features are consistent from one subject to the next. This very early finding indicates that it is possible to use concurrent measures of brain electrical activity and blood flow to predict dementia risk.

Commercial Question

High-volume manufacturing cost calculations and feedback from clinical stakeholders indicate feasibility of the headband from a financial point of view. There could be a wide range of purchasers, from individual GPs to regional or national clinical bodies, and from individual consumers to businesses such as large employers, providers of private healthcare services and gyms.

DISSEMINATION EFFORTS

We have raised awareness of our technologies to GPs, specialist clinicians, clinical commissioners, Alzheimer’s Research UK, local councils and the public. Some of these individuals were subsequently recruited to our trial.
PROGRESS OVER STATE OF THE ART

- Greatly more sensitive and specific dementia risk scoring during mid-life. As susceptibility to inflammation from elsewhere in the body (e.g. due to diabetes, lack of physical activity, poor diet) 1. entering the brain and 2. causing damage to brain cells, is genetically controlled, the headband provides a remarkable window into the interaction of genetic and lifestyle factors to create truly personalised medicine intelligence non-invasively and at an early time-point in dementia progression (at least a decade before symptoms appear)
- Low-cost, simple-to-use and non-invasive method for calculating dementia risk with high accuracy. Other methods for collecting the same neuroimaging signals, such as MRI, OCT and PET scanning, have greatly reduced possibility for making widespread impact because of their high cost, size, radiation and requirement for specialist operators
- Linking of dementia risk-scoring technologies to an effective disease prevention tool (the behavioural change app). The app uses artificial intelligence to tailor content to the individual user, focussing on the lifestyle risk factors that would help to reduce their dementia risk most, paced according to their psychology and preferences, and incentivised in a number of ways (psychoeducation, community forum and rewards)

EXPECTED IMPACTS BY PROJECT END

This project has progressed the headband towards TRL 5. The positive results lend strong support to the continuation of this R&D and future development of ground-breaking products.

POTENTIAL IMPACTS

The headband is a measuring device and hence it has a very wide range of applications spanning academic research to drug development to clinical and public health improvement. Preliminary results emerging from the project indicate that, in combination with MoM’s behaviour change app, it has potential to transform scientific understanding of dementia and societal attitudes towards the disease, significantly reduce the number of people who develop the disease in future, and significantly improve the prognosis of those who do. Each of these applications could result in very significant benefits to society, including avoided years of disability and premature mortality, improved quality of life for people with dementia and their friends and family and cost-savings for employers, health and care providers and tax payers.
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