For 20 years, dementia researchers were stuck in a frustrating quagmire.
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researchers → stick → quagmire
Promising drug trials repeatedly collapsed.
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trials → collapse → ?
A practical diagnostic test remained elusive.
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test → remain → ?
Billions of dollars were spent – but nothing worked.
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nothing → spend → dollars
Pharmaceutical companies began to pull out.
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companies → begin → ?
And dementia surged to become Australia’s No.1 killer.
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dementia → surge → ?
Now, however, that impasse has lifted.
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impasse → lift → ?
At clinics and labs around the world, staff are cautiously embracing a new word: “Breakthrough.”
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staff → embrace → word
The first two drugs to successfully modify Alzheimer’s disease, the most common form of dementia, were approved by Australia’s medicine regulator, the Therapeutic Goods Administration, last year.
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drugs → modify → regulator
A blood test that can detect biomarkers up to 20 years before a patient’s first forgotten word with 92 per cent accuracy was approved two months ago.
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that → detect → accuracy
The disease is “no longer universally described as untreatable”, according to the World Alzheimer Report 2026 released late last month, and we’re entering a period of “remarkable scientific momentum”.
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we → describe → momentum
That’s evident in a busy global pipeline of 158 drugs being tested in 192 trials, from new brain-penetrating agents to mRNA vaccines and repurposed medications, including weight loss jabs and erectile dysfunction drugs.
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That → ’ → jabs
“It’s like an explosion in developments across the board,” said University of NSW Professor Kaarin Anstey, who sits on the World Health Organisation’s dementia panel.
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who → ’ → panel
“We are also becoming more aware of the risk factors.
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We → become → factors
It’s a very exciting time.”
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It → ’ → ?
Associate Professor Emma Devenney, a neurologist, recalls being urged to reconsider entering the field of dementia when she started out because it was considered so futile.
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it → recall → dementia
“This is changing the trajectory, which we haven’t been able to do until now,” she said.
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she → change → which
“It’s lovely for patients and their families to have some hope.”
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patients → ’ → hope
An estimated 460,000 Australians are living with dementia: a figure that’s forecast to blow out to half a million in the next three years and double to a million by 2061.
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that → live → 2061
Our prevalence rate sits behind countries with older populations such as Japan, Germany and Italy.
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rate → sit → Japan
But the Asia-Pacific region has been singled out as a timebomb, with rates expected to triple in line with ageing populations and lifestyle factors by 2050 – at which point it will be home to half of the world’s cases.
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it → single → cases
This isn’t a foregone conclusion, though.
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This → forego → ?
New testing and treatments – combined with a growing body of evidence for prevention – aim to detect, and slow or stop dementia before symptoms appear.
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symptoms → combine → dementia
Until now, the only way to get an accurate diagnosis for Alzheimer’s was to undergo a lumbar puncture or positron emission tomography (PET) scan, both of which are expensive, invasive and impossible to scale to meet demand.
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both → get → demand
An influx of new blood tests is set to simplify and democratise the process.
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influx → set → process
Described as the “holy grail”, the newly approved pTau217 blood test is just as accurate as the two current gold standard tests but returns a result in minutes for a fraction of the cost, about $400.
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test → describe → cost
Neuroscience Research Australia (NeuRA) chief executive Professor Matthew Kiernan said the test, which detects levels of abnormal tau proteins – a key biomarker for Alzheimer’s – empowers doctors and patients in determining treatment.
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which → say → treatment
It also accelerates research.
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It → accelerate → research
“Eventually, it will be a test you can get at your local blood lab,” Kiernan said.
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Kiernan → get → lab
Similarly, until new drugs were approved last year, people living with Alzheimer’s disease had limited medical options.
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people → approve → options
Medication could provide relief from symptoms, but there was nothing that would tackle the disease itself.
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that → provide → disease
The new drugs are monoclonal antibodies, donanemab and lecanemab, which work by harnessing a recipients’ own immune system to break down sticky amyloid-beta plaques that accumulate around the brain and are known as hallmarks of Alzheimer’s disease.
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that → work → disease
While they have each been proven to remove plaque and slow progression, they’ve also faced criticism for offering limited real-world benefits to only some patients at high cost and a risk of side effects, including swelling and bleeds in the brain.
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they → prove → brain
“[Donanemab and lecanemab] work in that they are really good at removing amyloid in the brain, even if the clinical benefit isn’t as much as we would hope for,” Devenney said.
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Devenney → work → brain
“We’ve shown the approach can work.
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approach → show → ?
Hundreds of drugs haven’t worked.”
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Hundreds → work → drugs
Kiernan reports some patients are digging into their superannuation to fund the unsubsidised therapies, which can add up to $100,000 a year with medical fees and required brain scans.
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which → report → fees
“It’s turning the disease back,” he said.
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he → turn → disease
“The first [generation of drugs] are never the best, but they are starting the whole area of treatment.”
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they → start → treatment
The next generation of monoclonal antibodies are designed to be more targeted with fewer side effects.
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generation → design → effects
…and 72 more, not listed.
The Aporia
