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An Unforgettable Truth About Alzheimer's

Posted Nov 25, 2015

“Sonia

Alanna Shaikh spoke at TED of how she is preparing to get Alzheimer's, should it arrive in the future, after watching her father's experience with the disease. Like all of us, she is hoping she does not get it, and that we will find a cure within 20 years that will protect us.

Dr. Alois Alzheimer, from Wikimedia Commons

Though the disease was first described by Dr. Alois Alzheimer over 100 years ago, there is no effective treatment or cure. It is a chronic neurodegenerative disease that progressively worsens over time as brain cell connections and the cells themselves die. The disease is the leading cause of dementia, and it is estimated that there are 5.3 million Americans with Alzheimer’s in 2015. Thankfully, advances in Alzheimer's research have revealed many hopeful clues. However, is hope enough to invest in a company working on Alzheimer's solutions?

Consider the Medical Research

cerebral amyloid angiopathy as seen in AD

Solving a puzzle such as Alzheimer's has been a difficult scientific challenge for researchers over the last century, and advances are promising but seem to lead to additional questions. We used to think the disease was caused by the buildup of amyloid-beta proteins, or plaques, in the brain, and most of the funding for research since 1991 has been directed towards this or similar hypotheses. In 2009, this theory was updated to state that the beta-amyloid plays a complementary role instead. Other competing theories for the cause of Alzheimer’s include genetic heritability, the cholinergic hypothesis (on which most drug therapies are based), and tau protein abnormalities. There is also evidence of Alzheimer’s being a “Type 3 Diabetes.

Albert Einstein reportedly said that insanity is doing the same thing over and over again and expecting different results. Perhaps a medical breakthrough will only be achieved when people think differently about the disease. Healthcare research gravitates towards the traditional pathway-specific approach to disease, rather than a systemic approach or an individual’s variability in genes, lifestyle, and environment (precision medicine). One 2014 small study by UCLA and Buck Institute used a systems approach to Alzheimer’s instead of focusing on a single targeted agent. For the first time, memory loss attributed to Alzheimer’s was reversed in nine of the ten trial participants.

New Approaches Needed

comparison between healthy brain and brain with Alzheimer'sFinding new approaches to Alzheimer’s will be essential, especially in the light of failed Alzheimer’s drug programs developed by pharma giants such as Roche or Eli Lilly. Roche’s R&D program failed last year with the antibody treatment gantenerumab that was intended to destroy beta-amyloid. Startups are looking for innovative solutions, such as San Francisco Biotech Alector, which has partnered with Johnson & Johnson’s pharmaceutical arm, Janssen Pharmaceuticals. They are combining new antibody technology and genetic discoveries to create a platform of therapeutics. Even a big company normally not in the medical technology business--the food giant Nestle--is partnering with a Swiss biotech to develop a diagnostics device for the early detection of Alzheimer’s. They will be developing a test for Tau proteins, another hallmark of neurodegeneration. These companies are doing progressive work, but the community is still short of a medical breakthrough. Once we are closer, venture capital should play a larger role than it is now.

It is hard to accept that we have no cure for Alzheimer’s, and the world's aging population will be increasingly susceptible to dementia. Alanna Shaikh said in her moving TED talk that we tend to do two things due to our understandable fear of dementia. Either we enter into a state of denial, believing that Alzheimer’s will never touch us, or we decide that we will do everything in our power to prevent its onset. Yes, there are things we can and should do that may reduce the risk of Alzheimer’s, such as maintain a healthy lifestyle and keep our minds active. However, the truth is that we have not reached a medical breakthrough yet. The third approach, investing in potential treatments for Alzheimer’s, has yet to yield results. Like Alanna, we’ll have to wait and see. The next step is to follow Einstein’s advice and start thinking differently about the disease for a future solution.

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