Komthing is as important for our life as our health, little can be as drastic as physical limitations or mental suffering. Accordingly, a good ten percent of public spending worldwide went into this area even before the corona pandemic – this relative share is higher in Europe and the USA and lower in Africa. In absolute numbers, the differences are even greater. Health and sustainability are closely intertwined – climate change or air pollution bring illness and stress, at the same time the healthcare sector is also a significant burden on the environment, and prevention is the much more sustainable alternative to therapy, as two sessions of the Falling Walls conference made clear.
The first took on the issues of depression and dementia – with the pharmaceutical company Biogen as a sponsor. With regard to Alzheimer’s disease, which is after all a global health crisis, there has been a lot of hope for the company in recent years: with the antibody aducanumab, Biogen last year received approval for the first new Alzheimer’s drug in the USA in around 20 years. But although it removes deposits in the brain, according to studies it probably does not improve memory.
The remedy is at least a new approach, says Anthony Hyman, Director of the Max Planck Institute for Molecular Cell Biology and Genetics and recently awarded the Körber Prize for discoveries of previously unknown cellular processes – for which he also received that of Silicon Valley billionaires awarded “Breakthrough Prize 2023”. “If you can’t take the first step, how do you get into the whole process,” says Hyman, who also founded a company himself.
between dementia and depression there are some similarities, emphasizes the psychiatrist Mazda Adli from the Berlin Charité: Both are major challenges for global health, the WHO estimates that there are more than 50 million dementia patients and 280 million patients with depression worldwide – the latter are around five percent of all Affected adults, the proportion is slightly larger in seniors. The causes are multifactorial, says Adli: There are genetic as well as environmental influences, air pollution with fine dust, for example, is a trigger for both diseases.
Many problems are avoidable
This is where dementia researcher Frank Jessen from the Cologne University Hospital wants to start: research on biomarkers and antibodies is very exciting, but even in Europe it is difficult to give the therapies to patients, and in poorer countries this is almost impossible. And so only a small proportion of those affected worldwide receive modern treatments – the neuroscientist Christiane Sommer from Biogen agrees with a nod. Avoidable risk factors are responsible for around 40 percent of all dementia cases, says Jessen, with genetics for the remaining 60 percent. Not all diseases are preventable, but many are. A big problem is obesity and diabetes, which will lead to significant problems in brain health, according to Jessen. This depends on the long-term lifestyle of the people.
“We have to start with aging – with numerous prevention strategies,” says Maryna Polyakova from Max Planck Institute for cognitive and neurosciences. Evaluations by the UK Biobank, for example, have shown that sport is associated with a significant reduction in the risk of dementia, and hearing problems are also known to be a cause. Germany is one of the worst countries when it comes to collecting important data for this, says Hyman. That has to change – in order to be able to evaluate the consequences of different lifestyles in 30 or 40 years. “There are many structures that are dedicated to treatment – but we don’t have anyone who is responsible for prevention,” says Polyakova. “We really need that very urgently in Germany.” Global action plans are also too much focused on treatments. After all, it is now known that dementia is partly avoidable, Jessen interjects – previously this was seen as fate. So far the advice “protect your heart” has applied, now come to it: the brain. “Our western diet is not the best,” says Jessen – according to a study at his university hospital, food is the most important risk factor. A possible trigger for dementia like depression is loneliness, says Adli. New strategies are needed here – including urban planning to create more public space and contact opportunities.