Dementia: Fuelling the Moonshot

Baroness Brinton Excerpts

Tuesday 16th November 2021 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, I add my congratulations to the noble Baroness, Lady Greengross, on securing this important debate, and to the All-Party Parliamentary Group on Dementia on the publication in September of the very powerful report Fuelling the Moonshot. I also thank Alzheimer’s UK and the UK Dementia Research Institute for their briefings. It is especially good to see the research side and the community-facing side coming together to work. I have seen this in the arthritis field, and there are real benefits it can bring.

There is nothing to beat evidence-based care, as the noble Baroness, Lady Greengross, has already said. She noted that 850,000 people are living with dementia, and that the number will increase as we in the baby-boomer generation come to our later years. Some 11% of deaths in 2020 were from Alzheimer’s and dementia. But past data on the number of dementia deaths is difficult to ascertain. My family knows about this from our own experience. In my father, a broadcaster and later an MP 40 years ago, who died over a decade ago, we saw the consummate communicator that he was change as vascular dementia took over. When he finally went into hospital and died, it said “cancer” on the death certificate. My stepmother had to ask for “dementia” to be added. His last years were blighted by dementia, but it appeared then that it was not recognised. It was added—although in a different-coloured pen, which seems bizarre. Even that caused problems later, with people querying why a cause of death had been added in a different colour. So it is good that it is now routinely listed on death certificates, and I thank my stepmother and those like her who, over the years, have fought for this to happen.

It is shocking that dementia research has been funded so poorly compared with many more “attractive” medical issues, given the high number of people who have it. But it is not just an issue of research; the current crisis in social care speaks volumes about the way dementia and elder care are funded by the state, and how they are misunderstood or even ignored by too many of the public. Today’s debate is about finding that elusive cure, and this report is excellent for setting out a road map for the Government to help fund, facilitate and encourage.

The words in the Tory manifesto, already mentioned by other noble Lords, are absolutely clear and set out in the moonshot report. The Conservative Party’s 2019 election manifesto made a commitment to save millions of people and their families from suffering the agony of a slow decline due to dementia. The party promised that it would make

“finding a cure one of our Government’s biggest collective priorities—one of the ‘grand challenges’ that will define our future … This will include doubling research funding into dementia and speeding up trials for new treatments.”

The party also committed to investing

“more than £1.6 billion … into research over the next decade to find a cure for dementia under a Conservative majority government”,

which would provide the

“largest boost to dementia research ever in the UK … double current funding levels”

and set

“Britain’s finest scientists to work on a ‘Dementia Moonshot’”.

These are fine words, but worryingly, in the Budget, Rishi Sunak announced a two-year delay to the funding of the £22 billion “sciences superpower”. Can the Minister say if this includes a delay to the £1.6 billion promised for dementia research in the manifesto? The wording in that Tory manifesto is unequivocal: it is

“one of our Government’s biggest collective priorities … that will define our future”—

except that if it is delayed, it is not. If there are concerns about it being included in the delay, I hope the Minister will undertake to put pressure on the Chancellor to ensure that dementia research is not part of this delay.

The recommendations in the report set out a number of key methods for achieving the moonshot, and I want to address one or two of them. The first is the

“novel methods for early diagnosis, such as blood and other biomarkers”.

It is noticeable that other diseases have benefited from such research. For example, 30 years ago someone with suspected coeliac disease could be diagnosed only by going into hospital and having a very uncomfortable gastroscopy procedure. Now, a simple blood test tells your GP if you have the markers, so you can then be referred speedily to a gastroenterologist. Other autoimmune diseases have benefited from similar ground-breaking research. Inflammation markers found through regular blood tests are now commonplace; I have blood tests monthly to monitor mine. There are many other markers that provide early diagnosis for other diseases, but not yet for dementia. Many other biomedical and translational research for other diseases, notably cancer, have also had access to long-term government planned funding, but not yet dementia.

For me, the most exciting moonshot report recommendations are about creating more centres of excellence and ensuring that anyone newly diagnosed gets the support they need at the start of their journey. The practical multidisciplinary approach is already using technology to help people to live well with their dementia. Professor David Sharp, the director of the DRI Care Research & Technology centre at Imperial College, is using technology in a pilot to help people living with dementia avoid hospitalisation. It is shocking that 25% of hospital beds are currently taken up by people living with dementia. These new technologies can monitor people in their homes and enable the early identification of risks such as sleep disturbance, incontinence, or infections. They know that this works. The early detection of these risks could enable people with dementia to live at home safely for longer. Access to that funding would allow the trials to happen on a larger scale, and then perhaps become commonplace. There is another benefit too: it will reduce the costs to and pressures on our hospitals.

I move now to the workforce to deliver the moonshot. The fourth recommendation in the report is

“to establish a specific fund of £40m to support both clinical and preclinical postdoctoral research positions”.

These are vital if talent is to be attracted and retained in dementia research. Can I ask the Minister if this is also part of the manifesto promise and if it, too, might be delayed? Dementia has in the past been a poor relation, and it becomes harder to attract clinical postdoctoral research students. If there is no money, there are no students, and no students means no future research scientists and professors, and without a long term well-funded scheme it will not get the momentum that it so badly needs.

There is a particular importance in attracting talent from abroad, which our universities and research establishments have thrived on for many years. On the power of research funding, the report says:

“The creation of institutions like the UK Dementia Research Institute has attracted world-leading talent to the UK from across the globe.”


It says that the director of the UK DRI, Professor Bart De Strooper, estimates

“that around a third of its research Group Leaders have come from overseas”,

and that he

“himself moved to the UK to lead”

the work here,

“being impressed by the UK’s research infrastructure and ambition to be a world leader in the field.”

However, we know that, at present, it is harder to attract first-class talent from abroad, so a scheme such as this, with government support, would be very beneficial.

For the UK DRI’s new report, Race to Cures, it conducted a survey of more than 200 researchers, which found that 90% think that new treatments for dementia will be found in the next 10 years. Nearly three-quarters think that the pace of discoveries and breakthroughs is increasing, and 100% think additional funding is important to enable breakthroughs. As someone who has seen grandparents and parents living and dying with dementia, I am really encouraged that researchers think new treatments will be found within the next decade. But that cannot happen on thin air, and the moonshot report from the all-party group sets out the mechanisms by which the Government can deliver their manifesto promise. I urge the Minister to help deliver the funding needed to make this a reality, so that dementia is no longer a grim sentence that people really fear.