While We Wait for a Scientific Miracle Cure:
Investigating Ways to Prevent Alzheimer’s Disease
By Guest Blogger,
If you follow Alzheimer’s disease (AD) research news you may have noticed momentous discoveries that might lead to a cure are announced regularly. A Google search of “Alzheimer’s disease breakthrough” will provide numerous examples. Regrettably, these promising results have not been translated into effective treatments and AD continues to take a terrible toll.
The good news is that average life expectancy has increased substantially over the last hundred years since Alois Alzheimer described the first case of early-onset dementia that has come to bear his name. The bad news is that a significant risk factor for AD development is advanced age and we have experienced an ominous increase in dementia incidence as people live longer. The really bad news is that this trend is projected to get even worse in the future (1). The financial and other burdens imposed by AD might become unimaginably difficult if these predictions are accurate.
Aware potential disaster looms ahead, scientists are working to understand the mechanisms behind AD pathology and develop ways to halt it. Decades of effort have revealed how the cardinal brain lesions of AD dementia such as amyloid plaques and neurofibrillary tangles are constructed. Researchers have exploited an understanding of the key molecules involved and how they are produced to devise ways to disrupt amyloid plaque deposits or prevent their formation in the first place. Unfortunately, clinical trials of these strategies have yielded consistently disappointing results prompting introspective searches for new treatment application modes (2) and targets.
While we await the outcomes of important new clinical trials and hope for the best, it is clear that an effective and practical AD cure has been elusive. In addition, dementia pathology pathways and processes have turned out to be far more diverse than initially assumed, suggesting aspirations for a single, simple cure might be an impossible dream. Both the general public and scientific community are anxious for progress.
A recent post on Alzforum highlighted some tantalizing findings suggesting that dementia rates are dropping in some regions (3). Several factors are in play, but AD development has long been appreciated to exhibit a sensitivity to environmental factors. One possibility is that taking steps to improve the overall health of the public such as identifying persons with cardiovascular issues like high blood pressure and treating them early might reap the additional reward of lowering the incidence of dementia. These findings provide a potent rationale and impetus to expand efforts to identify the most significant environmental/lifestyle impacts on AD risk. Recognizing the factors exerting the greatest effects on lifetime brain health may suggest simple, eminently practical interventions to decrease the dementia threat in the near term. Unfortunately, these efforts may not seem as glamorous or deemed as news-worthy as the more traditional research strategies which have been heavily promoted and financed to date.
Intense efforts to comprehend and control AD have been proceeding for over 30 years. However, at best any traditional pharmacological cure for AD may lie somewhere in a murky future. That means the virtually unheralded and currently underfunded work to clarify critical environmental risk factors might actually spare many from developing dementia in the potentially long interim before an AD cure is ready to go as well as minimize the need for such probably expensive interventions if and when they become available. While we wait patiently for a scientific miracle, it is important to foster and promote all approaches that might contribute significantly to the goal of preventing AD.
(2) J. L. Molinuevo et al. 2016. Ethical challenges in preclinical Alzheimer’s disease observational studies and trials: Results of the Barcelona summit. Alzheimer’s & Dementia (Epub ahead of print) http://www.alzheimersanddementia.com/article/S1552-5260(16)00076-5/fulltext
(3) M. B. Rogers. 2016. Dementia incidence in Britain, dropped, mostly in men. Alzforum, 21 April 2016 http://www.alzforum.org/news/research-news/dementia-incidence-britain-dropped-mostly-men