Middle Age Health Alert: Alzheimer's Disease

In a lengthy and detailed article, the Los Angeles Times has summarized the state of the war on Alzheimer's disease. It's not pretty and can be summed up in one sentence, "Scientists still aren't sure what causes the disease or how to cure it."

There are currently five medications approved for treatment of Alzheimer's in the United States, one of which causes severe problems and is rarely prescribed. The other four take in an estimated $4 billion a year. They do nothing to stop the disease and have only marginal, often transitory effects on its symptoms. They're on sale because there is little else to offer people afflicted with the mind-crippling disease.

There are 56 more drugs in some stage of the clinical trials regulated by the Food and Drug Administration; few people other than their creators have great hopes they will work. Sometimes, not even the creators are optimistic.

This is no small problem. There are roughly 4.5 million people who have been diagnosed with Alzheimer's and this number is expected to triple by 2050 as people continue to live longer and the aging Baby Boom generation hits its peak years. Also contributing to the importance of combating Alzheimer's is the very nature of the disease. By all accounts it is a heinous disease that literally destroys the brain. It affects not just the patient but their families and care givers. It can reduce sufferers mental capabilities to such a degree that they lose not just memories but also their personalities and their ability to provide even basic care for themselves. The result is very expensive care. (Medicare reportedly spends nearly three times as much for care of dementia patients). And with such large numbers of expected cases, the numbers become staggering. According to the Times, by 2035, the amount of money going to Alzheimer's care could overtake the defense budget in expense.

Neural diseases like Alzheimer's are particularly difficult to develop drugs for and in absence of better data on what causes Alzheimer's, drug companies are shooting in the dark in trying to develop drugs to combat it.

Neil Buckholtz, chief of the dementias of aging branch of the National Institute on Aging, said the pharmaceutical industry had little choice. "This is basically a 'throw the spaghetti against the wall' strategy. . . . We just have to try these various approaches. It's very time consuming, very expensive, but it's the only way we'll know if things work or not."

Yet another contributing factor to the complexity of investigating Alzheimer's is that there are no definitive physical markers for Alzheimer's in living patients. That is there is no blood test to tell if someone has the disease. There is no screening and instead it is diagnosed by the symptoms that a patient exhibits.

The two leading hypotheses of the cause of Alzheimer's are the "amyloid hypothesis" and the the "tau hypothesis." The amyloid hypothesis has been the leading explanation and focuses on plaque-like substances that have been found in the brains of Alzheimer's victims. The tau hypothesis focuses on the protein tau that can group into fibrous structures, called tangles, inside the cells. While both have showed promise, neither are well-understood or can account for all observable data. These problems have opened up the way for newer approaches to be promoted, however nothing has gone beyond early, exploratory stages.

Lifestyle Plays a Role:

Note that this does not mean that you are powerless in facing Alzheimer's in your future. While age and genes are believed to be the primary determinants on whether one will develop Alzheimer's, lifestyle and environmental factors can dramatically increase or decrease the risk. Read LifeTwo's Alzheimer's section for articles on Alzheimer's risk reduction.

Source of quoted material: Los Angeles Times