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Will we ever cure Alzheimer’s?

Non-communicable diseases (NCDs) appear to be the major health challenge in the developed world. Among the NCDs, the neurodegenerative diseases occupy a special place. It’s always difficult to watch a loved one succumb to any of these diseases, and Alzheimer’s seems to be the most devastating of all. There’s an unspeakable pain that comes with watching someone who means the world to you struggle to remember who you are. Whether it’s a parent or a partner, the many years of shared memories make it difficult to come to terms with the fact that they would never remember you again.

Currently, more than 5.7 million Americans are afflicted with Alzheimer’s. It’s the most common type of dementia and it’s hard to find an American who doesn’t know someone that has or had the disease. Current projections show that the number of affected Americans may rise to 17 million by 2050. Still, the medical world is no closer to finding a cure or finding a cure or at least a proven way to slow down the progression of the disease. While we take solace in the fact that our understanding of the disease is better than ever before, the question ‘will we ever cure Alzheimer’s’ remains unanswered.

It’s complicated, to say the least

There is a strong correlation between Alzheimer’s and the development of amyloid plaques. The plaques are always a feature in people suffering from the disease and scientists previously thought reducing amyloid accumulation is the key to curing Alzheimer’s. Many drugs that can do the job have been developed but none of them have been able to slow down, let alone cure Alzheimer’s.

Researchers also delved into developing drugs that act against ‘tau’ a protein that prevents smooth communication between neurons. Tangles of this protein are observed in brains with amyloid accumulation. Unfortunately, the anti-tau drugs also did nothing to stop the disease. The reason why our understanding of the pathophysiology of Alzheimer’s has not led to the development of a cure remains a mystery.

Photo by Craig Whitehead

Where are we now?

Currently, there are 5 drugs approved by the FDA for the treatment of Alzheimer’s. All the drugs can only help with the early symptoms and there hasn’t been a new drug for more than 15 years. During that period, we’ve had a fair share of early clinical trials that ‘showed a glimpse of promise’ but nothing concrete has been developed.

Why are things slow on the Alzheimer’s front

There are different propositions regarding why there hasn’t been much progress on finding an Alzheimer’s cure. Many of these go beyond understanding the pathophysiology of the disease. An important consideration, for example, is that it’s hard to engineer Alzheimer’s symptoms in laboratory animals. Thus, researchers are unable to extensively test drugs on animals before proceeding to clinical trials.

Another mitigating factor that is frequently cited is that brain damage in people with Alzheimer’s begin long before they start experiencing the symptoms. Perhaps. The drugs being administered could help with the disease but the timing is too late. This hypothesis led to the initiation of anti-amyloid therapy in people with certain markers that point toward Alzheimer’s. The results of such interventions are yet to be fully assessed.

Photo by Cristian Newman

What does the future hold?

With the failure of the drugs targeting the obvious manifestations, scientists are now more open to novel theories that attempt to explain the pathophysiology of Alzheimer’s. Scavenger cells, lost synapses, viruses, and many other explanations have been proposed. Scientists are working round the clock to explore these explanations and hopefully, develop a drug that would do better than all the available options.

Many of the published clinical trials we came across focused on stopping Alzheimer’s from eating up the brain. It follows that the drugs developed may be capable of stopping the sufferer from getting worse but may not be able to make them better. At this stage, however, we do not have drugs that are capable of doing any of the two. Any progress at all would be a giant step in the right direction.

So, would we ever cure Alzheimer’s? The question may never have a definite answer. But it’s only a matter of time before we find a way of stopping it. And probably move one step further by discovering how to prevent it.

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