What is ‘tau’ and what role does it play in dementia?

In the laboratory, dementia researchers focus on understanding how sickness in the brain can lead to loss of memory and identity. Over many studies, a few key proteins have stood out as having a significant role, and one of them is tau. 

Dr Miguel Ramirez Moreno studies tau through his work as a postdoctoral researcher with Professor Amrit Mudher, through her AS funded project grant. Miguel has put together this helpful explainer on tau's function in dementia.

What is tau?

Tau is a protein naturally produced by our cells, helping them function properly. Its roles include supporting the internal structure of cells - by acting as a kind of strengthening scaffolding - to make them stronger.  

This is especially important for our neuron cells, as they need to be made up of strong and resilient parts, to communicate with each other, transporting everything from electric signals to vital nutrients

Good maintenance by proteins like tau keeps our bodies working efficiently. However, tau has gained a negative reputation because it is involved in several diseases that lead to dementia, including the most common one, Alzheimer’s disease.  

An illustration of tau tangles in a neuron

In the image above, we see a healthy neuron (top). tau acts normally across the structure of a neuron, but abnormal tau starts forming fibrous tangles (centre), that eventually are all what remains of the neuron (bottom).  

Did you know... We all have tau inside our brains – inside every one of our cells. And normally that is fine. The problem is not the protein itself, but its behaviour.

Untangling findings on tau and Alzheimer’s disease

Dementia is not a single disease, but a syndrome caused by many different conditions affecting the brain. Alzheimer’s disease is responsible for more than half of all the diagnosed cases of dementia.

The disease was first spotted over a century ago, by Alois Alzheimer. He described the strange clumps he’d seen inside of the brains of people affected - fibre-like structures, or “tangles”.  

As is often the case with major scientific breakthroughs, it took a collaborative effort to understand what these fibres actually were.

In 1975, a group at Princeton University (USA) discovered tau as a protein involved in protecting the internal structure of the cells. But it was not until 1988 that several scientists at Cambridge University (UK) found out that tau was making the tangles that Alzheimer described decades earlier.  

The mystery of the tangles Alois Alzheimer had seen was solved: Finding tau was present in a form it should not be in Alzheimer’s disease. But this opened up more questions for researchers of Alzheimer’s disease. what  Was this just an unusual presentation or something more? Could tau be responsible of for damaging our neurons getting hurt?  

How relevant is tau for dementia?  

Alzheimer’s disease is marked by the presence of abnormal tau tangles, alongside excessive depositions of amyloid beta – commonly known as senile plaques.

Scientists have discovered many ways in which these two proteins interact in the disease process. According to the amyloid cascade hypothesis, amyloid beta is disrupted first, which subsequently leads to changes in tau and other proteins. Abnormal tau is also linked to many other forms of dementia, either on its own or in combination with other proteins. This is why these conditions are collectively referred to as ‘tauopathies’. In each of these diseases, tau may be more or less important, but it is always involved.  

What do and don’t we know about tau?

When tau protein becomes abnormal, it stops doing its usual job of keeping brain cells healthy. This leaves the cells more vulnerable to damage. But it doesn’t just stop helping, it can start harming the brain. 

Scientists have found that abnormal tau can move from one neuron to another, which helps explain how the damage spreads across the brain in diseases like Alzheimer’s.

What research are Alzheimer's Society supporting into tau?

Research will beat dementia and will lead to improved diagnosis, effective treatments and the high-quality care that everyone living with dementia deserves. Learn more about some of the research we are funding to answer the outstanding questions about the tau protein, and how it could be targeted by future treatments.

Normally, the body clears out unnecessary tau, but in people with diseases like Alzheimer’s disease, it builds up and harms brain cells eventually causing the cells to die and the symptoms of dementia appear. Dr Croft’s previous research shows that tau knots can unravel on their own, but very slowly.  

Dr Croft’s project will help us to understand how tau breaks down and whether we can speed up this process to prevent harmful tangles from forming. By identifying ways to boost tau removal, researchers could develop new treatments that could slow or prevent Alzheimer’s disease.

Find out more about this research project

Researchers know the tau protein can move from one nerve cell to another through the areas where two cells connect. This is how the disease spreads through the brain in Alzheimer’s disease, making the symptoms worse over time.  

Professor Mudher is using clever genetic manipulation in fruit flies to turn genes on and off in their nerve cells. This will reveal the genes responsible for helping tau spread between brain cells. 

Find out more about this research project

During sleep, the brain’s natural cleaning system called the glymphatic system flushes out waste.  Dr Harrison’s previous research has shown that tau can also be cleared away by the glymphatic system.  

However, as people age, this cleaning system becomes less effective. Dr Harrison and his team will investigate whether a new drug can boost the brain’s waste removal process, helping to slow or prevent memory loss. 

Find out more about this research project

34 comments

Are you running any trials for”Tau” as we would be very interested in you need volunteers .

Hi Susan,

 

We’re not running any trials ourselves but if you're interested in taking part in clinical trials in general then you can through the join dementia research service: www.joindementiaresearch.nihr.ac.uk.

 

Best wishes,

The Alzheimer's Society research team

To hear people living with Dementia is so powerful, lived experiences are so helpful for people like me as their comments are so informative.
My wife has had Alzeimers for 3/4 years. We visit the Neurologist 6 monthly. Each time he tests her .Last visit he advised the test had enough of a result for him to advise that he could not script something that may /or not provide a little relief .This seemed odd to me that a doctor be bound from providing care for an obviously stricken patient .Even a 1% chance . Why keep going ?

Hi Harry,

 

Thank you for your comment. The appointments with your neurologist sound really difficult.

 

You might want to get in touch with our Dementia Support Line on 0333 150 3456. We can offer advice and help for you and your wife.

 

You can find out more about the Support Line and how our Advisers can help on this webpage: https://www.alzheimers.org.uk/get-support/dementia-support-line.

 

Best wishes,

The Alzheimer's Society web team 

I would like to know is there treatment for getting rid of the bad tau?

Hi Zee,

 

At the moment, there isn’t an approved treatment which would target abnormal tau. But researchers and pharmaceutical companies are actively working on developing tau-specific therapies for the future. You can find more information on this webpage: https://www.alzheimers.org.uk/what-we-do/researchers/news/researching-new-drugs-alzheimers-disease.

 

Best wishes,

The Alzheimer's Society research team

My husband who Alzeimers , was invited to go for trials at the panthera clinic in Preston, they were doing trials to try and remove the build up of proteins in the brain… unfortunately they said they needed people at the very beginning of Alzeimers, so my husband wasn’t invited back, which was understandable . We still live in hope that there will be a miracle cure. Good luck with all you do now and in the future.Regards
I now have a better grasp on tau and dementia but my memory status will challenge me to recall @ 80 years old!!
As always, wonderful work and very informative
My mother is at the 2nd stage of alzheimer's she nearly 80 my ? Is do u no how long it will be b4 she be in the 3tr stage

Hi Jonh,

 

I’m so sorry to hear about your mother. I’m afraid it’s very hard to be able to predict with any confidence how quickly someone will progress – both in terms of how quickly their symptoms get worse and how long they will survive with their condition. 

 

We do have information on progression in dementia, if you’re interested in knowing more: https://www.alzheimers.org.uk/about-dementia/stages-and-symptoms/progression-stages-dementia 

 

However, other than average survival times after diagnosis, which are very much just averages with some people declining much quicker and others much slower, we can’t give you an answer that would allow you to plan for any kind of individual timeline. It’s one of the most difficult parts of supporting someone with dementia.

 

Best wishes,

The Alzheimer's Society knowledge team

Mary beal my husband as dementia but will not accept it he his 93 yrs I would say he has had iit oround 3and a half yrs it’s vascular dementia. I can tell now when he his going to have an attack(I think) I see him in his face like he’s planning something,also he says bad things to me like I’m a low life just look at the staight of you.he said he didn’t like my face and got up from the table.(I I took his dinner to see what would happen nothing he just went to bed.igavehis dinner to the dog.he is quite obsessed about money but we have none a land line and Callander the social services I must say are just some girl with just let’s get some remarks on paper.

Hi Mary,

 

Thank you for your comment. This sounds so incredibly difficult.

 

You might want to get in touch with our Dementia Support Line on 0333 150 3456. We can offer advice and help for you and your husband.

 

You can find out more about the Support Line and how our Advisers can help on this webpage: https://www.alzheimers.org.uk/get-support/dementia-support-line.

 

Best wishes,

The Alzheimer's Society web team 

This explanation is both informative and helpful. I volunteer at a care home so have done several courses regarding dementia and have met many types. Watching the negative changes in residents is both sad and so the advances being made in these areas is encouraging even though it takes so long to bring the research through it's stages to be of direct benefit to sufferers. Changes in nature and aggressiveness are particularly distressing for staff, relatives and friends.
Very interesting! i look forward to seeing the outcomes of this research, well done guys
I would like to know more about Altzeimer’s as I have dementia/Altzeimer’s. Thank you.

Hi Clare Virginia Heather,

 

Thanks for your comment. You can find out more about Alzheimer's disease on this webpage: https://www.alzheimers.org.uk/about-dementia/types-dementia/alzheimers-disease

 

You might also want to get in touch with our Dementia Support Line on 0333 150 3456. You can find out more about the Support Line and how our Advisers can help on this webpage: https://www.alzheimers.org.uk/get-support/dementia-support-line.

 

Best wishes,

The Alzheimer's Society web team 

Iwas diagnosed with Alzheimer’s in 2016. I saw my MRI scan which showed brain shrinkage and tangles of tau an white spots. Being a proactive person I joined a dementia study with Recognition UK. Some months into the study I was informed that I had no amyloid plaque in my spinal fluid ergo not Alzheimer’s disease.( my mother , her sister and my grandmother had it) Subsequently I have had a TIA so I believe my dementia is Vascular .I have no idea how testing has developed in the last 10 years.
Hi Marylin, since 2024 I'm participating on a donanemab trial with ReCognition Health Guildford. This drug delays the disease. My mum has the disease for over 20years. (in advance state at present) With changes in her diet, exercises (mental/physical) and proper care 24hs. At home. It seems to have decreased the speed of the disease. From the laboratories investigation side things seem to go quite fast lately. Hoping a cure is found soon 🙏
My husband was diagnosed with nocturnal epilepsy twenty years ago which is controlled with drugs. Last year he was told he had Alzheimer’s following a brain scan. Is there any link between the two?

Hi Liza,

 

Yes, there are links between epilepsy and dementia.

 

People who have a history of seizures, particularly if they’ve struggled to control them, are more likely to have problems with their memory as they get older.

 

Sometimes this can develop into Alzheimer’s or other types of dementia. It also works the other way around. People with Alzheimer’s disease are much more likely to develop seizures as their condition progresses. 

 

We have a blog post on the topic, if you would like to know more: https://www.alzheimers.org.uk/blog/what-link-between-seizures-and-dementia

 

Best wishes,

The Alzheimer's Society knowledge team

Hi, I've had ftd for 8 years now, but my consultant said looking at my scans, which I have yearly I should be a lot worse.. I've always kept my mind active and that desire to fight this "enemy" I think helps.. Thank you 🤗 for your time researching this condition. Can they not do a test at birth to see what condition your 'tau' is like whether it will be a problem in your future for you....

Hi Sherry,

 

It’s great to hear that you’re managing to adjust well to your frontotemporal dementia. It’s definitely a good thing to keep as active and engaged as you can.

 

Frontotemporal dementia would only be detectable at birth if it was caused by a disease gene, which sometimes it can be.

 

But knowing if you or your child carries an FTD disease gene is a very difficult decision for most people to make. Ideally, it’s one they should make when they’re adults and can decide if they want to live with that knowledge.

 

Best wishes,

The Alzheimer's Society knowledge team

So is research focused on why tau protein behaves abnormally , or on how to stop it from doing so? The former would make more sense long term?

Hi Jacintha,

 

Both! We're funding research to understand the causes of dementia, develop effective treatments, improve care and ultimately find a cure. Understanding how and why tau behaves abnormally is important to develop potential therapies that would stop these events, which is a current focus of many research projects we fund.

 

Best wishes,

The Alzheimer's Society research team