WASHINGTON (AP) -
Look for a fundamental shift in how
scientists hunt ways to ward off the devastation of Alzheimer's disease -
by testing possible therapies in people who don't yet show many
symptoms, before too much of the brain is destroyed.
The most ambitious attempt:
An international study announced Tuesday will track whether an
experimental drug can stall the disease in people who appear healthy but
are genetically destined to get a type of Alzheimer's that runs in the
family. If so, it would be exciting evidence that maybe regular
Alzheimer's is preventable too.
A second study will test
whether a nasal spray that sends insulin to the brain helps people with
very early memory problems, based on separate research linking diabetes
to an increased risk of Alzheimer's.
The new focus emerges as
the Obama administration adopts the first national strategy to fight the
worsening Alzheimer's epidemic - a plan that sets the clock ticking
toward finally having effective treatments by 2025.
"We are at an exceptional
moment," with more important discoveries about Alzheimer's in the last
few months than in recent years, Dr. Francis Collins, director of the
National Institutes of Health, declared Tuesday.
But a meeting of the
world's top Alzheimer's scientists this week made clear that meeting the
2025 deadline will require developing a mix of treatments to attack the
different ways that Alzheimer's damages the brain - much like it can
take a cocktail of drugs to treat high blood pressure or the AIDS virus.
Perhaps more importantly,
it will require testing possible drugs before full-blown Alzheimer's
sets in, when it may be too late to do much good. After all, Alzheimer's
starts ravaging the brain at least a decade before memory problems
appear. And doctors don't wait until the worst symptoms appear before
treating heart disease, cancer or diabetes, noted Dr. Reisa Sperling of
Harvard Medical School.
"Once the train leaves the
station of degeneration, it might be too late to stop it," Sperling
said. "We need to define the critical window for intervention."
Future therapy is far from
the only goal of the first National Alzheimer's Plan. It's a two-pronged
approach, promising to provide better and support for overwhelmed
families along the way.
"A lot more needs to be
done and it needs to be done right now, because people with Alzheimer's
disease and their loved ones and caregivers need help right now," Health
and Human Services Secretary Kathleen Sebelius said in announcing the
plan.
Among the first steps: A
new website - www.alzheimers.gov - that Sebelius called a one-stop shop
for families offers easy-to-understand information about dementia and
links to resources in their own communities. The government will offer
free training to doctors and other health providers on how to spot the
early signs of Alzheimer's and care for those patients. This summer, a
campaign will begin to improve public awareness of Alzheimer's,
important in reducing the stigma that helps fuel late diagnosis and the
isolation that so many affected families feel.
Patient advocates applauded
the move, and country music legend Glen Campbell, who has Alzheimer's,
appeared on Capitol Hill to urge more research.
Alzheimer's "has been in
the shadows for far too long," said Eric J. Hall of the Alzheimer's
Foundation of America. The plan "provides solid stepping stones toward
substantial change."
Already, 5.4 million
Americans have Alzheimer's or related dementias. Barring a research
breakthrough, those numbers will jump by 2050, when up to 16 million
Americans are projected to have Alzheimer's.
There is no cure, and the
five medications available today only temporarily ease some symptoms.
Finding better ones has been a disappointing slog: Over the last decade,
10 drugs that initially seemed promising failed in late-stage testing,
Sperling said.
Moreover scientists still
don't know exactly what causes Alzheimer's. The chief suspects are a
sticky gunk called beta-amalyoid, which makes up the disease's hallmark
brain plaques, and tangles of a protein named tau that clogs dying brain
cells. One theory: Amyloid may kick off the disease while tau speeds up
the brain destruction.
Previous studies of
anti-amyloid drugs have failed, but that new international study will
test a different one, in a different way: About 300 people from a huge
extended family in Colombia who share a gene mutation that triggers
Alzheimer's in their 40s will test an experimental drug, Genentech's
crenezumab, to see if it delays onset of symptoms. The study also will
include some Americans who inherit Alzheimer's causing gene mutations.
Meanwhile, there are
brain-protective steps that anyone can take that just might help, Dr.
Carl Cotman of the University of California, Irvine, told Tuesday's NIH
meeting.
"It's just a well-kept secret," he said.
The advice:
--Your brain is like a
muscle so exercise it. Intellectual and social stimulation help build
what's called "cognitive reserve," the ability to withstand declines
from aging and dementia.
-Getting physical is
crucial also. Clogged arteries slow blood flow to the brain, and people
who are less active in middle age are at increased risk of Alzheimer's
when they're older. "Any time your heart is healthier, your brain is
healthier," said Dr. Elizabeth Head of the University of Kentucky.
--Don't forget diet, she
added. The same foods that are heart-healthy are brain-healthy, such as
the omega-3 fatty acids found in fish.
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