GOOD NEWS ABOUT ALZHEIMER’S
Cases are tripling, but new research and interventions give us hope.
There’s still no cure, and cases are expected to triple by 2050 to 152 million worldwide. So why are scientists and advocates upbeat about Alzheimer’s disease (AD)?
“So many building blocks to disease-modifying treatments are coming together,” says Cleveland Clinic’s James Leverenz, a neurologist who directs the Cleveland Lou Ruvo Center for Brain Health. “And we’re better understanding why the disease varies from person to person.”
Leverenz, who also leads the Cleveland Alzheimer’s Disease Research Center (one of 31 NIH-funded Alzheimer’s research centers), points to game-changing advances like these.
New blood tests tell who’s at risk
Not so long ago, brain scans and lumbar punctures to collect spinal fluid were the only ways doctors could see early brain changes associated with Alzheimer’s. Now blood tests offer a less invasive, more affordable and (soon) more widely available option. The first, PrecivityAD, helps determine the presence of amyloid plaques in the brain, a disease hallmark.
Earlier interventions
Biomarkers like amyloid are improving how researchers screen
study subjects and flag patients
for early treatment. For example, scientists are combining other new blood tests, such as one for another protein called tau, with genetic and cognitive testing to predict who’s at high risk.
“We’re identifying people with the disease at its earliest stages, even years before they have symptoms,” Leverenz says.
The goal: finding interventions
that prevent or delay any impact on daily life.
Personalized treatments
Many different types of dementia have been identified (like frontotemporal, vascular and Alzheimer’s); now researchers are focusing on atypical Alzheimer’s forms. These mystifying disorders have biomarkers that suggest Alzheimer’s but symptoms seen in other forms of dementia.
“Just like cancer isn’t just one thing called ‘cancer,’ dementia isn’t one thing either. There are many subtypes, and each reacts to therapeutics differently,” Leverenz says. Treatments will become increasingly individualized, he says.
Big data speeds research
Researchers can now analyze tens of thousands
of de-identified (anony
mous) medical records to
find patterns associated
with dementia. For example, Cleveland Clinic’s Feixiong Cheng, Ph.D., found a statistical link between taking
sildenafil (Viagra) and reduced risk for Alzheimer’s. These artificial
intelligence-harvested clues don’t prove associations but provide shortcuts to ideas to test.
The first drug to slow disease
The first disease-slowing AD treatment, aducanumab (Aduhelm), was approved by the FDA in 2021. Controversial due to its high costs, side effects and limited effectiveness, it’s still a breakthrough because the five other Alzheimer’s drugs only ease symptoms. Dozens of disease-modification clinical trials, along with an Alzheimer’s vaccine, are in the pipeline.
Amazingly, 99 percent of AD drugs tested have failed. Researchers think they were intervening too late (after brain damage had occurred) or studied the wrong subjects (people misidentified as having AD because of poorer screening tests).
Pinpointing prevention
Exercise, sleep and, increasingly, having strong social ties are now seen as ways people can protect brain health. Exciting new research is looking at how the immune system and inflammation influence Alzheimer’s, Leverenz adds.
“We’re so much further along than we’ve ever been,” he says.