Alzheimer’s disease is a degenerative brain disease that is growing increasingly common among the elderly. According to the National Alzheimer’s Association, Alzheimer’s disease currently afflicts an estimated 5.3 million people over the age of 65 in the United States alone, and is expected to afflict 11 million or more by 2050. Currently, there is no cure for Alzheimer’s. Alzheimer’s disease is difficult to detect efficiently; many existing tests are inaccurate, expensive, invasive, or difficult to administer. Detection is also complicated by Alzheimer’s disease’s symptoms being similar to many other cognitive problems, particularly in its early phases. In fact, the only existing method of certain diagnosis is an examination of the brain tissue of the deceased. 1
As Alzheimer’s disease becomes more prevalent, it has become increasingly obvious how essential early detection and treatment are to combating the disease. In a recent article in Time, Alice Park stressed the importance of the medical community focusing its efforts on Alzheimer’s disease research and treatment.8 In a recent poll, 81% of respondents reported to see “great progress” being made toward curing heart disease. 71% felt the same way about curing cancer. Only 48%, however, shared that belief regarding Alzheimer’s. 9 Much of this perception, and the reality behind it, stems from a lack of spending on Alzheimer’s disease research. A meager $500 million is spent a year on studying Alzheimer’s disease, compared to $1 billion a year on cancer research and $5.6 billion on heart disease. Though heart disease and cancer may be more frightening, “what is going to get most of us in the next few years is Alzheimer’s,” explained Dr. Ronald Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center. His concern is valid: health experts currently estimate that a 65 year-old American has a 10% risk of developing Alzheimer’s disease. 8
Despite a lack of funding compared to other major health threats, many are attempting to develop better methods of detection and treatment. Within the past year, and particularly within the last few months, substantial progress has been made in the areas of Alzheimer’s disease research, detection, diagnosis, and treatment.
One of the first obstacles to progress is a lack of communication of research between different groups working toward common goals. Because of differences in diagnostic methods and research standards, time and effort are wasted in redundant research and translating the research of others into familiar terms. This issue may soon be resolved, thanks to a collaboration aimed specifically at combating the most problematic inconsistencies found in this area; this September, the Canadian Institutes of Health and Research has partnered with research centers in the United Kingdom and Germany with the goal of creating universal standards for animal models, brain imaging, and biomarkers used when researching Alzheimer’s disease and other neurodegenerative diseases. The £3 million, three-year initiative aims to eradicate the obstacle of miscommunication and inconsistencies within this research in order to maximize efficiency and progress.
Despite this barrier to progress, a number of research groups and pharmaceutical companies have accomplished substantial advancements toward Alzheimer’s disease detection, diagnosis, and treatment. The most promising of these breakthroughs has led to a method of detection that could revolutionize the accessibility and accuracy of Alzheimer’s disease diagnosis. Researchers at UT Southwestern Medical Center participating in a statewide study have identified a set of proteins in blood serum that may prove to be an accurate and accessible method of diagnosing Alzheimer’s disease.
Based on this set of proteins, the research team has developed an affordable and relatively non-invasive test. The test allows for the examining of over 100 blood proteins and, through a mathematical analysis developed at UT Southwestern Medical Center, the measuring of a person’s risk of having Alzheimer’s disease. When combined with a clinical exam, this measurement proved to be 94 percent accurate in identifying suspected Alzheimer’s disease in patients, and 84 percent accurate in ruling out Alzheimer’s disease.
According to Dr. Diaz-Arrstia, one of the researchers and authors of the paper on these findings, this test would be equivalent to testing blood cholesterol to detect cardiovascular disease. The research team hopes that this test will be easy to administer at hospitals and clinics, and will provide a more affordable, approachable method of screening. By making detection more accessible and frequent, the team also hopes to allow for earlier treatment for those who do have Alzheimer’s disease, which would in turn open the door for more efficient early management of Alzheimer’s disease.
Another promising development in the field of detection came earlier this month, with the announcement that a 30-second Alzheimer’s disease screening may be available in as few as two years. The test, which users a computer program to study a patient’s reaction time, would be completely noninvasive and could be performed in GP’s surgeries. 7 The test is aimed at being used to detect Alzheimer’s disease in patients as young as 40. Early detection, when combined with new drugs and preventive lifestyle changes, such as a healthier diet and increased exercise, may mean that some people who show signs of Alzheimer’s disease never actually develop symptoms.
In the field of treatment, progress has not come as easily, though several big-name pharmaceutical companies, including Pfizer, Lilly & Co., and Johnson & Johnson, are working to develop treatments. 6 Both Pfizer and Lilly recently suffered setbacks with their respective treatments that were in development. In March, Pfizer and Medivation announced that Dimebon, a promising and potent treatment that Pfizer bought licensing rights to in 2008, failed in a large late-stage trial. Lilly announced in August that it was halting development of one of their drugs, semagacestat, after patients experienced worsening conditions and an increased risk for skin cancer. 1,5Lilly has had greater success with solanezumab, their second experimental drug aimed at targeting what is believed to be onr of the central causes of Alzheimer’s disease. Though both semagacestat and solanezumab attack amyloid plaque in the brain, they used different methods; semagacestat is a pill that blocks an enzyme which aids the formation of amyloid, while solanezumab is an intravenously delivered antibody that “essentially vacuums up amyloid” that is present in the brain before it forms plaque. According to Jan Lundbery, head of Lilly’s research unit, “So far, the safety profile of solanezumab appears to be very good.” 6
At the moment, our lack of understanding the disease itself acts as a significant speed bump in the road of developing both diagnostic methods and treatments. As research methods become more efficient and detection more accessible, those studying Alzheimer’s disease will have greater resources as their disposal. Additionally, there is strong incentive for better research and treatment, especially for pharmaceutical companies; industry analysts predict that a new drug able to modify the progression of Alzheimer’s disease would be exceptionally profitable, tapping into a multi-billion dollar market. 6 Though we’re a long way from curing this increasingly threatening disease, progress is being made at a near-constant rate, and significant advances are on the horizon.