Changing the Course of Dementia: What Will Make the Biggest Difference?

Dementia Researcher Vodcast

08/14/26

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47m

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Changing the course of dementia depends entirely on where you are standing, and this panel is standing in four different places.

Recorded in front of a live audience at the Alzheimer's Research UK Thames Valley Network Dementia Research Day 2026, Professor Emma Mead, Chief Scientific Officer at the ARUK Oxford Drug Discovery Institute, puts the question to four people who see the problem from very different ends: Associate Professor Sanjay Manohar, computational neuroscientist and lead of the Cognitive Disorders Clinic at the John Radcliffe; Professor Michele Hu, consultant neurologist at Oxford, who runs the 1,600 person Oxford Discovery Parkinson's cohort; Associate Professor Laura Winchester, bioinformatician in Oxford's Department of Psychiatry; and Peter Johnson, head of service at Dementia Oxfordshire. They cover precision diagnosis, adaptive trial design, blood biomarkers, exercise and diet, digital monitoring at home, and what patients say frightens them most, plus audience questions on genetic testing and the biomarker gap. It closes with a quick fire round where four specialists name four different priorities, and not one of them is a drug.

Key takeaways

Of roughly 500 patients seen with Alzheimer's, only about 10 have typical Alzheimer's and nothing else. Everyone else carries a different combination, and that fingerprint matters now that treatments target specific molecules.
Until this year, getting a biological diagnosis meant a lumbar puncture, so around 70% of patients never had one. Blood markers change who gets tested, and raise the harder question of what you tell people afterwards.
Multi-arm multi-stage designs, borrowed from prostate cancer, run several treatment arms against one placebo group and force go or no go calls at 6 to 12 months. ACT-PD is doing it for Parkinson's.
In the exenatide trial the placebo group improved over two years simply from being in a trial. Regular contact and something to aim at has a measurable effect you have to design around.
Once the survival figure and the monitoring burden are explained, most patients conclude the new Alzheimer's therapies are not yet for them. What they ask for is quality of life, not longer decline.
Asked what would make the biggest impact, the panel chose home digital monitoring, opening up trial data after studies close, AI as a support for thinking, and joined up hospital and community care. Not one of them named a drug.

A transcript of this show, links and show notes and profile on all our guests are available on our website at https://www.dementiaresearcher.nihr.ac.uk.

If you prefer to watch rather than listen, you will find a video version of this podcast on Apple Podcasts, YouTube, and on our website.

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We gratefully acknowledge the support of our funders: Al...

Previous Episode

XXplored - The Neuroscience of Motherhood

July 31

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67m

Around 80% of women worldwide will become mothers, and pregnancy triggers the largest hormonal shift the body will ever experience. So what does it do to the brain, and does any of it last?

In this episode of XXplored, host Dr Laura Stankeviciute, University of Gothenburg is joined by Dr Magdalena Martínez-García, Scientific Director of Maternal Health at the Ann S. Bowers Women's Brain Health Initiative, University of California Santa Barbara, and Dr Laura Pritschet, an NIH funded postdoctoral scholar at the University of Pennsylvania who leads the Maternal Brain Mapping Project.

They get into the hormonal cascade that drives the whole process, what those widely reported grey matter reductions actually mean, and how one volunteer scanned 26 times from IVF to two years postpartum filled in the gap between before and after. They also take on baby brain, whether repeat pregnancies stack up in the brain, what the UK Biobank data hints at for later life dementia risk, the near total absence of miscarriage and stillbirth from this research, and where postpartum care falls short. Both guests are living through matrescence themselves while studying it, and they talk openly about what that has been like.

Key takeaways

Pregnancy brings hormone surges into the hundreds and thousandfold, far beyond anything seen across the menstrual cycle, and sensitivity to those shifts matters more than the absolute levels.
Grey matter reductions across pregnancy are among the most replicable findings in neuroscience, and larger reductions are linked to stronger postpartum bonding rather than damage.
Follow-up work found some of those changes still present six years after birth, suggesting they may be long-lasting or permanent.
A second pregnancy produces the same pattern of change but less pronounced, and UK Biobank data suggests a trace of parity in the brain that levels off around four or five births.
Baby brain gets reframed rather than dismissed: subjective reports are real, objective differences are slight and temporary, and increased cognitive load may carry later advantages.
Miscarriage, stillbirth and abortion are almost entirely missing from maternal brain research, and both guests believe those women would be among the most motivated participants.
Research now treats the perinatal period as a neurological transition, but healthcare has not caught up, with a single six week check standing in for what should be ongoing postpartum care.

A transcript of this show, links and show notes and profile on all our guests are available on our website at https://www.dementiaresearcher.nihr.ac.uk.

If you prefer to watch rather than listen, you will find a video version of this podcast on Apple Podcasts, YouTube, and on our website.

Leave us a tip:

https://dementia-researcher.captivate.fm/support

Follow us on social media:

Download and Register with our Community App:

https://www.onelink.to/dementiaresearcher

We gratefully acknowledge the support of our funders: Alzheimer’s Association, Race Against Dementia, Alzheimer’s Research UK, Alzheimer’s Society, and the National Institute for Health and Care Research.

The views and op...

Next Episode

Fellowship vs Lectureship: Which Is Right for You?

August 28

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48m

Should you pursue a fellowship or apply for a lectureship? The choice is often framed as protected research time versus a permanent contract, but the reality is more complicated.

Dr Fiona McLean hosts Dr Warren Donnellan from University of Liverpool, Dr Kamar Ameen-Ali from Teesside University, and Dr Sarah-Naomi James from University College London, to compare the jobs as they are actually experienced. They discuss teaching, hidden administration, research independence, institutional support, pay, promotion and what happens when funding ends. They also ask whether any academic role can now be considered secure, and share the questions candidates should ask before accepting a post.

Their routes show that fellowships and lectureships are not separate tracks: teaching can strengthen a fellow's next move, lecturers can still win fellowships, and careers rarely follow the tidy sequence shown on a CV.

In this episode:

What teaching-and-research and teaching-and-scholarship lectureships involve day to day
How fellowships create independence, and where institutional control still applies
Why teaching, administration and student support often consume more time than workload figures suggest
What happens when a fellowship ends, including tenure-track promises and the need for further funding
How salary bands, spine points and contribution points affect pay
Whether any academic role can now be considered secure
The interview questions that reveal expectations and departmental culture
Why teaching experience, mentorship and resilience can keep more than one career route open

A transcript of this show, links and show notes and profile on all our guests are available on our website at https://www.dementiaresearcher.nihr.ac.uk.

If you prefer to watch rather than listen, you will find a video version of this podcast on Apple Podcasts, YouTube, and on our website.

Leave us a tip:

https://dementia-researcher.captivate.fm/support

Follow us on social media:

Download and Register with our Community App:

https://www.onelink.to/dementiaresearcher

The views and opinions expressed by guests in this podcast are their own and do not necessarily reflect those of the producers, funders, or sponsors.

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