The Challenge of Curing Alzheimer’s Disease

July 2, 2013

Caregiver with Alzheimer's PatientResearchers have been trying to find a cure for Alzheimer’s for over 30 years.  Some drugs have shown initial promise in slowing the development of symptoms only to have poor results in later clinical trials.  Some drugs have unpleasant side effects.

One drug that has been widely administered, Aricept, is viewed to have limited short-term benefit and do little to slow the advance of Alzheimer’s.   Officially known as donepezil, Aricept works by inhibiting the breakdown of acetylcholine.  Acetylcholine is important for healthy brain cell activity, and people with dementia have low levels of this chemical.

researchers are skeptical of the drug and believe its greatest value has been serving the commercial needs of its manufacturer.   Aricept is made by Eisai and marketed in the US by Pfizer.   In an article published in the British Medical Journal, two researchers at Dartmouth Medical College last year concluded that the companies’ most recent formulation, Aricept 23, would only cause net harm.  They indicated there will be no meaningful cognitive improvement with increased likelihood of gastrointestinal upset.

This year the National Institutes of Health agreed to sponsor a new trial costing $36 million.  While this is a sizable sum, many in the Alzheimer’s research community question if it is the right effort.

For starters, the focus of the tests will be on therapies that control the development of beta-amyloid plaques in the brain.  These plaques are common in the brains of Alzheimer’s patients and are believed to limit the ability of the brain to process information.  Not all researchers, however, believe that beta-amyloid plaques are the cause of the disease.  Others believe the disease results from the presence of tau proteins – tangled structures – in the nuclei of brain cells.

Others are critical because the trial has no hope of helping existing patients.  If the trials resulted in a marketable drug, it would be several years before it would be commercially available.  A recent article in the New Yorker magazine observed that if a person demonstrates even mild dementia he has already lost 50 percent or more of the brain cells responsible for healthy cognitive processes.

Many of our home care patients in Chapel Hill suffer from Alzheimer’s.  We fervently hope that a cure will be found.

 

 

 

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