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DR CLAIRE TAYLOR:
Our population is ageing,

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and as we're all getting older,
rates of dementia are rising.

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It's just as if somebody
had switched my brain off.

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Dementia is the UK's
fastest-growing health condition.

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I don't think Marie understands
herself, really,

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the changes
that have happened to her.

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Our ability to think,
our memory and our reasoning

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are things we all hold dear.

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It's how we define ourselves.

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The thought of losing those
is almost unimaginable.

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We are more scared
of being diagnosed with dementia

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than we are of getting cancer.

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There is no known cure for dementia,

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but research is moving fast,
looking for new drugs to treat it

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and ways to protect us
from getting it in the first place.

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The evidence seems to be building
that actually, lifestyles

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may have a larger role to play
than we had perhaps assumed before.

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To find out who's most at risk
from dementia,

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I want to meet those living with it.

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I'd put a saucepan of water on
to make coffee at home.

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A minute later, I thought,
I turned round,

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and it had boiled dry.

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I want to uncover
the very latest science.

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Cells die, tissue is lost.

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People are left to function with
much less than they should have.

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'I'm going to be a human guinea pig,

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'putting myself to the latest test
to reveal the earliest signs.'

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Are you ready for the first one?
I think so.

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'I believe that by understanding
how dementia can affect us,

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'I can help shed light on a question
that so often gets asked.'

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My name is Dr Claire Taylor,
and I'm an NHS GP.

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Last year, I travelled the country,
seeing patients

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in the GPs Behind Closed Doors
mobile surgery.

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I saw many patients
with memory issues.

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Can you remember that address
I told you?

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No.

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And more specifically,
a concern they might have dementia.

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And I'm terrified
that I might get it,

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and then who's gonna
look after John, you know?

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'The term "dementia" covers a group
of conditions that affect the brain.

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'It's progressive and degenerative,
and there's currently no cure.'

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It's not surprising
that people are worried.

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We're in a country
with an ageing population,

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and there are headlines about
dementia in the news most weeks.

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It can be daunting, and rightly so.

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Dementia was the leading cause
of death in 2022,

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and there are twice as many people
living with the disease

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as there are living with cancer.

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But diagnosis is a long process.

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So, this is the tool
that I have as a GP

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to assess people
in clinic for dementia.

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It's a very simple screening test.

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It has just six questions
which look at recall and memory,

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and then a context part to it
where I ask the patient

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why they're worried
and what's impacting them.

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I'm gonna ask you
a few questions now.

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Who is the present monarch?

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Erm...

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Er, the new king.
You're talking about the Queen died.

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So that is, erm... Now, that is...
That's gone.

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That has gone.

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'If they struggle, I'll refer them

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'to a specialist memory clinic
for further investigations.'

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They can do
some more specific testing

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around where that memory
is letting you down.

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'But this process can take anything
from a few weeks

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'to more than a year.

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'An early diagnosis
can make a real difference

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'to how we treat dementia.'

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I want to find out what we can do
beyond this checklist.

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If you think you may be at risk
of getting dementia,

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what are the very earliest signs
you need to look for?

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But first, I'm going to find out
what it's like

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to live with dementia
in the real world.

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I normally only get to see
my patients in the GP surgery,

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and there's a limited amount
of information I can gather

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in a clinical setting.

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Today, I'm going to meet someone
with Alzheimer's

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in a completely different
environment.

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WOMAN: Two, three, four.
One, two, three, four...

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'87-year-old
award-winning dancer Kenneth

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'was diagnosed with
Alzheimer's disease two years ago.

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'It's the most common form
of dementia,

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'accounting
for nearly 70% of all cases.

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'Kenneth's been dancing for 50 years
and has no intention of stopping.'

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Thank you very much.
Lovely to meet you. I'm Claire.

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Tell me, what drew you to dancing?

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Dancing is a major part of my life.

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It is so stimulating. It's exciting.

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I mean, I can't think of anything
that is equal to dancing.

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Wonderful.

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But I used to dance
seven nights a week. Wow.

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And I'd be the first one in there
from seven o'clock in the evening

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until one o'clock in the morning.
Wow.

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And I absolutely loved it.

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And that love is still with me.

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'The dance floor was also one of
the places, around three years ago,

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'where Kenneth first noticed
something amiss.'

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When I was doing an exam,
I was doing a jive,

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and I stopped halfway through it.

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My partner, teacher, said,
"What are you doing?"

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"I don't know."

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I said, "It's gone. It's...
I don't know what I'm doing.

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"I don't know what I've done.

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"And I don't know
what I've got to do next."

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It's just as if somebody
had switched my brain off.

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That must have been
really difficult.

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'Forgetting something
that you previously knew well

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'is often one of the first signs
of Alzheimer's.

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'But Kenneth didn't know that then.

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'He didn't seek help
until a few months later.'

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I'd put a saucepan of water on
to make coffee at home,

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and a minute later, I thought,
I turned round to make my coffee,

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and it had boiled dry.

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I was determined
to go and see the doctor

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because this was definitely not me.
Mm-hm.

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It's only because I became aware
that something's wrong with me

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that I started to pay attention
to Alzheimer's and what it is,

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how it is, what it does,
the way it affects people.

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'Kenneth was diagnosed
two years ago,

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'more than a year
after he first noticed symptoms,

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'but he still loves to dance.'

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Thank you so much
for talking to me,

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and I won't keep you
from your dancing.

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No, you're not going without...

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We'll have a dance together first.

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'That was wonderful
to dance with Kenneth.'

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And so great that he's still able
to do the thing he loves

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despite his Alzheimer's disease.

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Kenneth's very typical
of my patients.

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He lost his memory for some time
before he sought a diagnosis.

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It was only when something dangerous
happened that he saw the doctor.

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But memory loss
isn't the only symptom of dementia.

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Next, I want to find out
if there might be other ways

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for people like Kenneth,
or anyone else who might be worried,

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to spot the very earliest signs.

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An estimated two thirds of people
in the UK

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over the age of 50
fear they will develop dementia.

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Memory loss is generally recognised
as the first outward symptom,

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but it's only by looking
inside the brain

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we can understand
what's really going on.

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Coincidentally,
my next stop is a place

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that holds a lot of memories for me.

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It's bringing back so many memories
being here at Bristol University,

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where I was at medical school.

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Today,
I'm at the Bristol Brain Bank,

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and I'm going to get to see
some dissection.

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It's been 20 years
since I've dissected a brain,

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and I'm really excited.

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'The Brain Bank collects and stores
brain tissue donations...'

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Hi.
Hi, I'm Claire.

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'..from both people
who have died with dementia

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'and those with no sign of it
at all.

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'By looking at samples like these,

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'scientists have been able
to determine

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'that there are over 100
different subtypes of dementia,

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'all of which affect the brain
in slightly different ways.'

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We can see here,
using these 3D models...

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So these were taken
from scans of patients.

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This person had Alzheimer's disease,

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and this person didn't have
any known neurological condition.

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If you want to feel the weight of
the person with Alzheimer's disease

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and compare it
to the person who didn't.

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Gosh, so much lighter.

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They can lose up to a third
of the weight of their brains.

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That much? My goodness.

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'All forms of dementia
cause cells within the brain to die.

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'But Alzheimer's in particular
leads to large losses.'

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As the cells die, tissue is lost.

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People are left to function with
much less than they should have.

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'With many dementias,
this damage is caused

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'by a build-up of proteins
in the brain.'

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We think that they begin
to accumulate in our 30s and 40s,

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which is why, if we're going
to look at preventing these diseases

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in the future,
we need to start to learn

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who is affected
by the build-up of these proteins

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and perhaps how we can stop that.

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'By dissecting the donated brains,

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'Laura can see which areas
have been affected by cell death.'

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May I hold that?
Of course.

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Wow, I never got to do this
in medical school.

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It makes such a difference,
doesn't it,

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to see the real structures?

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All the things
that we can learn in textbooks

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don't substitute for the real thing.

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'Different types of dementia
cause damage

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'to different parts of the brain.'

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We've got the frontal lobe -

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so the area in the brain

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that's particularly important
for our behaviours.

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We've got the temporal lobe,

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the primary site in the brain
for learning and memory.

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'This means that each dementia
comes with its own set of symptoms.

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'Behavioural changes can be linked
to vascular dementia.

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'Sleep issues with hallucinations

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'can be a sign of dementia
with Lewy bodies,

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'and a much rarer form,
like frontotemporal dementia,

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'can have symptoms
such as vocabulary loss.

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'But what they all have in common

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'is that the diseases
that cause dementia

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'start much earlier
than you might expect.'

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That was fascinating.

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Seeing how the changes in the brain

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of symptoms of dementia

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just shows how important it is
to get an early diagnosis.

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But with over 100 types of dementia,

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spotting those early signs
is really not straightforward.

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But it's not only unusual symptoms
that prevent an early diagnosis.

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For some people, it's their age.

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So, today,
I'm going to go and see Marie,

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who is a patient who has been
diagnosed with dementia.

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She isn't
your typical dementia patient.

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Marie was diagnosed four years ago
at just 49 years old.

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Hi, Neil. I'm Claire.
Hi, Claire.

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Lovely to meet you.
Come in.

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Hi, Marie. Lovely to meet you.

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Thanks so much.
Nice to meet you as well.

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'As a primary school teacher,

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'it was with the children
in her class

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'that she first noticed lapses
in her memory.'

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There you go, Claire.
Thank you.

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I would always know their names.

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In Year 3, there was 30 of them,
and I knew all of those 30.

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But then recently,
I forgot all of their names.

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And did you worry
it might be dementia

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when you first started
having these symptoms?

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No, I didn't think it was.

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Only when I was, you know,
being tested.

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Mm-hm.
Yeah.

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'Initially,
Marie assumed it was menopause.'

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You were having hot flushes
at the time, weren't you?

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You thought it was the menopause,
that's what was making you forget

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words and places and things,
wasn't it? Yes.

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Looked into the menopause
a little bit, and it was right,

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all the symptoms you both mentioned,

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we kind of said,
"OK, it might be that."

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And then they told me
that it wasn't menopause.

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They told me dementia.

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'Marie has semantic dementia,

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'a form of frontotemporal dementia
that starts by affecting

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'the comprehension of words.'

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I was just crying, you know,
all the time when I had it.

243
00:12:40,020 --> 00:12:41,780
I never thought
I would have it before.

244
00:12:41,940 --> 00:12:45,260
And there was never a cure either,
so I was sad about it.

245
00:12:45,420 --> 00:12:47,220
And no family members
had ever had it or...?

246
00:12:47,380 --> 00:12:49,500
No, no.
No, they didn't.

247
00:12:49,660 --> 00:12:54,220
'Marie's condition is progressive,
and over the last four years,

248
00:12:54,380 --> 00:12:56,500
'life has changed
for the whole family.

249
00:12:57,980 --> 00:13:01,420
'Last year, Marie reluctantly
gave up her beloved teaching job,

250
00:13:01,580 --> 00:13:05,260
'and Neil has gone part-time to make
sure he's around to care for her.

251
00:13:05,420 --> 00:13:08,060
'And he's planning
to take early retirement.'

252
00:13:08,180 --> 00:13:10,860
Just really nice memories.

253
00:13:11,020 --> 00:13:14,340
It was best to be at home with Marie
to do things together.

254
00:13:14,500 --> 00:13:18,180
You see, she might be a little bit
blank or she's a bit confused.

255
00:13:18,340 --> 00:13:19,980
Then it's kind of like, you think,
"OK, yeah,

256
00:13:20,100 --> 00:13:22,100
"I need to just sit down with her."

257
00:13:22,260 --> 00:13:24,540
I don't think Marie
understands herself, really,

258
00:13:24,700 --> 00:13:27,100
what's... the changes
that have happened to her.

259
00:13:31,940 --> 00:13:35,780
'Early onset dementia is rare -
less than 5% of diagnoses.'

260
00:13:37,900 --> 00:13:39,900
'For most people
in their 40s and 50s,

261
00:13:40,060 --> 00:13:42,860
'brain fog IS menopause
or another condition.

262
00:13:43,020 --> 00:13:46,420
'One reason why memory isn't always
a reliable diagnostic tool.'

263
00:13:49,220 --> 00:13:52,380
Now scientists are looking at
other signs to spot dementia early,

264
00:13:52,540 --> 00:13:55,540
creating tests that one day
might be used for diagnosis.

265
00:13:56,860 --> 00:13:58,700
When someone has a problem
with their hearing,

266
00:13:58,860 --> 00:14:00,900
they don't necessarily have an issue
with their ears.

267
00:14:01,060 --> 00:14:02,900
Much of our hearing
comes from our brains,

268
00:14:03,020 --> 00:14:04,860
and we call that brain hearing.

269
00:14:05,020 --> 00:14:07,500
Studies have shown that people
with unaddressed hearing loss

270
00:14:07,660 --> 00:14:10,380
are five times more likely
to be affected by dementia.

271
00:14:11,980 --> 00:14:15,180
'At the Dementia Research Centre
at University College London,

272
00:14:15,300 --> 00:14:17,140
'Professor Jason Warren and his team

273
00:14:17,300 --> 00:14:19,020
'are investigating
some of the reasons why.'

274
00:14:20,540 --> 00:14:21,660
It's lovely to meet you.

275
00:14:21,820 --> 00:14:23,700
Although I'm slightly surprised
to be meeting you

276
00:14:23,820 --> 00:14:25,220
in the middle of a beautiful square.

277
00:14:25,380 --> 00:14:27,180
What's the reason
that we're meeting here?

278
00:14:27,300 --> 00:14:29,620
There's a lot of background noise.

279
00:14:29,780 --> 00:14:32,700
Your brain is doing
an amazingly complicated thing.

280
00:14:32,860 --> 00:14:36,940
So as we're talking, it's hopefully
paying attention to what I'm saying,

281
00:14:37,100 --> 00:14:41,460
but it's doing that in the midst of
a lot of other distracting sounds.

282
00:14:41,620 --> 00:14:44,860
'This is known
as the cocktail party effect.'

283
00:14:45,020 --> 00:14:47,340
If you're in a crowded place
and there's lots of chatter,

284
00:14:47,500 --> 00:14:50,060
and someone says your name
over the other side of the room,

285
00:14:50,180 --> 00:14:51,860
you can often zone in on it.

286
00:14:51,980 --> 00:14:53,380
And actually, with a bit of effort,

287
00:14:53,540 --> 00:14:55,540
it sometimes does take effort
and attention,

288
00:14:55,660 --> 00:14:56,900
you can track that conversation

289
00:14:57,060 --> 00:14:59,700
having been keyed in
by hearing your name.

290
00:14:59,860 --> 00:15:02,140
'Not just helpful
at cocktail parties,

291
00:15:02,300 --> 00:15:06,300
'this skill could be the key to
an early diagnosis of Alzheimer's.

292
00:15:06,460 --> 00:15:09,740
'And I'm about to see
how I measure up.'

293
00:15:09,900 --> 00:15:12,100
So, Claire, I'm gonna run
a quick test with you.

294
00:15:12,260 --> 00:15:16,100
'I'm at the mercy
of PhD student Ben and his clipboard

295
00:15:16,220 --> 00:15:17,660
'and feeling a little nervous.'

296
00:15:17,820 --> 00:15:19,940
You're going to hear
two pairs of sounds,

297
00:15:20,100 --> 00:15:22,460
and I'd like you to tell me
which four sounds you heard.

298
00:15:22,580 --> 00:15:24,180
Is that clear?

299
00:15:24,340 --> 00:15:27,380
'He's interested in whether my brain
can process two sounds at once.

300
00:15:27,540 --> 00:15:30,100
'If I struggle,
it could be an early indication

301
00:15:30,260 --> 00:15:32,780
'of the brain changes
that could lead to Alzheimer's.'

302
00:15:32,940 --> 00:15:34,980
So, if you'd like to go this way
into the booth.

303
00:15:35,100 --> 00:15:36,380
Thank you.

304
00:15:39,420 --> 00:15:41,860
Are you ready for the first one?
I think so.

305
00:15:41,980 --> 00:15:43,380
Great.

306
00:15:43,540 --> 00:15:46,540
'All I have to do is separate out
the individual sounds.'

307
00:15:47,740 --> 00:15:50,180
WHISTLE,
GARGLING

308
00:15:50,340 --> 00:15:52,460
LAUGHING,
THUNDER

309
00:15:52,620 --> 00:15:55,660
Gargling and whistle.
Laughing and thunder.

310
00:15:57,580 --> 00:15:59,900
BELL,
WHISTLE

311
00:16:00,060 --> 00:16:02,860
POURING LIQUID,
TYPING

312
00:16:03,020 --> 00:16:05,740
Bell and whistle.
Pouring liquid and typing.

313
00:16:07,820 --> 00:16:10,180
Pouring liquid and baby talking.

314
00:16:10,340 --> 00:16:11,860
'For 20 minutes,
I give it my best shot.'

315
00:16:12,020 --> 00:16:15,580
Gargling, typing.
Laughing and pouring liquid.

316
00:16:15,740 --> 00:16:19,740
Thanks so much, Claire.
You can take off the headphones now.

317
00:16:19,860 --> 00:16:21,140
How did you find that?

318
00:16:21,300 --> 00:16:23,900
Erm, harder than I expected,
actually.

319
00:16:24,020 --> 00:16:26,100
'Now the moment of truth.

320
00:16:26,260 --> 00:16:28,700
'Time for Jason to tell me
how I did.'

321
00:16:28,860 --> 00:16:31,460
First of all, just to say
that this is not a clinical test.

322
00:16:31,620 --> 00:16:33,060
But having said that,
you did very well.

323
00:16:33,180 --> 00:16:34,540
Oh, that's quite a relief.

324
00:16:34,700 --> 00:16:36,500
So, we're comparing
your performance,

325
00:16:36,620 --> 00:16:37,740
which is top of the range,

326
00:16:37,900 --> 00:16:41,740
with a group of healthy people,
probably around the age of 60,

327
00:16:41,900 --> 00:16:44,540
and a group of people
with Alzheimer's disease

328
00:16:44,660 --> 00:16:46,620
of different levels of severity.

329
00:16:46,780 --> 00:16:48,860
But if you turn to the people
with Alzheimer's disease,

330
00:16:49,020 --> 00:16:51,260
really have a very wide spread
of scores.

331
00:16:51,420 --> 00:16:54,260
They're all lower
than the healthy control group.

332
00:16:54,420 --> 00:16:56,660
And we think that
what's probably happening

333
00:16:56,820 --> 00:16:58,820
is that the test
is tracking the severity

334
00:16:58,940 --> 00:17:01,620
of their Alzheimer's disease.

335
00:17:01,780 --> 00:17:03,540
'It's clear to see
that Alzheimer's affects

336
00:17:03,700 --> 00:17:06,380
'your ability to distinguish
between simultaneous sounds.'

337
00:17:06,540 --> 00:17:09,700
Ultimately, we really do hope
that this sort of test

338
00:17:09,820 --> 00:17:12,140
will allow us to tell quite early on

339
00:17:12,300 --> 00:17:15,700
if somebody is on a trajectory
that's heading toward that disease.

340
00:17:15,860 --> 00:17:17,620
And if that's gonna be able
to give you a guide

341
00:17:17,780 --> 00:17:20,140
as to where people's illness is
or where their disease is.

342
00:17:20,260 --> 00:17:22,620
I mean, that would be so useful

343
00:17:22,780 --> 00:17:25,580
for all parts of managing
their dementia.

344
00:17:25,740 --> 00:17:28,420
'In the future, Jason and his team
are hoping that their tests

345
00:17:28,580 --> 00:17:31,860
'will be able to help
with other forms of dementia, too.

346
00:17:32,020 --> 00:17:34,780
'But in the meantime,
there's a clear message.'

347
00:17:34,940 --> 00:17:36,820
You shouldn't assume
because you've got a problem

348
00:17:36,980 --> 00:17:39,180
with your hearing that
you're developing early dementia.

349
00:17:39,300 --> 00:17:40,820
So go and get your hearing tested

350
00:17:40,980 --> 00:17:42,660
is the most important
take-away message.

351
00:17:42,820 --> 00:17:44,540
Absolutely.
And that's music to my ears as a GP.

352
00:17:44,660 --> 00:17:45,780
Yes. Yes, indeed.

353
00:17:47,700 --> 00:17:50,060
I'm really relieved to have
done well in that hearing test,

354
00:17:50,220 --> 00:17:52,100
but it was fascinating to hear
that hearing

355
00:17:52,260 --> 00:17:54,740
may be a better diagnostic indicator
than memory.

356
00:17:54,900 --> 00:17:56,780
In the future, I might be able
to use a hearing test

357
00:17:56,940 --> 00:17:59,820
in the surgery
to diagnose my patients.

358
00:17:59,980 --> 00:18:02,380
It's something that could have
got Kenneth, who I met earlier,

359
00:18:02,500 --> 00:18:05,140
a potentially much sooner diagnosis.

360
00:18:05,300 --> 00:18:09,140
He started having hearing problems
some 15 years ago.

361
00:18:09,300 --> 00:18:13,620
I'm not very good
when there is a group session

362
00:18:13,780 --> 00:18:17,140
and people are speaking
across each other.

363
00:18:17,300 --> 00:18:20,340
Being a disease of the brain,
dementia has the ability

364
00:18:20,500 --> 00:18:24,180
to change all aspects
of how we experience the world.

365
00:18:24,340 --> 00:18:27,580
And our hearing isn't the only sense
that can be affected by dementia.

366
00:18:29,180 --> 00:18:31,940
If your taste or sense
of smell changes,

367
00:18:32,100 --> 00:18:34,500
that can be
an early warning sign, too.

368
00:18:34,660 --> 00:18:36,820
And scientists are currently
developing a taste test

369
00:18:36,980 --> 00:18:39,620
that might also become
an early diagnostic tool.

370
00:18:45,060 --> 00:18:48,300
At a training facility
in a rainy car park in Essex,

371
00:18:48,460 --> 00:18:50,540
I'm about to discover
how these sensory changes

372
00:18:50,700 --> 00:18:53,140
might be experienced
by someone with dementia.

373
00:18:54,460 --> 00:18:55,700
Ah.

374
00:18:55,860 --> 00:18:57,700
'I'm joined by Neil...'
Hiya, Claire.

375
00:18:57,860 --> 00:19:01,700
'..who wants to find out what life
might be like for his wife, Marie.

376
00:19:05,940 --> 00:19:08,780
'The Dementia Tour is designed
to mimic the experiences

377
00:19:08,940 --> 00:19:11,500
'of trying to complete tasks
when your senses are compromised.'

378
00:19:12,940 --> 00:19:14,420
Are you coming in?

379
00:19:14,580 --> 00:19:17,820
'We're given instructions
with little explanation...'

380
00:19:17,940 --> 00:19:19,140
You sit there.

381
00:19:23,860 --> 00:19:26,820
Take your shoes off.

382
00:19:26,980 --> 00:19:29,860
Wait. Put these inside your shoes,
spikes pointing up,

383
00:19:30,020 --> 00:19:32,860
then put your shoes back on.
OK, thank you.

384
00:19:33,020 --> 00:19:35,900
'..and a collection of items to wear
which have been specially designed

385
00:19:36,060 --> 00:19:38,740
'to distort our sense of touch,
vision and hearing.'

386
00:19:44,340 --> 00:19:47,820
Questions cannot and will not
be answered from now on.

387
00:19:52,460 --> 00:19:54,260
Find the white shirt and put it on.

388
00:19:54,420 --> 00:19:58,340
Write a three-sentence note to your
family and put it in an envelope.

389
00:19:58,500 --> 00:20:00,340
Put the belt
through the loops on the trousers,

390
00:20:00,460 --> 00:20:01,500
match six pairs of socks.

391
00:20:01,660 --> 00:20:03,980
I can't hear anything you're saying.
Clear the dinner table.

392
00:20:04,140 --> 00:20:05,740
Draw a picture of your family
and name them.

393
00:20:05,860 --> 00:20:08,540
Find a necktie and put it on.

394
00:20:08,660 --> 00:20:10,340
I didn't hear.

395
00:20:10,500 --> 00:20:12,700
'A relatively straightforward set
of instructions

396
00:20:12,860 --> 00:20:16,180
'now feels almost impossible
due to the changes in our senses.'

397
00:20:17,860 --> 00:20:20,860
Don't hide things in there, look.
They'll get lost.

398
00:20:21,020 --> 00:20:23,180
No, no. Give that to me.
That's my paperwork.

399
00:20:23,300 --> 00:20:26,020
Leave that alone, look. No!

400
00:20:28,380 --> 00:20:32,220
'These few minutes had
a profound impact on both of us.'

401
00:20:32,380 --> 00:20:35,060
All right,
you can take your glasses off.

402
00:20:35,220 --> 00:20:37,100
Are you all right?
Yeah.

403
00:20:37,260 --> 00:20:40,020
Yeah.
That was really overwhelming. Wow.

404
00:20:40,140 --> 00:20:41,260
'Time for a debrief.

405
00:20:41,420 --> 00:20:44,420
'A much more friendly
instructor Matt reveals all.'

406
00:20:44,580 --> 00:20:46,820
A lot of the time, when I was
taking things away from you,

407
00:20:46,980 --> 00:20:50,180
I was approaching you from behind
so you couldn't see me coming.

408
00:20:50,340 --> 00:20:53,340
No, no, no, give that to me. No,
you shouldn't be doing that, look.

409
00:20:53,500 --> 00:20:55,500
That felt scary
when you suddenly were doing it.

410
00:20:55,660 --> 00:20:57,100
It was like,
"Where did you come from?"

411
00:21:00,540 --> 00:21:03,540
'Jeez, man, it was horrible.'
'Frightening, actually.'

412
00:21:03,700 --> 00:21:06,140
There was no relationship at all
there between yourself and us.

413
00:21:06,300 --> 00:21:08,380
When we were in the experience,
you kind of...

414
00:21:08,540 --> 00:21:10,140
It felt like
you were manhandling us.

415
00:21:10,300 --> 00:21:12,220
You know,
you were physically moving us

416
00:21:12,340 --> 00:21:14,140
without any permission to touch us.

417
00:21:14,300 --> 00:21:17,820
'This assault on our senses
is designed to replicate

418
00:21:17,980 --> 00:21:21,740
'the multiple changes common in
the mid to late stages of dementia.

419
00:21:21,900 --> 00:21:24,100
'But some of these are seen
in early dementia, too.

420
00:21:25,860 --> 00:21:28,300
'For Neil, this experience
has also highlighted

421
00:21:28,460 --> 00:21:30,900
'how easy it was
to appear unable to do things.'

422
00:21:33,100 --> 00:21:35,340
There you go, time for your dinner.
Look, there we go.

423
00:21:35,460 --> 00:21:37,260
There you go. Mmm. Look at that.

424
00:21:37,420 --> 00:21:39,540
You're getting it on your chin
there, look. Come on.

425
00:21:39,660 --> 00:21:40,980
It's on your chin.

426
00:21:41,100 --> 00:21:42,300
It felt awful.

427
00:21:42,460 --> 00:21:45,900
It's just so demeaning to...
just to keep, like, pretending

428
00:21:46,060 --> 00:21:49,060
you're feeding me without any kind
of, like, passion or caring.

429
00:21:49,220 --> 00:21:52,020
You're doing everything I hope
I would never, ever do.

430
00:21:52,140 --> 00:21:53,300
So...

431
00:22:03,860 --> 00:22:05,420
Yeah. Sorry.
Don't be sorry.

432
00:22:05,540 --> 00:22:06,980
That's great. It's great experience.

433
00:22:07,140 --> 00:22:08,860
Don't be sorry.
Really good.

434
00:22:08,980 --> 00:22:12,620
It's powerful, it's emotive,

435
00:22:12,780 --> 00:22:15,060
and it's there to make people think.
Yeah.

436
00:22:17,100 --> 00:22:19,260
'That was really incredible.'

437
00:22:19,380 --> 00:22:21,420
It was really difficult.

438
00:22:21,540 --> 00:22:24,020
It was really hard to see

439
00:22:24,180 --> 00:22:27,460
how Neil had to deal with what
we'd just been through together.

440
00:22:27,620 --> 00:22:32,060
But in a positive way,
it was incredible to experience

441
00:22:32,220 --> 00:22:35,460
some of what my patients with
dementia might be going through.

442
00:22:36,820 --> 00:22:39,500
And it's given me a new insight
into the warning signs.

443
00:22:41,300 --> 00:22:42,980
'Of course, not all changes
to your senses

444
00:22:43,100 --> 00:22:44,420
'mean that you will get dementia,

445
00:22:44,580 --> 00:22:46,860
'but recognising
the important role that they play,

446
00:22:47,020 --> 00:22:49,260
'whether that's hearing,
touch or vision,

447
00:22:49,420 --> 00:22:51,780
'could help
with an earlier diagnosis.'

448
00:23:00,660 --> 00:23:02,820
I'm uncovering
the latest dementia research

449
00:23:02,980 --> 00:23:06,180
to try and understand
who's likely to get it.

450
00:23:06,340 --> 00:23:08,820
It's the fastest-rising
health condition in the UK,

451
00:23:08,980 --> 00:23:11,780
and over half of us know somebody
who is currently living with it.

452
00:23:14,180 --> 00:23:17,340
While some rare forms of dementia
are genetically inherited,

453
00:23:17,500 --> 00:23:19,620
in most cases,
your genes might only increase

454
00:23:19,740 --> 00:23:21,540
the likelihood of it developing.

455
00:23:21,700 --> 00:23:25,180
My grandpa, my maternal grandfather,
developed Alzheimer's in his 80s,

456
00:23:25,340 --> 00:23:28,940
and so I may be at a greater risk
genetically of developing dementia,

457
00:23:29,060 --> 00:23:30,660
but I can't do anything about that.

458
00:23:30,780 --> 00:23:32,380
We can't control our genetics.

459
00:23:32,500 --> 00:23:34,140
What I'm really keen to find out

460
00:23:34,300 --> 00:23:37,100
is what factors play a role
in dementia that we can control.

461
00:23:38,420 --> 00:23:40,460
I'm travelling 400 miles
up to Edinburgh

462
00:23:40,580 --> 00:23:41,700
to meet Professor Alan Gow,

463
00:23:41,860 --> 00:23:45,540
an expert in how lifestyle affects
our brain health as we age.

464
00:23:45,700 --> 00:23:48,660
Hi, Claire. How are you doing?
I'm doing well, thanks, Alan.

465
00:23:48,820 --> 00:23:51,300
'I'm hoping he'll be able
to give me an insight

466
00:23:51,460 --> 00:23:55,020
'into how I can best reduce
my chances of getting dementia.'

467
00:23:55,180 --> 00:23:56,860
So, we'll be seeing
each other shortly,

468
00:23:57,020 --> 00:23:59,460
but you should have, hopefully,
a map in front of you,

469
00:23:59,620 --> 00:24:02,420
and it's got a few tasks
for you to complete.

470
00:24:02,540 --> 00:24:04,660
And no using my smartphone.

471
00:24:04,820 --> 00:24:06,900
Let's try and avoid it for now
and see how you get on.

472
00:24:07,060 --> 00:24:08,740
OK, I guess I'll see you
when I see you,

473
00:24:08,900 --> 00:24:10,700
although I'm not sure
when that will be.

474
00:24:10,820 --> 00:24:12,180
Excellent.

475
00:24:12,340 --> 00:24:16,020
The tasks he set are designed
to keep my brain in good shape.

476
00:24:17,180 --> 00:24:19,980
I must hit four checkpoints
across the city

477
00:24:20,140 --> 00:24:23,300
before ending up at a bridge club,
where I'll meet Alan.

478
00:24:24,940 --> 00:24:29,140
Map memorised,
first, I need to get my bearings.

479
00:24:29,300 --> 00:24:31,060
So, this is gonna be using
a part of my brain

480
00:24:31,180 --> 00:24:32,540
I haven't used in a while.

481
00:24:32,700 --> 00:24:34,660
Like everybody else,
I rely on satnav.

482
00:24:34,780 --> 00:24:37,340
I think the castle is that way,

483
00:24:37,500 --> 00:24:42,380
which means the Royal Mile
must be this way, I think.

484
00:24:42,540 --> 00:24:45,980
So if I head that way,
I think I'm on the right track.

485
00:24:48,620 --> 00:24:52,820
I think Alan has got a plan for me
to be doing some exercise up here.

486
00:24:54,940 --> 00:24:56,220
Alan has sent me the long way.

487
00:24:58,100 --> 00:24:59,860
I actually prescribe exercise
to people

488
00:25:00,020 --> 00:25:01,860
as it's so good
for the body and mind.

489
00:25:02,020 --> 00:25:04,940
It can help treat depression
and improve brain function.

490
00:25:09,940 --> 00:25:13,540
A-ha! The Royal Mile. I've made it.

491
00:25:13,700 --> 00:25:18,980
So, the next challenge Alan has
for me is to talk to strangers.

492
00:25:19,140 --> 00:25:21,140
Now, let's see if anybody's up
for chatting to me.

493
00:25:23,100 --> 00:25:26,660
Although I have to talk to strangers
every day as part of my job,

494
00:25:26,820 --> 00:25:29,580
going up to people in public
is still a bit daunting.

495
00:25:29,740 --> 00:25:31,860
Excuse me, do you mind
if I just stop you for a moment

496
00:25:31,980 --> 00:25:33,940
and have a chat? Thank you.

497
00:25:34,100 --> 00:25:36,140
Could I ask you
what you are doing here in Edinburgh

498
00:25:36,300 --> 00:25:38,740
if you're not from Edinburgh?
Just having three days on holiday.

499
00:25:38,900 --> 00:25:40,940
How lovely.
Yeah.

500
00:25:41,100 --> 00:25:44,300
'This is definitely putting me
outside my comfort zone.

501
00:25:44,460 --> 00:25:47,460
'But I do know that social isolation
can be detrimental,

502
00:25:47,620 --> 00:25:52,260
'and that we are increasingly
vulnerable to it as we get older.'

503
00:25:52,420 --> 00:25:55,100
I see your sign says "speak to me".
Is that all right if I do so?

504
00:25:55,260 --> 00:25:56,700
Please do. Yeah.
Brilliant.

505
00:25:56,860 --> 00:25:59,020
So, you're out here every day
talking to strangers.

506
00:25:59,180 --> 00:26:01,580
And what is your job?
So, my job is a storyteller.

507
00:26:01,740 --> 00:26:04,540
Over there, The Real
Mary King's Close. How fantastic.

508
00:26:04,700 --> 00:26:07,100
I'll have to come back and come on
your storytelling adventure.

509
00:26:07,260 --> 00:26:08,860
You'd be more than welcome.
Thank you.

510
00:26:10,660 --> 00:26:13,220
Next, I'm hunting down
iconic Edinburgh landmark

511
00:26:13,380 --> 00:26:16,060
Greyfriars Bobby
to gather information.

512
00:26:16,220 --> 00:26:18,300
Learning new things
is good for your brain.

513
00:26:20,340 --> 00:26:23,020
Ah! Greyfriars Bobby.

514
00:26:23,180 --> 00:26:27,220
So, Greyfriars Bobby the dog
sat in the churchyard for 14 years

515
00:26:27,380 --> 00:26:29,420
with his master,
who was buried there.

516
00:26:29,540 --> 00:26:30,820
Amazing.

517
00:26:31,940 --> 00:26:33,140
Just touch his nose for luck.

518
00:26:38,380 --> 00:26:42,820
Still navigating from memory, I am
delighted to arrive in an oasis.

519
00:26:49,940 --> 00:26:51,780
SHE EXHALES

520
00:26:51,940 --> 00:26:54,260
I can't believe
I'm in the middle of a city,

521
00:26:54,420 --> 00:26:57,500
in the city centre of Edinburgh,
at the Botanical Gardens,

522
00:26:57,660 --> 00:27:00,260
just surrounded
by the most beautiful nature.

523
00:27:00,380 --> 00:27:02,180
I feel better and lighter already.

524
00:27:08,700 --> 00:27:12,300
But I'm not sure exactly what
the link here to dementia might be.

525
00:27:12,420 --> 00:27:15,140
Time to find out at the bridge club.

526
00:27:23,580 --> 00:27:27,100
Hello, ladies. How are you?
I'm very well, thank you.

527
00:27:27,260 --> 00:27:28,860
How are you?
I'm fine. I'm Claire.

528
00:27:29,020 --> 00:27:31,340
Thank you for allowing me
to join you this evening.

529
00:27:31,500 --> 00:27:34,220
I have to confess,
I have never played bridge.

530
00:27:35,380 --> 00:27:37,660
CHATTER

531
00:27:40,020 --> 00:27:42,340
'I'm not sure bridge is my forte,

532
00:27:42,500 --> 00:27:44,460
'but it certainly got my brain
into gear,

533
00:27:44,620 --> 00:27:47,020
'just in time to sit down
with Alan.'

534
00:27:47,140 --> 00:27:49,140
Alan, so lovely to meet you at last.

535
00:27:49,300 --> 00:27:52,900
I've completed all your tasks,
and I have a suspicion

536
00:27:53,060 --> 00:27:55,060
about why you might have asked me
to do some of them,

537
00:27:55,220 --> 00:27:58,220
but I'd really like to know
what it all had to do with dementia.

538
00:27:58,380 --> 00:28:02,260
So, everything you've done today
is a small example

539
00:28:02,420 --> 00:28:05,500
of the kinds of lifestyles
and choices

540
00:28:05,660 --> 00:28:08,260
that might be good for
our brain health as we get older.

541
00:28:08,380 --> 00:28:09,420
You spoke to people.

542
00:28:09,580 --> 00:28:12,220
So social interaction,
being with other people.

543
00:28:12,380 --> 00:28:15,380
Physical activity,
fitness may be associated

544
00:28:15,540 --> 00:28:17,420
with keeping
our thinking skills sharp.

545
00:28:17,580 --> 00:28:20,300
The fact about Greyfriars Bobby
is just a small example,

546
00:28:20,420 --> 00:28:22,180
but you might think about education.

547
00:28:22,300 --> 00:28:24,500
And going to the Botanical Gardens,

548
00:28:24,660 --> 00:28:26,420
and you told me
to breathe in the fresh air.

549
00:28:26,540 --> 00:28:27,580
What was that one about?

550
00:28:27,740 --> 00:28:31,220
So, interestingly,
there's growing evidence

551
00:28:31,340 --> 00:28:32,860
about the impact that air pollution

552
00:28:33,020 --> 00:28:35,460
might have
on brain health specifically.

553
00:28:35,620 --> 00:28:38,660
And so air pollution
is one of the factors

554
00:28:38,820 --> 00:28:42,700
that recently got added
to a bigger list of risk factors

555
00:28:42,860 --> 00:28:46,700
compiled by a group of researchers
working on what was termed

556
00:28:46,860 --> 00:28:49,820
The Lancet Commission
for Dementia Prevention.

557
00:28:49,940 --> 00:28:52,420
And they identified 12 factors.

558
00:28:52,580 --> 00:28:55,460
As well as the four
I've already explored,

559
00:28:55,580 --> 00:28:57,740
the 12 factors also include...

560
00:29:11,700 --> 00:29:14,260
The evidence seems to be building
that, actually, lifestyles

561
00:29:14,420 --> 00:29:18,540
may have a larger role to play
than we had perhaps assumed before.

562
00:29:19,780 --> 00:29:23,580
'Surprisingly, together, these
factors can have a huge impact.'

563
00:29:23,740 --> 00:29:26,980
They were able to look
at the interplay

564
00:29:27,100 --> 00:29:29,180
between genes and lifestyles,

565
00:29:29,340 --> 00:29:32,020
environments
across lifetime changes,

566
00:29:32,180 --> 00:29:35,420
and they estimated that
those lifetime changes

567
00:29:35,580 --> 00:29:39,420
might be about 25%
genetically determined

568
00:29:39,580 --> 00:29:42,540
and perhaps up to 75%
maybe other factors.

569
00:29:42,660 --> 00:29:44,300
And that's huge.

570
00:29:44,420 --> 00:29:45,500
You know, as a GP,

571
00:29:45,660 --> 00:29:47,820
thinking about how I might be able
to guide my patients

572
00:29:47,980 --> 00:29:51,020
to maybe change some of those
factors you're talking about.

573
00:29:51,180 --> 00:29:54,260
'Just like a game of cards,
you can still play a good game

574
00:29:54,420 --> 00:29:56,740
'even if you weren't dealt
the best hand.'

575
00:29:56,900 --> 00:30:00,060
What can we do
to perhaps increase our ability

576
00:30:00,220 --> 00:30:04,060
to play the winning hand
with brain health and dementia?

577
00:30:04,220 --> 00:30:06,940
So, actually, that's quite
a hopeful message in many ways.

578
00:30:07,100 --> 00:30:09,460
While many people
will receive a diagnosis,

579
00:30:09,620 --> 00:30:12,140
it's not something that we should
be assuming will happen.

580
00:30:12,300 --> 00:30:15,180
It's not a normal part
of the ageing process.

581
00:30:17,660 --> 00:30:19,820
Chatting to Alan
has really opened my eyes

582
00:30:19,980 --> 00:30:22,220
into what I could be doing
for my patients going forward.

583
00:30:22,380 --> 00:30:24,340
The evidence shows
there is no magic bullet,

584
00:30:24,500 --> 00:30:26,900
but there are lots
of different tweaks we can make,

585
00:30:27,060 --> 00:30:30,620
and adding up those small changes
can make a really big difference.

586
00:30:30,780 --> 00:30:33,740
Thankfully, you can reduce
your chances of getting dementia.

587
00:30:36,740 --> 00:30:38,060
But it's not just small tweaks.

588
00:30:40,740 --> 00:30:42,620
In the last decade,
there has been concern

589
00:30:42,740 --> 00:30:44,460
about contact sports and dementia,

590
00:30:44,620 --> 00:30:46,900
in particular
the risk to football players.

591
00:30:49,260 --> 00:30:52,180
I'm on my way to meet
one of Scotland's national heroes.

592
00:30:52,300 --> 00:30:54,540
I love it! Go, dribbling about.

593
00:30:54,660 --> 00:30:55,940
GIRL SHOUTS

594
00:30:56,060 --> 00:30:57,900
Bring it in. Keep it in.

595
00:30:58,060 --> 00:31:01,740
'43-year-old ex-professional
Julie Stewart MBE...'

596
00:31:01,900 --> 00:31:05,740
Go!
'..played for Scotland and Arsenal.'

597
00:31:05,900 --> 00:31:09,220
You got a ball? Lottie, go and grab
a wee ball out the bag.

598
00:31:09,380 --> 00:31:12,060
'She is Scotland's
most prolific goal-scorer

599
00:31:12,220 --> 00:31:14,220
'with well over 100 goals
to her name.'

600
00:31:15,780 --> 00:31:18,020
And football runs in the family.

601
00:31:18,180 --> 00:31:20,540
Julie's dad, Jim,
also played professionally

602
00:31:20,700 --> 00:31:23,660
and worked as director of football
at the Scottish FA.

603
00:31:25,420 --> 00:31:28,460
So, this is the picture.

604
00:31:28,580 --> 00:31:30,020
This is my dad here.

605
00:31:30,180 --> 00:31:32,460
A lot of volume in his hair
at this stage.

606
00:31:32,620 --> 00:31:35,980
And this is my father-in-law, who
was the goalkeeper in that game.

607
00:31:36,140 --> 00:31:40,260
This is at the old pitch, which
was at the other side of the town.

608
00:31:43,740 --> 00:31:47,780
'Julie's dad was diagnosed with
chronic traumatic encephalopathy.

609
00:31:47,940 --> 00:31:50,140
'CTE, as it's known,
is a brain condition

610
00:31:50,300 --> 00:31:52,580
'thought to be linked
to repeated blows to the head.

611
00:31:52,740 --> 00:31:56,500
'It slowly gets worse over time
and leads to dementia.'

612
00:31:57,620 --> 00:32:01,540
When did you start to know
about your father's dementia?

613
00:32:01,660 --> 00:32:02,700
How long ago was that?

614
00:32:02,860 --> 00:32:06,060
Probably about
maybe three years ago.

615
00:32:06,180 --> 00:32:07,860
It was maybe the very start.

616
00:32:08,020 --> 00:32:12,660
But my dad has known himself
for probably about seven years now.

617
00:32:12,820 --> 00:32:15,180
'It's thought that Jim's condition
was caused by years

618
00:32:15,300 --> 00:32:16,860
'of heading the ball.'

619
00:32:17,020 --> 00:32:20,180
Had you ever thought about the link
between dementia and football?

620
00:32:20,300 --> 00:32:21,460
No, not at all.

621
00:32:21,580 --> 00:32:22,740
My dad was a centre-back,

622
00:32:22,900 --> 00:32:25,500
so even more so
than how they play the game now,

623
00:32:25,620 --> 00:32:27,500
it was about heading the ball.

624
00:32:27,660 --> 00:32:30,660
My own position as a striker,
again, it was really important.

625
00:32:30,820 --> 00:32:35,060
Go on, Harlow!
Good tackle. Keep going.

626
00:32:35,220 --> 00:32:37,620
'Julie isn't currently showing
any signs of dementia.'

627
00:32:37,780 --> 00:32:41,180
You ready, girls? They're coming
to kick your ball out the square.

628
00:32:41,340 --> 00:32:44,100
'But she knows
she is at risk of CTE,

629
00:32:44,260 --> 00:32:48,660
'so she's taking part in a new trial
monitoring ex-athletes for signs.'

630
00:32:48,780 --> 00:32:51,180
From a selfish point of view,

631
00:32:51,340 --> 00:32:54,140
I was thinking the earlier
that they can detect anything,

632
00:32:54,300 --> 00:32:58,060
if there's ever gonna be an issue
for me, then the better.

633
00:32:58,220 --> 00:33:01,300
And unselfishly, this information
might help other people.

634
00:33:02,860 --> 00:33:06,980
The man in charge of the study
is Professor Willie Stewart.

635
00:33:08,540 --> 00:33:10,060
'After looking at the records

636
00:33:10,220 --> 00:33:13,140
'of just under 8,000 professional
footballers in Scotland,

637
00:33:13,300 --> 00:33:15,340
'Willie discovered
that their risk of dementia

638
00:33:15,500 --> 00:33:19,100
'is three-and-a-half times higher
than that of the average population.

639
00:33:20,620 --> 00:33:23,780
'Amongst those whose brains
have been examined at postmortem,

640
00:33:23,900 --> 00:33:26,620
'around 70% have CTE.

641
00:33:26,740 --> 00:33:28,020
'A lifetime of heading footballs

642
00:33:28,180 --> 00:33:30,060
'can cause very distinct damage
to the brain.'

643
00:33:31,460 --> 00:33:32,660
This is a cortical section

644
00:33:32,820 --> 00:33:35,900
from one of the players whose brains
were received last year.

645
00:33:36,060 --> 00:33:38,740
What's really distinctive is
the way... See that kind of splotch

646
00:33:38,900 --> 00:33:40,540
that's there at the depths
of the fold,

647
00:33:40,660 --> 00:33:41,780
the depths of the sulcus?

648
00:33:41,940 --> 00:33:46,220
That is absolutely stereotypical,
you know, of the CTE pathology

649
00:33:46,380 --> 00:33:49,140
and what sets it apart
from Alzheimer's disease.

650
00:33:49,260 --> 00:33:50,780
'The aim of Willie's latest study

651
00:33:50,940 --> 00:33:53,020
'is to find ways of helping people,
like Julie,

652
00:33:53,180 --> 00:33:55,980
'who might have already
put themselves at risk.'

653
00:33:56,140 --> 00:34:00,780
What we're trying to do with Julie
is try and figure out in midlife,

654
00:34:00,940 --> 00:34:02,700
so long before
the dementia might set up,

655
00:34:02,860 --> 00:34:05,820
is what changes there are
in their brain.

656
00:34:05,980 --> 00:34:08,740
So you're looking at
what might be going on in that time

657
00:34:08,900 --> 00:34:10,580
between finishing
that professional career

658
00:34:10,740 --> 00:34:14,020
and when the onset of dementia
might start to show itself.

659
00:34:14,180 --> 00:34:18,340
The disease begins decades before
the patient turns up at clinic.

660
00:34:18,500 --> 00:34:23,460
So in the 30s, 40s, 50s,
the disease is already progressing.

661
00:34:23,620 --> 00:34:26,020
And what we're doing here
is we're looking to see

662
00:34:26,180 --> 00:34:29,420
if we can get the very earliest
signs of that happening.

663
00:34:29,580 --> 00:34:32,180
And that gives us a prospect of
if we can identify what's going on

664
00:34:32,300 --> 00:34:33,900
and identify what's driving it,

665
00:34:34,060 --> 00:34:37,700
we'll come up with measures
to try and reduce the risk.

666
00:34:37,860 --> 00:34:41,060
'Sports like football have huge
physical and mental-health benefits,

667
00:34:41,220 --> 00:34:43,660
'and Willie's research aims
to support those who play

668
00:34:43,780 --> 00:34:46,340
'rather than restrict them.'

669
00:34:46,460 --> 00:34:48,700
What we've found is our families

670
00:34:48,860 --> 00:34:50,740
who we've been working with
over the years

671
00:34:50,860 --> 00:34:52,100
that they're reporting often

672
00:34:52,260 --> 00:34:56,660
up to 70,000, 80,000 headers
in a player's career.

673
00:34:56,820 --> 00:34:58,980
Most of those,
nobody would ever see.

674
00:34:59,100 --> 00:35:00,220
They're in training days.

675
00:35:00,380 --> 00:35:03,260
So can we get rid
of as many of those as possible

676
00:35:03,420 --> 00:35:05,660
and still have the game
that we love?

677
00:35:05,820 --> 00:35:08,620
Should we be worried about this
in recreational sports?

678
00:35:08,780 --> 00:35:10,500
The message is the same
whether you're playing

679
00:35:10,660 --> 00:35:13,260
grassroots Saturday afternoon,
Sunday league,

680
00:35:13,420 --> 00:35:15,260
or whether you're playing
professional levels,

681
00:35:15,420 --> 00:35:17,860
is to cut down as much
on unnecessary head impacts.

682
00:35:18,020 --> 00:35:21,140
'In 2020,
Scotland became the first country

683
00:35:21,300 --> 00:35:24,580
'to ban heading the ball in training
for under-12s.

684
00:35:24,740 --> 00:35:26,820
'And no matter
what your age or sport,

685
00:35:26,940 --> 00:35:28,860
'reducing head impact of all kinds

686
00:35:29,020 --> 00:35:31,820
'is something that can lower
your future risk of dementia.'

687
00:35:31,980 --> 00:35:35,220
Research like Willie's into
brain health is really important.

688
00:35:35,380 --> 00:35:37,380
If we can protect future generations
from dementia,

689
00:35:37,500 --> 00:35:38,860
we should be doing it.

690
00:35:39,020 --> 00:35:42,060
We often think of dementia as
a disease of the elderly, and it is.

691
00:35:42,220 --> 00:35:45,220
But it's what we do before
we get to old age that matters.

692
00:35:45,340 --> 00:35:47,220
Next, I want to find out

693
00:35:47,380 --> 00:35:49,060
what treatments are available
for dementia,

694
00:35:49,220 --> 00:35:51,660
and if there's anything we can do
to keep it at bay

695
00:35:51,780 --> 00:35:53,820
if we are diagnosed with it.

696
00:35:53,940 --> 00:35:55,860
Take it down. Go on, Maya!

697
00:35:59,420 --> 00:36:01,780
If we aren't able to stop people
from getting dementia,

698
00:36:01,900 --> 00:36:04,020
the thing we all hope for is a cure.

699
00:36:05,540 --> 00:36:07,820
We're regularly bombarded
with headlines promising

700
00:36:07,940 --> 00:36:09,820
there is one just around the corner.

701
00:36:11,980 --> 00:36:14,580
But the reality is,
we haven't had a new dementia drug

702
00:36:14,740 --> 00:36:18,140
approved in the UK
for more than 20 years.

703
00:36:18,300 --> 00:36:21,180
At the moment, if you were to be
diagnosed with dementia,

704
00:36:21,300 --> 00:36:23,020
you may be offered some medication,

705
00:36:23,180 --> 00:36:25,140
if you're in the early stages
of the disease,

706
00:36:25,300 --> 00:36:28,380
and this medication would help
with thinking or memory

707
00:36:28,500 --> 00:36:29,900
and alleviate some of your symptoms.

708
00:36:30,020 --> 00:36:31,780
But there's no medicine available

709
00:36:31,940 --> 00:36:34,940
that could change the course
of your disease or prevent it.

710
00:36:36,260 --> 00:36:38,700
But in the last couple of years,
there have been what seems to be

711
00:36:38,860 --> 00:36:41,300
some very exciting developments
with Alzheimer's.

712
00:36:44,100 --> 00:36:47,380
"Alzheimer's drug hailed
as momentous breakthrough.

713
00:36:47,500 --> 00:36:49,300
"New Alzheimer's drug brings hope

714
00:36:49,460 --> 00:36:51,860
"of slowing the disease
for UK patients.

715
00:36:52,020 --> 00:36:56,260
"The biggest medical breakthrough
in Alzheimer's disease for decades."

716
00:36:56,420 --> 00:36:59,660
I'm really keen to talk to somebody
who knows a lot more about this.

717
00:36:59,820 --> 00:37:02,500
Two drugs in particular
are showing promising results

718
00:37:02,660 --> 00:37:05,420
in the final stages
of US clinical trials.

719
00:37:06,780 --> 00:37:09,540
'Professor of neurodegeneration
Tara Spires-Jones

720
00:37:09,700 --> 00:37:12,580
'from the University of Edinburgh
has been following their progress.'

721
00:37:14,100 --> 00:37:15,460
Can you tell me
what's been going on?

722
00:37:15,620 --> 00:37:17,780
Yeah, these new types of drug
are a huge breakthrough.

723
00:37:17,940 --> 00:37:21,860
We've had 100% failure rate
in clinical trials for decades.

724
00:37:21,980 --> 00:37:23,580
Finally, for the first time ever,

725
00:37:23,740 --> 00:37:25,620
there are treatments
coming through the pipeline

726
00:37:25,780 --> 00:37:27,620
that actually change the course
of the disease.

727
00:37:27,740 --> 00:37:29,540
They slow the progression.

728
00:37:29,660 --> 00:37:31,100
'These two new drugs have been shown

729
00:37:31,260 --> 00:37:34,060
'to slow the progression
of Alzheimer's by 35%,

730
00:37:34,220 --> 00:37:37,420
'which sounds impressive,
but what does it actually mean?'

731
00:37:37,580 --> 00:37:40,140
There is some debate in the field
from my clinical colleagues

732
00:37:40,300 --> 00:37:42,740
who think that that's not going
to be a very noticeable slowing

733
00:37:42,860 --> 00:37:43,820
of cognitive decline.

734
00:37:43,940 --> 00:37:45,300
People aren't getting better,

735
00:37:45,460 --> 00:37:47,540
they're just getting worse
more slowly.

736
00:37:47,700 --> 00:37:50,740
'The trials have also shown rare
but dangerous side effects.'

737
00:37:52,020 --> 00:37:54,780
Do you think it's OK
to be optimistic

738
00:37:54,940 --> 00:37:56,700
over the next decade
that things will change

739
00:37:56,860 --> 00:37:58,700
and there may well be
some treatments available?

740
00:37:58,820 --> 00:37:59,940
I'm very optimistic.

741
00:38:00,060 --> 00:38:01,340
I think with these new drugs

742
00:38:01,500 --> 00:38:03,140
that actually do
slow disease progression,

743
00:38:03,260 --> 00:38:05,140
they've opened the door for us.

744
00:38:05,260 --> 00:38:07,100
'According to Tara, each small step

745
00:38:07,260 --> 00:38:09,220
'brings more opportunity
in the field.'

746
00:38:10,540 --> 00:38:12,300
We can do this.

747
00:38:12,460 --> 00:38:15,060
With enough research,
we can stop these diseases.

748
00:38:15,220 --> 00:38:18,460
So it's very exciting
future prospects. Very exciting.

749
00:38:18,580 --> 00:38:20,380
'And a new Alzheimer's blood test

750
00:38:20,540 --> 00:38:23,180
'is expected
to be widely available soon,

751
00:38:23,300 --> 00:38:25,060
'detecting tell-tale proteins

752
00:38:25,220 --> 00:38:28,620
'ten to 15 years
before symptoms show.'

753
00:38:28,780 --> 00:38:30,860
We're getting closer
to being able to figure out

754
00:38:30,980 --> 00:38:32,500
who is in the very early stages,

755
00:38:32,660 --> 00:38:34,660
and that's very important
for the current drugs

756
00:38:34,820 --> 00:38:36,420
and also for any future drugs
coming along

757
00:38:36,580 --> 00:38:38,420
because we want to stop
the disease progression.

758
00:38:38,540 --> 00:38:39,500
And the earlier we stop it,

759
00:38:39,660 --> 00:38:42,180
the less effect it will have
on your daily life.

760
00:38:42,340 --> 00:38:44,420
'The future of Alzheimer's,
and more widely dementia,

761
00:38:44,540 --> 00:38:46,260
'is looking up.

762
00:38:46,420 --> 00:38:49,540
'Even if you get it, we might
one day be able to stop it.'

763
00:38:49,700 --> 00:38:51,700
It was fascinating
to hear from Tara

764
00:38:51,860 --> 00:38:53,940
about these great breakthroughs
in drug development,

765
00:38:54,100 --> 00:38:56,300
but it's really important
to remember at this stage

766
00:38:56,420 --> 00:38:58,380
that we're not talking about a cure,

767
00:38:58,540 --> 00:39:00,860
but about slowing the progression
of dementia.

768
00:39:00,980 --> 00:39:03,460
Whilst we wait for these new drugs,

769
00:39:03,620 --> 00:39:07,580
I want to see if there's
any other way we can treat dementia.

770
00:39:07,740 --> 00:39:10,460
And I've heard of some scientists
trying an exciting new way

771
00:39:10,620 --> 00:39:12,580
of reversing the effects
of Alzheimer's.

772
00:39:15,340 --> 00:39:17,540
I'm here to find out
a bit more about DBS,

773
00:39:17,700 --> 00:39:21,100
or deep brain stimulation,
which is pioneering research

774
00:39:21,260 --> 00:39:24,420
into using electricity and not drugs
to try to treat Alzheimer's.

775
00:39:26,060 --> 00:39:29,820
'And waltzing into the lab
is my dance partner, Kenneth.'

776
00:39:29,940 --> 00:39:31,620
All right.

777
00:39:31,740 --> 00:39:33,700
Take a seat, Kenneth.

778
00:39:33,860 --> 00:39:36,540
'Kenneth is under the watchful eye
of Professor Nir Grossman

779
00:39:36,700 --> 00:39:38,700
'at the UK Dementia Research
Institute.

780
00:39:40,220 --> 00:39:43,180
'Using a technique called
temporal interference,

781
00:39:43,340 --> 00:39:44,940
'electric currents
are going to stimulate

782
00:39:45,100 --> 00:39:47,620
'part of Kenneth's brain,
called the hippocampus.'

783
00:39:47,780 --> 00:39:52,900
The deep structure is a fundamental
structure for memory and learning.

784
00:39:53,060 --> 00:39:57,220
'It's this part of the brain that's
most affected by Alzheimer's.

785
00:39:57,340 --> 00:39:58,940
'Electric currents switched on,

786
00:39:59,100 --> 00:40:02,940
'this non-invasive treatment aims
to retune cells and stop damage.'

787
00:40:03,100 --> 00:40:06,460
What you're seeing now
is Kenneth receiving

788
00:40:06,620 --> 00:40:11,660
the temporal interference
stimulation of the hippocampus.

789
00:40:11,780 --> 00:40:13,660
'As two small electrical currents,

790
00:40:13,820 --> 00:40:15,620
'the equivalent to holding
a nine-volt battery

791
00:40:15,780 --> 00:40:18,740
'between your fingers,
are stimulating Kenneth's brain,

792
00:40:18,900 --> 00:40:21,980
'he's carrying out memory tasks
that activate the same region.

793
00:40:23,580 --> 00:40:26,180
'The currents spark
damaged brain cells back to life,

794
00:40:26,340 --> 00:40:29,140
'and this enhances
his memory skills.

795
00:40:29,300 --> 00:40:31,020
'It's a bit like
souped-up brain training,

796
00:40:31,180 --> 00:40:33,900
'and the aim is eventually
for long-term improvements.'

797
00:40:35,260 --> 00:40:37,340
This kind of physiotherapy,

798
00:40:37,500 --> 00:40:39,740
you want the movement,
the right movement.

799
00:40:39,900 --> 00:40:43,580
Function. Exactly.
And then we just augment that.

800
00:40:43,740 --> 00:40:46,540
How many times has Kenneth
had this done so far?

801
00:40:46,700 --> 00:40:51,180
So, the experiment
was ten sessions. Mm-hm.

802
00:40:51,340 --> 00:40:56,900
Each time, it's about 50 minutes
divided to five-minute blocks.

803
00:40:58,060 --> 00:40:59,340
'The first round of trials

804
00:40:59,500 --> 00:41:01,780
'showed memory improvements
in healthy subjects.

805
00:41:01,940 --> 00:41:04,980
'This is the first time they're
working with Alzheimer's patients.'

806
00:41:06,420 --> 00:41:11,100
The most important outcome measure
for us was safety and tolerability.

807
00:41:11,220 --> 00:41:12,620
Can we do this procedure?

808
00:41:12,740 --> 00:41:16,260
We see early signs of improvement,

809
00:41:16,420 --> 00:41:21,940
but it's too early for us
to make a decisive comment about it.

810
00:41:22,100 --> 00:41:24,740
'I caught up with Kenneth
to see what he makes of it.'

811
00:41:24,860 --> 00:41:26,460
Would you like a cup of tea?

812
00:41:26,620 --> 00:41:28,820
I would love a cup of tea, Kenneth.
Thank you.

813
00:41:31,540 --> 00:41:34,300
'We're in the living lab,
where patients test out treatments

814
00:41:34,460 --> 00:41:37,500
'over longer periods...

815
00:41:37,660 --> 00:41:40,740
'whilst being monitored
by Nir's team.'

816
00:41:40,900 --> 00:41:43,060
Do you want sugar?
No, thank you. I'm sweet enough.

817
00:41:43,180 --> 00:41:44,340
SHE LAUGHS

818
00:41:44,500 --> 00:41:47,500
'It's one step closer
to the eventual goal

819
00:41:47,660 --> 00:41:50,180
'of getting this treatment out
to patients at home.'

820
00:41:50,300 --> 00:41:51,700
Cheers.

821
00:41:54,740 --> 00:41:57,180
Oh, lovely cuppa.

822
00:41:57,340 --> 00:42:00,740
So, Kenneth, tell me,
how does it feel doing things

823
00:42:00,860 --> 00:42:03,700
whilst you've got the headset on?

824
00:42:03,860 --> 00:42:06,700
It doesn't make
a slightest bit of difference.

825
00:42:06,820 --> 00:42:08,580
I don't feel anything.

826
00:42:10,660 --> 00:42:13,580
I've got very slight weight.

827
00:42:13,740 --> 00:42:15,500
That's it.
That's it.

828
00:42:15,660 --> 00:42:18,340
And how has it felt being part
of this trial for you?

829
00:42:18,500 --> 00:42:23,660
The word that comes to my mind...
"stimulating".

830
00:42:23,820 --> 00:42:27,020
I'm one of those people
that don't shout, I don't swear,

831
00:42:27,140 --> 00:42:29,900
but I will keep asking questions.

832
00:42:30,060 --> 00:42:33,740
When I found
that I've got Alzheimer's,

833
00:42:33,900 --> 00:42:37,820
I wanted to know what it is,
where it is,

834
00:42:37,940 --> 00:42:39,940
how can it be treated?

835
00:42:40,100 --> 00:42:42,420
Which is why I went in
for the trials.

836
00:42:42,580 --> 00:42:46,260
So, tell me, Kenneth, what are
your thoughts about this technology,

837
00:42:46,380 --> 00:42:48,620
this research and the future?

838
00:42:48,740 --> 00:42:54,740
This technology is going to, I feel,

839
00:42:54,860 --> 00:43:00,780
cure people who have this dementia.

840
00:43:00,940 --> 00:43:04,100
That was a brave and ambitious hope
for the future,

841
00:43:04,260 --> 00:43:06,660
but a wonderful one.
Absolutely.

842
00:43:06,820 --> 00:43:09,700
'Perhaps one day,
there will be a cure.'

843
00:43:12,940 --> 00:43:15,500
What really excited me
was the possibility that, actually,

844
00:43:15,660 --> 00:43:19,500
there is an actual effective
treatment for Alzheimer's.

845
00:43:19,660 --> 00:43:21,540
It feels as though
there's been such a deficit

846
00:43:21,700 --> 00:43:23,580
in treatment for dementia
as a disease,

847
00:43:23,740 --> 00:43:26,420
and as GP's, it's been very sad
for us to not be able

848
00:43:26,580 --> 00:43:28,820
to offer our patients very much
in terms of treatment.

849
00:43:28,980 --> 00:43:32,740
So I was really, genuinely excited
to hear about this.

850
00:43:32,860 --> 00:43:34,540
In an ageing population like ours,

851
00:43:34,700 --> 00:43:37,940
the rise of dementia
is perhaps inevitable.

852
00:43:38,100 --> 00:43:39,700
But I think
what surprised me the most

853
00:43:39,860 --> 00:43:42,220
is how much we can do
to help prevent dementia.

854
00:43:42,380 --> 00:43:44,380
I've got a much better understanding
of this now,

855
00:43:44,540 --> 00:43:47,340
and I intend to pass that on
to my patients.

856
00:43:47,500 --> 00:43:49,860
The key is constantly making
small improvements

857
00:43:50,020 --> 00:43:52,420
to your brain health and being
on the lookout for changes.

858
00:43:52,580 --> 00:43:56,820
Whether it's memory, hearing,
taste, or something else,

859
00:43:56,940 --> 00:43:58,940
early intervention is best.