Alzheimer's disease can be distressing both for those with the condition as well as those close to them.

Alzheimer’s disease can be distressing both for those with the condition as well as those close to them.

Research into finding a cure for Alzheimer’s disease is perhaps only rivaled by cancer, in terms of the financial and time focus it gets from groups around the world.  There is increased hope, however, that both of these will become the 21st Century equivalents of diseases such as smallpox, once fearsome, seemingly incurable beasts that fell against the relentless march of science.

Alzheimer’s differs from cancer, however, in that there is still relatively little known about what causes the disease – at most, 5% of cases can be identified as being due to a genetic reason.  There is also no existing evidence that anything can be done to prevent the onset and development of Alzheimer’s disease.[1]  Of the scientific trials that have been conducted to date, the results have been inconsistent, with no correlation found between treatments and the progression of the condition.[2]  This is exacerbated by a general lack of public knowledge surrounding the condition, and dementia, regardless of its severity or nature, is often misdiagnosed as Alzheimer’s.

Even when medical professionals correctly diagnose Alzheimer’s, it is usually initially done so based on testimonials from relatives surrounding a patient’s behavior, corroborated with recent medical records.[3]

Breakthrough?

Last week’s document[4] released by the U.S Food and Drug Administration (FDA), Alzheimer’s Disease: Developing Drugs for the Treatment of Early Stage Disease, proposes that drug companies may be able to test combative medicines from an earlier stage.  Much of the document is based around recent advancements in knowledge surrounding Alzheimer’s that has been made by scientists researching the condition.  It is now believed that one is actually suffering from Alzheimer’s disease up to ten years before the symptoms first appear.

This indicates that identifying the condition as early as possible is paramount to the chances of successfully managing, or even curing, Alzheimer’s in the future.  Dr Russell Katz, of the FDA, who said, “The scientific community and the FDA believe that it is critical to identify and study patients with very early Alzheimer’s disease before there is too much irreversible injury to the brain,” mirrors this thought.

Those last five words from Dr Katz, surely, are the key to dealing with Alzheimer’s, at least in the short to medium term when it is unrealistic to expect a definitive cure to be developed.  Currently, there is a range of drugs prescribed that deal with the symptoms associated with Alzheimer’s, however, these are unable to arrest the deterioration of brain condition and neurological function, which is the ultimate, heart-breaking endgame that the disease inevitably leads to.

Of course, the enduring question is that, when we can only identify genetics as the cause of a maximum of 5% of cases, how on Earth can we possibly know who is suffering from Alzheimer’s until they start to display symptoms?

The Way Forward

One of the biggest positives of the FDA report is that, in effect, it allows for the design and undertaking of clinical trials that could begin to untangle the complexities of Alzheimer’s disease to a fuller degree.  Conditions such as prodromal disease, which causes changes in cognitive function that have been linked with Alzheimer’s, could potentially be treated better and serve as a delaying mechanism in terms of brain deterioration.

So far, some of the world’s largest drug companies have enjoyed little success in terms of trialing products to deal with the disease.  Such trials have taken place predominantly in those with mild to moderate symptoms of Alzheimer’s, but have failed to produce any notable results.

A Growing Need

The need for a pharmaceutical solution in the battle with Alzheimer’s is becoming increasingly urgent.  Studies have shown that almost 14million Americans could suffer from the disease by 2050, which would represent a three-fold increase.  Globally, the increase is expected to see four times the current number of diagnosed patients.

Clearly, the increases are happening due to the populace living longer – we are not all doing something in our lives that will see more of us developing Alzheimer’s disease in the coming years.  One problem that could occur in the longer term, however, is the costs of things such as palliative care, especially if there are drugs developed that can deal with the symptoms and prolong a person’s lifespan, but are unable to deliver restored brain function or increased quality of life.

Alzheimer’s, thankfully, is not an issue that is going ignored around the world.  UK Prime Minister David Cameron has spoken several times of his desire to move research forward, increase awareness of Alzheimer’s and dementia in general massively, and to improve the care and support on offer to both patients and their families and care givers.

Last year, President Obama signed the National Alzheimer’s Plan, which intends to find a way to treat or prevent the disease by 2025.

The more we learn about dementia and Alzheimer’s disease, the closer we will come to understanding whether or not a cure is a possibility.  While reversing brain deterioration will likely be beyond the realms of science, if research is directed into identifying the condition early, and taking action to prevent further onset of symptoms and maintain cognitive functions, then Alzheimer’s will become a manageable condition at some stage of this century.

Sources:

[1] http://www.nih.gov/news/health/apr2010/od-28.htm

[2] http://informahealthcare.com/doi/abs/10.1080/09540260701797944

[3] http://www.ncbi.nlm.nih.gov/pubmed/17407994?dopt=Abstract

[4] http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM338287.pdf

Mental Health - Alternative to Medication