Despite hundreds of drug trials costing millions, a cure for dementia remains elusive. But have scientists been looking in the wrong place for a treatment to tackle this modern-day epidemic?<\/p>\n
Recent evidence suggests the key to beating Britain\u2019s biggest killer may not be a drug \u2013 but surgery.<\/p>\n
And the operation is not a complex neurological procedure that requires risky access to the brain. Instead, it\u2019s a relatively straightforward technique, which doctors liken to clearing a blocked drain, in order to flush out toxic proteins linked to dementia.<\/p>\n
Called lymphaticovenous anastomosis (LVA), this type of treatment is already used on the NHS<\/a> to help women with breast cancer<\/a> who develop lymphoedema, swelling of the arms and legs due to a build-up of fluid.<\/p>\n The condition \u2013 which affects an estimated 400,000 people in the UK \u2013 develops when surgeons remove lymph nodes (tiny bean-shaped nodules that filter out waste products from the bloodstream) to stop cancer spreading.<\/p>\n Although it can be life-saving, removing the lymph nodes can lead to swelling in the limbs which makes everyday tasks, such as getting dressed, difficult.<\/p>\n With the LVA procedure, a tiny incision is made under the armpit, then surgeons stitch the lymph vessel that\u2019s full of fluid to a nearby vein \u2013 allowing the excess fluid to drain into the bloodstream and get flushed out through the kidneys. The benefits are well-established, although the NHS tends to reserve the procedure for severe cases.<\/p>\n Now researchers are experimenting with a similar technique \u2013 attaching lymph vessels in the neck to veins \u2013 to treat dementia.<\/p>\n The key to beating dementia may not be a drug \u2013 but surgery. And the operation is not a complex neurological procedure that requires risky access to the brain \u2013 instead, it\u2019s a relatively straightforward technique<\/p>\n<\/div>\n The brain has its own lymphatic drainage system to dispose of waste. As we age, this system becomes sluggish, allowing harmful proteins in the waste fluid to accumulate in the brain.<\/p>\n These proteins can lead to the formation of deposits \u2013 amyloid plaques \u2013 which start to harm cognitive function, eventually leading to symptoms such as memory loss, confusion, language problems and personality changes.<\/p>\n Around 2,000 patients with dementia have so far undergone the procedure, with claims that in some cases they\u2019re once again able to recognise loved ones and regain memories lost to the disease.<\/p>\n The surgery involves making a small incision in the neck just below the jaw. This accesses the deep cervical vein \u2013 which drains blood from the neck \u2013 where it runs parallel to a lymphatic vessel, which carries waste products from the brain.<\/p>\n A hole is then cut into the vein and the lymphatic vessel is stitched into place. Almost immediately, plaque-causing proteins start to drain away. The operation, which is done under general anaesthetic, takes a couple of hours.<\/p>\n \u2018It\u2019s pretty much the same principle as that behind many of today\u2019s newer drugs, which is basically to try and flush out the bad proteins,\u2019 says Pat Kehoe, a professor of translational dementia research at the University of Bristol.<\/p>\n The drugs in question \u2013 lecanemab and donanemab \u2013 are designed to bind to the damaging proteins so they are transported out of the brain.<\/p>\n However, the drugs are not approved on the NHS due to their cost (up to \u00a380,000 a year), limited benefits and side-effects, which include brain bleeds.<\/p>\n But the new surgical approach is controversial.<\/p>\n Almost all of the 2,000 or so procedures on dementia patients that have been carried out so far have been done in China, where \u2013 critics say \u2013 surgeons have been able to operate without first establishing that the procedure is even safe (let alone effective).<\/p>\n Although LVA for cancer-related lymphoedema carries little risk (there\u2019s a small chance of infection or abnormal scarring), it\u2019s not clear if operating on the neck is as safe.<\/p>\n Pat Kehoe, a professor of translational dementia research at the University of Bristol, warns that even if patients do benefit from the procedure, it\u2019s almost certainly not a cure<\/p>\n<\/div>\n In fact, the Chinese government became so concerned at the surge in these dementia operations that, in July 2025, it banned the procedure unless part of a research project.<\/p>\n Most of the evidence on whether it works comes from individual case reports or press releases from hospitals.<\/p>\n For example, in June last year, the Chinese PLA General Hospital in Beijing announced it had successfully performed LVA surgery on an 80-year-old woman who was previously unable to recognise her family members and relied on others for daily activities.<\/p>\n The hospital said: \u2018She has shown significant improvements in memory. She can not only accurately say relatives\u2019 names and occupations, but also engage in conversations.\u2019<\/p>\n There have been two small studies that purport to show the surgery is effective.<\/p>\n One, at the Army Medical University in Chongqing, China, monitored 26 patients with Alzheimer\u2019s who\u2019d had the controversial operation.<\/p>\n One month later, according to results published in the International Journal of Surgery last year, all patients registered significant improvements on the Mini-Mental State Examination (MMSE), a questionnaire that measures cognitive decline generally by assessing memory, attention, language and orientation.<\/p>\n The second study, also published last year, by Zhengzhou University in China, involved 41 patients with mild to moderate Alzheimer\u2019s.<\/p>\n Writing in the Journal of Alzheimer\u2019s Disease Reports, researchers said that three months after surgery, there were similar improvements in MMSE scores, as well as in a test called Activities of Daily Living \u2013 a measure of how well dementia patients can manage simple everyday tasks such as bathing, dressing and eating.<\/p>\n However, the second study did not report on all the participants, so it\u2019s not known how many improved.<\/p>\n Even if patients do benefit, it\u2019s almost certainly not a cure, warns Professor Kehoe.<\/p>\n \u2018The likelihood is that the procedure only buys you time because all you\u2019re doing is helping to flush out the system, while whatever is driving the production of those proteins is still happening,\u2019 he says.<\/p>\n \u2018That said, if it slowed down progression of the disease by ten years or so, then that would be a huge benefit. But the proof of that will only come in proper, large-scale trials.\u2019<\/p>\n He adds that an overstretched NHS would struggle to cope with all those needing the procedure (nearly one million people in the UK have Alzheimer\u2019s).<\/p>\n Other experts are more scathing. Robert Howard, a professor of old-age psychiatry at University College London (UCL), says any apparent improvement is almost certainly due to wish fulfilment.<\/p>\n \u2018People with dementia are desperate to see some improvement and the placebo effect is very powerful,\u2019 he told the Daily Mail. \u2018There is no good evidence that surgery has any effect on amyloid plaques. I\u2019ll only believe it is effective if and when there is evidence from proper clinical trials.\u2019<\/p>\n Gill Livingston, a professor of psychiatry of older people at UCL, adds: \u2018There is too little evidence that it works at all.\u2019<\/p>\n Nevertheless, research teams outside of China are launching trials. In January, doctors in Singapore began recruiting ten patients with mild to moderate dementia to undergo the surgery. Results are due in 2030. And at Yale University in the US, there are plans to operate on five volunteers over the next few years.<\/p>\n<\/div>\n![\"Pat](\"https:\/\/i.dailymail.co.uk\/1s\/2026\/04\/13\/18\/107863195-15729711-image-a-2_1776100538114.jpg\")
<\/div>\n<\/p><\/div>\n