Will Alzheimer's drug make a difference? Your questions answered

1. We're answering your questions after a new drug was found to slow the destruction of the brain in Alzheimer's
2. Health experts say the medicine - called lecanemab - could be groundbreaking in the fight against the disease
3. But the effect in trials has been small and it only works in the early stages of the disease - the drug is yet to be approved for wider use
4. Alzheimer's is the most common form of dementia, with more than 55 million people affected around the world
5. Our health correspondent James Gallagher is answering your questions - get in touch by emailing [e-mail] or on Whatsapp [phone]

Thanks for joining us

We're bringing our Q&A on a breakthrough drug to treat Alzheimer's to an end shortly - thanks for sending us your questions.

Thanks also to our health and science correspondent James Gallagher for providing plenty of really useful answers.

And if you want to know more, read on about on lecanemab, the first drug to slow the destruction of the brain in Alzheimer's, here.

Today's page was also written by Marita Moloney, Gem O'Reilly and Sam Hancock, and edited by Dulcie Lee and Andrew Humphrey.

How can I get involved?

James Gallagher

Health and science correspondent

Ana, from Brazil, says she lost both parents to the disease and asks how she can get involved in the study and whether she can volunteer to take the medicine.

Today, the medicine is only available through clinical trials and the one that has just reported its data is not enrolling more volunteers.

You would have to see if any future trials are being run at hospitals where you live as the drug has to be given every two weeks and you would need regular examinations.

The drug may become available more widely next year if medicines regulators give it the all clear.

Will slowing down the disease lead to a worse quality of life?

James Gallagher

Health and science correspondent

Clare asks whether slowing down dementia will lead to people living with a worse quality of life for longer.

Alzheimer’s is normally a long drawn out disease that slowly robs you of your brain power over the course of years.

The idea of slowing the disease down in the earliest stages is that you get more time when you are still independent and have a higher quality of life.

Alzheimer’s is a disease that tends to happen towards the end of our lives so such a drug may not help us live any longer, but may help us live better.

No decisions on exactly how the drug will be used have been made, but it could be something you come off in the latter, most severe, stages of the disease.

Does the drug help with other forms of dementia?

James Gallagher

Health and science correspondent

Simone, from Australia, says her 83-year-old father has dementia and asks whether the drug assists with Alzheimer’s only or with other forms of dementia as well.

As you rightly point out Simone there are many types of dementia.

Alzheimer’s is the most common but there’s also vascular dementia, frontotemporal dementia, Lewy body dementia and diseases like Parkinson’s or Huntington’s also cause dementia.

This drug works only in Alzheimer’s disease.

That’s because it’s designed to attack one of the key features of Alzheimer’s disease - a sticky gunge that builds up in the brain called beta amyloid.

If you look in the brains of people with other forms of dementia then large amounts of this toxic amyloid are not there, so the drug will not work.

Medical authorities should progress new drug ‘with gusto’

BBC

A man diagnosed with early onset Alzheimer's has hailed the research breakthrough on the lecanemab drug as “wonderful news”, adding that early intervention with the disease is crucial.

David Cox, from Lincolnshire, says life as he knew it was brought to a halt “in a flash” when he was diagnosed a decade ago at the age of 65.

His wife Heather noticed he was becoming less capable in daily tasks and his memory was deteriorating, but when his GP said he had Alzheimer's, David said it was an “enormous shock”.

“[But] it soon became apparent that life didn’t stop, as I thought it would, after diagnosis,” he told BBC News.

There was hope, which is “the key thing to hold on to”, he said, adding that he takes a drug daily for his condition.

“That has helped me but with the news of this new drug, and the earliest intervention that can be provided, that’s wonderful news,” David added.

“Let’s hope that the medical authorities progress this with gusto – there’s nothing to be lost.”

Who is making lecanemab?

James Gallagher

Health and science correspondent

The drug has been developed by two pharmaceutical companies: Japan’s Eisai and Biogen in the US.

The data is already being assessed by regulators in the US who will soon decide whether lecanemab can be approved for wider use.

There's more about its production, and the trial that followed, here.

How much of a difference will this drug make?

James Gallagher

Health and science correspondent

This is the question on many people's minds.

Symbolically this is massive as the impossible has just become possible.

Before today we did not have a treatment that altered the course of Alzheimer’s, now we have.

It will show scientists the way to make even better drugs and has been described as the start of a new era of Alzheimer’s therapies.

Lecanemab is slowing down the pace of the disease to preserve people’s independence and quality of life for longer.

So far it slows the decline by around a quarter in the first 18 months of treatment. We will have to wait longer to discover its long-term impact on the disease.

But ultimately the drug will help no-one unless people can be diagnosed with Alzheimer’s in the earliest stage of the disease when the drug can still make a difference.

Is my wife more likely to be offered the drug?

James Gallagher

Health and science correspondent

Brian, 84, from Shropshire, says his wife Doreen has been having "early cognitive impairment" and her close relatives have had the disease - he asks whether she's therefore more likely to get the drug.

Brian and Doreen, I wish you both well and I’m sorry I can’t give you a straight answer.

The results are exciting today, but there are still several stages we need to go through:

• The UK’s drug regulator has to decide whether lecanemab can be used here
• The NHS has to balance the benefits of lecanemab against the side effects and see if they are prepared to pay for it
• Then the NHS would have to make a tough decision around who (and at what stage of their Alzheimer’s) the drug is used for

We don’t have any of these answers yet, I hope they come quickly enough for your family.

'It gives me hope for the future'

Gem O'Reilly

BBC News

Mariel Kirton

Mariel says the drug gives her hope for the future

Mariel's father Ray has been living with advanced-stage young-onset Alzheimer’s for nearly 12 years.

While he wouldn’t be eligible for the drug even if it were available, Mariel says the news is incredibly exciting.

She says it gives her a lot of hope for the future, so other families won't have to go through what hers has been through.

"For anyone dealing with the hereditary side of Alzheimer's, it's an amazing breakthrough," she says.

"As a family that has been so hugely affected by the disease, it makes me worry less about the future for myself, my siblings and if we were to have children."

What is Alzheimer’s - and how is it different to dementia?

James Gallagher

Health and science correspondent

Lots of people have been asking this.

People often mix up dementia and Alzheimer’s, but they mean different things.

Dementia is about symptoms and is the term used to describe the decline in somebody’s memory and thinking skills.

But there are many different diseases that cause those dementia symptoms (just like there are many different infections and conditions that result in a cough).

Alzheimer’s disease is the number one cause of dementia.

People with Alzheimer’s have a build-up of toxic proteins in the brain that eventually destroys neurons (brain cells) and leads to the symptoms of dementia.

How can early symptoms be identified?

James Gallagher

Health and science correspondent

Alan from Staffordshire says many of his relatives have been affected by dementia. He asks how early symptoms should be identified so as to get treatment at the right time.

This new treatment still has to be considered by drugs regulators before it can be used outside of clinical trials.

It works best if people are diagnosed in the earliest stages of Alzheimer’s.

At this point the main symptoms are memory loss, struggling to concentrate, confusion and mood changes. You can see a full list on the NHS website.

It would then take another test – a brain scan or analysing spinal fluid – to know for sure whether it is Alzheimer’s disease.

However, at the moment these are rare. Only 1-2% of people with dementia in the UK get such tests.

'This is a historic moment'

'This is a historic moment for Alzheimer's research', Susan Kohlhaas

This is the first time researchers have shown that cognitive decline with Alzheimer's can be slowed down, says Susan Kohlhaas, director of research at Alzheimer's Research UK.

She told BBC Breakfast we don’t know when this drug will be available in the UK and that it will need to be cost-effective.

The main thing, she said, is that the NHS isn’t ready to deliver the drug as it currently stands.

Susan said Alzheimer's Research UK is asking the government to use their new dementia mission to bring NHS clinicians together so they are ready to deliver this treatment.

What are the signs of Alzheimer's?

James Gallagher

Health and science correspondent

Several people are asking about this.

The earliest signs are memory lapses.

It could be asking questions over and over again, forgetting conversations or things that have happened or struggling with names.

The changes in the brain can also alter people’s mood making them more anxious and agitated.

Symptoms get progressively worse and affect more of people’s lives as the brain is destroyed.

Disturbed sleep, mood swings, hallucinations, confusion, disorientation and delusions can all set in and people need help with simple tasks like eating and getting dressed.

Eventually people need full-time care.

What do you need to know?

Do you have a question to ask about lecanemab?

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How much will the new drug cost?

James Gallagher

Health and science correspondent

We don’t know yet, but it won’t come cheap.

Lecanemab is an expensive drug to manufacture, the companies will want to recoup the vast sums spent researching it and, as it is the first, there is no competition to drive down prices.

The best guess comes from a similar drug called aducanumab, which people hoped would work in Alzheimer’s.

It costs $28,000 (£23,300) per year in the US.

And that’s just the cost of the drug, so you have to add in the costs of tests and doctors' time etc.

How the new drug works

Before we kick off the questions, let's recap what this new drug is and how it works.

Lecanemab attacks the sticky gunge - called beta amyloid - that builds up in the brains of people with Alzheimer's.

It is an antibody - like those the body makes to attack viruses or bacteria - that has been engineered to tell the immune system to clear amyloid from the brain.

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While it is the first drug to slow the destruction of the brain in Alzheimer's, it has only a small effect and its impact on people's daily lives is debated.

The drug works in the early stages of the disease, so most would miss out without a revolution in spotting it.

One of the world's leading researchers behind the idea of targeting amyloid, Prof John Hardy, says his field is "delighted" with the breakthrough.

"I've been worried this day was never going to come," he told BBC Radio 4's Today programme, adding it will likely take two or three years before it can be made available to the British public.

Welcome along

Good afternoon and thanks for joining us as we answer your questions about the new breakthrough drug to treat Alzheimer's.

Lecanemab is the first drug to slow the destruction of the brain in people with Alzheimer's and has been heralded as "momentous", although its effect is small.

What does this development mean and what impact will it actually have on people with Alzheimer's?

The BBC's health and science correspondent James Gallagher will be answering your questions - stay with us.