Change of course
New direction needed for Alzheimer’s therapies, experts warn
By John Pastor
Dr. Todd Golde talks with doctoral student June Jung in his lab./Photo by Jesse S. Jones
Misaligned research, medical challenges and harsh economics are thwarting efforts to slow the destructive course of Alzheimer’s disease in the United States, according to a trio of nationally regarded Alzheimer’s researchers writing in the journal Neuron.
The foremost obstacle is that the most promising preventive strategies are being tested in patients firmly in the grip of Alzheimer’s disease — the ones least likely to be helped.
The approach would be similar to testing statins — drugs widely used to prevent heart disease — in patients who are already in cardiac arrest, according to Todd Golde, M.D., Ph.D., director of the UF College of Medicine’s Center for Translational Research in Neurodegenerative Disease.
With Edward Koo, M.D., of the University of California, San Diego, and Lon S. Schneider, M.D., M.S., of the University of Southern California, Golde pointed to a lack of alignment between studies in human volunteers, which focus on treatment, and laboratory studies, which are aimed at prevention.
“If we do the right types of clinical studies, we have the ability to move toward prevention, which would have a huge impact on this disease,” Golde said. “But we have to overcome our ‘prevention versus treatment’ dilemma. We already have more than 5 million people affected, and half of people in nursing homes, or more, have Alzheimer’s disease. As society ages, we are just going to continue to see Alzheimer’s drain the economy and the quality of human life.”
Without medical breakthroughs, a projected 7.7 million patients in the U.S. will have Alzheimer’s by 2030, according to the Alzheimer’s Association.
Researchers say solving the treatment-prevention problem will require the development of biomarkers — substances in the body that point to a disease — to identify patients before they show symptoms. With biomarkers, it may be possible to test Alzheimer’s drugs in pre-symptomatic volunteers.