Alzheimer's Disease : Treatments and Research

by National Institute on Aging

(Page 3 of 3)

Alzheimer's disease is a slowly developing disease, starting with mild memory problems and ending with severe brain damage. The course the disease takes and how fast changes occur vary from person to person. On average, Alzheimer's disease patients live from 8 to 10 years after they are diagnosed, though the disease can last for as many as 20 years.

No treatment can stop Alzheimer's disease. However, for some people in the early and middle stages of the disease, the drugs Cognex®, Aricept®, Exelon® or Razadyne® may help prevent some symptoms from becoming worse for a limited time. Memantine, also known by its brand name Namenda®, is approved for use in moderate to severe forms of the disease.

Also, some medicines may help control behavioral symptoms of Alzheimer's disease such as sleeplessness, agitation, wandering, anxiety, psychosis, and depression. Treating these symptoms often makes patients more comfortable and makes their care easier for caregivers.

Developing new treatments for Alzheimer's disease is an active area of research. Scientists are testing a number of drugs to see if they prevent Alzheimer's disease, slow the disease, or help reduce behavioral symptoms.

Medicines already used to help reduce the risk of heart disease may help lower the chances of developing Alzheimer's disease or may slow its progression. Clinical trials of drugs known as statins have begun to see if they might help slow down the progression of Alzheimer's disease.

Studies have shown that people with Alzheimer's often have higher levels of an amino acid called homocysteine in their blood. Folic acid and vitamins B6 and B12 can reduce levels of homocysteine in the blood, and scientists are conducting studies to see whether these substances can also slow rates of mental decline.

Research has shown that vitamin E slows the progress of some consequences of Alzheimer's disease by about 7 months. Scientists now are studying vitamin E to learn whether it can prevent or delay Alzheimer's disease in patients with mild cognitive impairment, or MCI.

Research also is under way to see if estrogen reduces the risk of Alzheimer's disease or slows the disease. One study showed that estrogen does not slow the progression of already diagnosed disease, but more research is needed to find out if estrogen may play another role. For example, scientists now are trying to find out whether estrogen can prevent Alzheimer's disease in women with a family history of the disease.

Estrogen and progesterone combination therapy is not recommended for prevention of cognitive decline or dementia. In one large national study of women 65 and older, Prempro, a specific form of combination hormone therapy, was found to double the risk of dementia in women on combination therapy when compared to those not taking the medication.

Recent research suggests that ginkgo biloba, an extract made from the leaves of the ginkgo tree, may be of some help in treating Alzheimer's disease symptoms. There is no evidence that ginkgo will cure or prevent Alzheimer's disease. Scientists now are trying to find out whether ginkgo biloba can delay or prevent dementia in older people.

People with Alzheimer's disease and those with mild cognitive impairment who want to help scientists test new treatments may be able to take part in research studies, otherwise known as clinical trials. These research studies are done on people to find out whether a new drug or treatment is both safe and effective.

New therapies are tested on people only after laboratory and animal studies show promising results. The Food and Drug Administration sets strict rules to make sure that people who agree to be in the studies are treated as safely as possible.

The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov.

The National Institute on Aging's Alzheimer's Disease Education and Referral Center, or ADEAR Center, is another reliable source of information about Alzheimer's disease. Contact them at 1-800-438-4380 or visit the ADEAR Center web site at www.alzheimers.org.

Scientists have come a long way in their understanding of Alzheimer's disease. Findings from years of research have begun to clarify differences between normal age-related memory changes, mild cognitive impairment, and Alzheimer's disease. Scientists also have made great progress in defining the changes that take place in the Alzheimer's disease brain, which allows them to pinpoint possible targets for treatment.

These advances are the foundation of the National Institutes of Health's Alzheimer's Disease Prevention Initiative, which is designed to

• understand why Alzheimer's disease occurs and who is at greatest risk of developing it.
• improve the accuracy of diagnosis and the ability to identify those at risk.
• discover, develop, and test new treatments.
• discover treatments for behavioral problems in patients with Alzheimer's disease.

Quiz

1. At present, there is no cure for Alzheimer's disease.

TRUE is the correct answer. There is no cure for Alzheimer's disease, but there is hope. Scientists learn more every day about the disease, and there are now four drugs available - Cognex®, Aricept®, Exelon®, and Razadyne® - which can provide modest relief for mild symptoms in the early and middle stages of the disease. There are also drugs available to control the behavioral symptoms associated with the disease.

2. Research shows that vitamin E can slow the progress of Alzheimer's disease.

TRUE is the correct answer. Research has shown that vitamin E can slow the progress of some consequences of Alzheimer's disease by about 7 months. Scientists are now studying vitamin E to learn whether it can prevent or delay Alzheimer's disease in a person with mild cognitive impairment, or MCI.

3. Research has shown that ginkgo biloba can prevent Alzheimer's disease.

FALSE is the correct answer. There is no evidence that ginkgo will cure or prevent Alzheimer's disease. Scientists now are trying to find out whether ginkgo biloba can delay or prevent dementia in older people.

4. The purpose of a clinical trial is to determine if a new treatment will be beneficial.

TRUE is the correct answer. Clinical trials are research studies on people to find out whether a new drug or treatment is both safe and effective. New therapies are tested on people only after laboratory and animal studies show promising results. The Food and Drug Administration sets strict rules to make sure that people who agree to be in the studies are treated as safely as possible.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.