MRC-funded research influences 2015 NICE Dementia Guidelines
21 Aug 2017
The MRC Cognitive Function and Ageing Study (CFAS) has led to important insights into the association of lifestyle factors with the risk of cognitive impairment. In 2015 the findings from this important study helped predict future demand for long term care and likely associated costs, thereby influencing the 2015 NICE Dementia Guidelines.
Tackling neurodegeneration and dementia at a societal level requires an understanding of its prevalence, and the measures we can take to reduce incidence through changes in policy. Doing this requires the long-term study of a group of representative people, to establish links between risk factors and health outcomes. These ‘cohort studies’ have proven extremely useful, as not many experiments are able to examine change over time.
Led by Professor Carol Brayne at the University of Cambridge, the MRC Cognitive Function and Ageing Study (CFAS) is a landmark study that was funded by the MRC and the Department of Health, starting in the 1980s. Since then, the CFAS I was used to estimate dementia prevalence between 1989 and 1994. Before CFAS I there were no population figures which could be confidently applied nationally and to specific geographical areas. CFAS I showed that dementia is common, more so than previously thought (overall prevalence of dementia in the 65+ population, 6.6 per cent), and increases as the population ages (prevalence in the 85-89 population, 25.3 per cent).
Between 2008 and 2011, new fieldwork was carried out in CFAS II to estimate dementia prevalence again, and to find out whether the results would be different from expected projections based on CFAS I. Published in a ground-breaking paper in 2013, these results provided compelling evidence of a reduction in the prevalence of dementia in the older population over two decades. CFAS II demonstrated an association between demographic and lifestyle factors and risk of cognitive impairment, including age, stroke and Parkinson's disease, and the protective effect of higher education and of self-reported `good' or `excellent' health.
CFAS II was able to update the evidence provided by CFAS I for policy purposes. CFAS II demonstrated the high cost of informal care in supporting people with dementia, which was much greater than previously estimated. The group was also able to predict future demand for long-term care and likely associated costs. Modelling long-term care needs and forecasting costs have been invaluable tools for policymakers. As such, Professor Brayne authored an ‘expert paper’ and several reviews that contributed to the NICE dementia guidelines published in 2015.
It is vitally important to develop a multi-faceted approach to tackling neurodegeneration and dementia; the biological mechanisms underpinning disease must be translated into effective treatments while also informing policy decisions which will impact our society as a whole. By funding research into neurodegeneration and dementia at its earliest stages, before the obvious symptoms of dementia manifest, the MRC helping to create a groundswell of innovation and excellence in dementia research in the UK and beyond.