Predicting when mild cognitive impairment progresses to dementia in the clinic

Lead investigator: Karl Herholz

• Institution: University of Manchester
• Grant type: Project grant
• Duration: 36 months
• Amount: £383,580

Why did we fund this research?    

Comment from our Research Network volunteers:

This proposal is spot-on: it is maximising the potential of the latest developments in technology in order to advance and refine risk assessment and diagnosis in dementia.

Project summary

New brain scanning technology can help to predict whether someone with mild memory or thinking problems is likely to go on to develop dementia or not. However, this has often required multiple scans, and it’s not clear exactly how useful these scans are in real clinics rather than research studies.

This project will use all-in-one brain scans to gather important information about brain health, and test whether they can be used in an NHS setting to give useful information to doctors and people with memory problems.

The background

People changes in their memory or thinking that are worse than expected for a healthy person of their age but aren’t severe enough to receive a diagnosis of dementia are often given a diagnosis of mild cognitive impairment (MCI).

Some people with MCI find their symptoms get worse over time, and they may eventually be diagnosed with dementia. However, some people with MCI find their symptoms get better, and some stay about the same.

The challenge for doctors at the moment is that when someone has MCI, it’s difficult to know if their symptoms will get worse or not.

Huge advancements have been made in technology for brain scanning, which means that it’s now possible for brain scans to show shrinkage of the brain, changes in the blood supply and whether someone has high levels of a protein associated with Alzheimer’s disease (called amyloid) in their brain.

These scans can help to answer the question of whether someone with MCI will go on to develop dementia. However, these scans are very rarely used in diagnosis, partly because their value hasn’t been fully tested in real clinical settings.

What does this project involve?

In this project, an all-in-one scan will be tested that allows brain shrinkage, blood supply and levels of the amyloid protein to be assessed in a single 30-minute brain scan. A particular type of brain scanner which combines two technologies (called magnetic resonance imaging and positron emission tomography) will be used to do this. 

One hundred people who are referred to memory clinics near Manchester and Cambridge will be offered the opportunity to take part. If they have MCI and decide to take part in the study, they will receive an all-in-one scan.

The researchers will ask questions to understand people’s experience of the scans, to find how helpful the scan results are and to see if using this kind of scan as part of the diagnosis process is feasible. They will also test how well these scans can predict whether someone with MCI will go on to develop dementia over a period of two years.

How will this help people affected by dementia?

The results of the study will inform whether combining information from these two brain scanning technologies is something that should be a standard diagnostic test for people with MCI in the NHS. This has the potential to give thousands of people more certainty about their memory concerns.

It could help to reassure people who are unlikely to develop dementia, and to give people who are likely to develop dementia knowledge about their own health and the opportunity to access information, advice and support. 

Although these scanners are not yet widely used, they are becoming more common. There are now eight across the UK and this number is expected to continue to grow.

The results of this study will also be informative for situations where the different scanning technologies have to be used separately, which is more common but less convenient for the person having the scans.