Where Is a Treatment for Alzheimer’s?

Over the last few days there’s been a burst of news about treatments for Alzheimer’s disease. Unfortunately, the news sounds about the same as everything else we’ve already heard: there’s a potential to slow the progress of the disease, but no real treatment, as in “making things better.”

The brains of people who have Alzheimer’s disease show two characteristic changes. The first is an accumulation of a protein called beta-amyloid on the surface of nerve cells. The second is tangles of a protein called tau inside nerve cells. Either of these disrupts the normal transmission of messages in the brain, leading to the symptoms of memory loss and changes in mood and personality.

Eventually, Alzheimer’s disease often leads to death, typically within 4 to 7 years of the first diagnosis. People with Alzheimer’s can lose the ability to swallow, so they aspirate food and develop pneumonia. Or they lose motor skills and fall. According to the CDC, Alzheimer’s is the sixth leading cause of death in the US. But a study released last year in the journal Neurology showed that Alzheimer’s disease may actually be the third-leading cause of death in this country, after heart disease and cancers. The discrepancy is because Alzheimer’s disease is often not listed on death certificates as a contributing cause.

What’s Making News for Alzheimer’s Disease

The recent news is about 2 “treatments.” The first is deep brain stimulation (DBS). This therapy is pretty much what it sounds like: electrodes are implanted deep in the brain and then charged. The therapy has shown some benefit for movement disorders such as Parkinson’s disease and essential tremor. An early test on 6 people showed that there might be some improvement in cognition, but in the most recent study, of 42 people with mild Alzheimer’s disease, there was no difference between those who received the genuine treatment and those who received sham treatment. (Sham treatment has the same function as placebo treatment—to mimic the real therapy so the patient doesn’t know what they received. “Sham” refers to physical treatments such as surgery or acupuncture.)

The second potential treatment is pharmaceutical. Two drug companies have developed compounds that they had hoped would improve things for people with Alzheimer’s disease. As I said earlier, unfortunately the only benefit is that the therapies slow the advancement of the disease. That’s not to be sneezed at, but it certainly isn’t the breakthrough everyone is hoping for.

The drugs are solanezumab from Eli Lilly and aducanumab from Biogen. Both drugs have been shown to slow the accumulation of beta-amyloid in the brain, and perhaps even clear some of the protein away. Still, there’s no evidence that either solanezumab or aducanumab can reverse the progress of the disease.

Of more than 125 experimental drugs brought to trial since 1998, only 4 have been approved for use in patients with Alzheimer’s disease—and even those 4 don’t really treat the condition. Sadly, with all the effort that’s been put into research into Alzheimer’s disease, there’s been little real progress in dealing with it. I’ll come back to the topic of Alzheimer’s from time to time as news warrants. Given the prevalence of the condition in our society, it’ll likely be sooner rather than later.

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