January is Alzheimer’s disease awareness month in Canada and Alzheimer’s Society chapters all over Canada are gearing towards raising awareness of the disease among Canadians. It is therefore, an appropriate time to sum up the top research stories on Alzheimer’s disease in 2018, as a reminder of the great work being done to develop treatments to improve the lives of individuals affected by dementia, to help physicians diagnose the disease early, and to identify interventions to reduce the risk of developing the disease.
The symptoms of Alzheimer’s Disease including problems with memory, thinking, behaviour, and inability to carry out daily living activities have been attributed to abnormal protein deposits in the brain, namely amyloid plaques and tau tangles.
In the realm of drug development for Alzheimer’s Disease, 2018 was a bitter-sweet year with some drugs failing to perform in human trials, and other drugs showing some early success.
Drug Trials: The most promising among these are immunotherapies — mainly, antibodies lowering amyloid (Aducanumab) or tau, and BACE inhibitors that reduce the formation of plaques.
Early studies have shown that Aducanumab can decrease amyloid in the brain to levels lower than that required for a PET scan to diagnose the disease. Later studies also confirmed its effectiveness in slowing down the progression of early to moderate disease.
Other anti-amyloid antibodies found beneficial in early Alzheimer’s disease and proceeding to final trials along with Aducanumab include Gantenerumab, Crenezumab, and BAN2401.
LMTM monotherapy, the only antibody targeting the abnormal tau deposits contributing to brain degeneration, has been approved for early trials in humans.
However, BACE inhibitor studies proved disappointing with 3 of their candidates Verubecestat, Atabecestat, and Lanabecestat worsening symptoms in trial participants. Nevertheless, one drug Elenbecestat has progressed to final trials with research community anxiously following their progress.
Bryostatin-1 is the only drug that has shown some potential in helping reverse symptoms in patients with moderate to severe Alzheimer’s, with sustained benefits.
Some drugs approved for other conditions, have been found promising as potential treatment for Alzheimer’s Disease in early studies. These include asthma medication Montelukast, diabetes drug Liraglutide, cancer drug Nilotinib, and epilepsy medication Levetiracetam.
Late 2018 brought the exciting news from University of Texas Southwestern Medical Center about their vaccine that could arm the body to attack Alzheimer’s plaques and tangles before they even start to shut down the brain. They hope to begin testing the vaccines in humans soon.
Researchers in Spain claimed they cleared amyloid from the brain by a plasma exchange process. A related approach of soothing the inflamed aging brain, either with whole plasma or defined fractions from the blood of young adults is in early stage trials.
Early Diagnosis: Efforts have been ongoing to develop tests to help physicians diagnose the disease early, and administer treatment. The much-awaited blood test is just around the corner, along with other non-invasive eye test, saliva test and cognitive test. These tests when available will help physicians identify people at risk of developing the disease up to 5 years ahead of time with accuracy.
Risk Reduction: Increasing recognition that it is easier to prevent dementia than to treat it has paved the way for extensive research in this direction and culminated in a multi-pronged approach to reduce risk. Risk reduction strategies with most evidence include regular physical exercise of moderate intensity (eg. brisk walking), for 30-45 minutes; engaging in life-long learning (learning a skill, language, musical instrument etc.) following a plant-based diet, such as Mediterranean diet; regulating blood pressure (120/80 ideally, or the lowest possible) and volunteering.
I hope that these top stories have helped you understand how you can reduce your risk of dementia and also raise hope among individuals diagnosed with Alzheimer’s disease and their families. Let us hope that 2019 will bring breakthroughs in treatments that may change the course of this devastating illness.
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 firstname.lastname@example.org