Alzheimer’s disease remains the most common form of dementia. In the United States, there are currently an estimated 5.5 million Americans living with this disease, and if there are no disease modifying drugs developed, it may increase to 16 million by 2050.1 Alzheimer’s disease causes loss of memory and other areas of cognitive functioning such as language, problem solving, planning, organizing and decision making. The mortality rates for major causes of death such as heart disease and cancer have decreased, but continue to rise for Alzheimer’s disease, which is the 6th leading cause of death among Americans.1 The total estimated cost of care for individuals with Alzheimer’s disease or other dementias in 2017 is $259 billion and could rise to $1.1 trillion by 2050.2
There are currently two classes of drugs approved for Alzheimer’s disease. The first class is the Cholinesterase inhibitors: Donepezil (Aricept), Rivastigmine (Exelon) and Galantamine (Reminyl). The second class of drug is the NMDA receptor antagonist Memantine (Namenda). Although these drugs provide symptomatic improvement for Alzheimer’s disease, unfortunately the condition will continue to get worse with time.
Due to the progressive nature of the disease, the need for better treatments such as disease modifying drugs or drugs that can stop the progression of the disease has become a national priority. There are currently multiple compounds that are in various stages of development that are geared toward Alzheimer’s disease.
The Alzheimer’s research community is currently investigating compounds that interfere with the production of the toxic class of amyloid, as well as active and passive immunotherapies to reduce and eliminate the already formed amyloid plaques from the brain. There are also receptor modulators, and new compounds that untangle the amyloid plaques to more soluble forms, and hence reduce the amyloid burden. It can take as long as 20 years for a person to develop Alzheimer’s disease, therefore we are working on ways to detect the abnormalities in the brain and spinal fluid before the disease starts. With these new techniques, researchers hope to be able to intervene before the disease presents itself and prevent the development of the symptoms. Through genetic testing we can also detect the most common susceptibility genes for the disease and identify the at-risk population for potential participation in Alzheimer’s prevention trials.
Alzheimer’s disease remains one of the most challenging diseases to treat; therefore, it takes multiple areas of expertise along with informed patients, family, and the community as a whole to tackle this devastating disease. It is imperative for the patients and families to be open about participating in clinical research trials, and realize that it will also help future generations if we can find better therapies and a cure for Alzheimer’s.
M. Reza Bolouri, MD
Board Certified Neurologist
- “2017 Alzheimer’s Disease Facts and Figures,” Alzheimer’s Association, accessed November 27, 2017, https://www.alz.org/documents_custom/2017-facts-and-figures.pdf
- “2017 Alzheimer’s Disease Facts and Figures,” Alzheimer’s Association, accessed November 27, 2017, https://www.alz.org/facts/#prevalence