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Seniors: Cure for Alzheimer’s disease – A mirage or a moving target?

This September we are celebrating the eighth anniversary of the World Alzheimer’s Month. Alzheimer Chapters all over the world are focusing on efforts to raise awareness about this devastating disease that robs our memories and other mental faculties, while sharing information about risk reduction.
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This September we are celebrating the eighth anniversary of the World Alzheimer’s Month. Alzheimer Chapters all over the world are focusing on efforts to raise awareness about this devastating disease that robs our memories and other mental faculties, while sharing information about risk reduction.

Although 115 years have passed since the first case of Alzheimer’s Disease (AD) was described by Dr. Alois Alzheimer, a cure has eluded us, despite intensive and relentless research efforts. Nevertheless, these efforts have expanded our knowledge of this disease and brought us closer to a disease-modifying agent, if not a cure.

Currently, there are 43,000 Albertans living with a diagnosis of dementia. It has been projected to double by 2031, due to population aging, in the absence of a disease-modifying agent.

This has serious social, financial, and personal consequences for the impacted families and nations.

Dementia is a progressive neurodegenerative condition characterized by memory loss, poor judgment, visual perception difficulties, communication difficulties, changes in mood, personality and behaviour, and inability to live independently.

There are several causes for dementia, the most common being Alzheimer’s disease. Here some proteins that are normally present in the brain get altered and form abnormal deposits called amyloid plaques and tau tangles. These plaques and tangles damage and destroy brain cells, slowly and silently, over years. These changes do not show up in CT or MRI scans, making early diagnosis difficult.

The medications currently available for symptom control, such as Donepezil (Aricept), Rivastigmine (Exelon), and Galantamine (Reminyl) work only in the early stage. Therefore, many people with AD fail to benefit from these medications.

The search for a cure or a disease-modifying drug and methods for early diagnosis have been ongoing, and remarkable advancements have been made in both areas.

Several researchers from different part of the world have developed highly sensitive blood tests, eye exams, cheek swab tests, and cognitive assessment tests to enable early diagnosis of the disease before the onset of symptoms and they are in the process of perfecting them.

As for medications to cure or slow the progression of Alzheimer’s, most of the research has focused on anti-amyloid agents that can either remove plaques from the brain or reduce their formation.

At least four drugs (Aducanumab, Gantenerumab, Eli Lilly’s N3pG, and BAN2401) have now demonstrated the ability to clear plaques from the brain, if administered before onset of symptoms. Among these drugs, Biogen’s Aducanumab and Roche’s Gantenerumab have entered the final stage of trial in humans.

Biogen recently reported that Aducanumab reduced deposits of amyloid plaque in the brains of early-stage patients participating in a three-year extension trial. The amyloid levels of patients treated for 36 months fell below the cut-off for a scan indicating Alzheimer’s, with sustained improvement in memory and ability to carry out daily activities.

Another drug that has entered the final stage of trial is Elenbecestat , which works by reducing the formation of plaques and is therefore indicated in the early stage of the disease.

One of these drugs is very likely to emerge as a disease-modifying agent capable of slowing down the progression of the disease in the next couple of years.

As for a cure, researchers are of the opinion that it will likely require a combination of multiple agents such as anti-amyloid, anti-tau, anti-inflammation and others, to tackle the multiple complex mechanisms involved in the development of this disease. Therapy would have to be individualized and precise, tailored to each person with the disease, and is likely a few years away.

While we await a cure, we can lead a healthy, active lifestyle to reduce our risk of developing dementia. This means engaging in 30-45 minutes of moderate intensity physical exercise most of the days of the week, doing mentally stimulating activities, following a healthy plant-based diet, avoiding smoking, limiting alcohol, and maintaining blood pressure, blood sugar, cholesterol and body weight at healthy levels.

Padmaja Genesh, who holds a bachelor degree in medicine and surgery as well as a bachelor degree in Gerontology, has spent several years teaching and working with health care agencies. A past resident of Red Deer, and a past board member of Red Deer Golden Circle, she is now a Learning Specialist at the Alzheimer Society of Calgary. Please send your comments to padmajaganeshy@yahoo.ca