Every 66 seconds, someone in the U.S. develops Alzheimer's disease, the progressive form of dementia that causes memory loss and cognitive decline.
By 2050, that rate will double, according to the Alzheimer’s Association. More than five million Americans are living with it now, and with a rapidly aging population of baby boomers, those numbers are skyrocketing.
There is no cure, and drugs on the market thus far have had limited effect. But the war against Alzheimer’s is being waged on many fronts, with drugs in development to treat or prevent what is now the sixth leading cause of death in the U.S.
Those efforts are the subject of “Can Alzheimer’s Be Stopped?” a NOVA documentary airing Apr. 13 on PBS. It presents the latest theories and clinical trials that some day may lead to prevention or cure.
Dr. Reisa Sperling, a professor of neurology at Harvard Medical School and director of the Center for Alzheimer’s Research and Treatment at Brigham and Women’s Hospital in Boston, appears in the program in conjunction with the study she’s conducting on a drug designed to halt Alzheimer’s before symptoms develop.
“We’ve learned that changes in the brain begin a decade, maybe two decades, before the dementia stage, before people have symptoms. Now, with PET (positron emission tomography) scans we have the ability to detect the amyloid plagues that build up in the brain,” Sperling said. “In heart disease, we give statin drugs to lower cholesterol and prevent buildup of plaques in the heart and arteries. We hope to do the same kind of thing with Alzheimer’s.”
Her trial involves an anti-amyloid antibody developed by Eli Lilly & Co. ‘We need 1,000 people for this trial, and we’re about halfway enrolled,” she said of the multinational, three-and-a-half year study, in which centers at UCLA, USC and UC Irvine are participating. “If we finish enrollment in 2016 or early 2017, I hope we’ll have results in 2019 or early 2020,” Sperling added, encouraging people 65-85 to sign up to participate at A4study.org. “The only way we’re going to get answers is if people join us in this fight.”
As presented in the documentary, other studies in the works target later-stage Alzheimer’s, some by targeting amyloid plaques and others by targeting tau, another protein that builds up inside brain cells and causes what are called “tangles.” Merck will soon test a BACE (enzyme) inhibitor. “I think we should be doing combination trials, more than one medicine, hit it with everything we can, like we do in cancer,” Sperling said. “I want us to try lots of different avenues of treatment but start them at a point that we can still rescue the brain.”
She’s hopeful that there will be an effective drug on the market in 10 years or less, but is sad that it will come too late to help her father, who recently died from Alzheimer’s, as did his father before him. “That’s part of the reason I study Alzheimer’s disease. It’s all very real to me,” Sperling said.
The fact that one in nine people over 65 will become afflicted makes it real for many families, “and it has the potential to bankrupt our health care system,” Sperling pointed out.
“Alzheimer’s disease is non-discriminatory. It affects people of all ethnicities, races and religions. The only way that it affects Jews specifically is that Jews have a long lifespan, and many live to the age of risk” and tend to be more educated and work to an older age in professional jobs, Sperling, who is Jewish, said. “Education protects people initially from showing their symptoms, but once educated people start to decline, they decline more rapidly. They may have a cognitive reserve that hides their Alzheimer’s disease for a long time, but [it] doesn’t protect them from getting the disease.”
Although there is a gene that is linked to Alzheimer’s, Sperling doesn’t recommend testing for it because the test “tells you your increased risk but it doesn’t guarantee whether you will or won’t get Alzheimer’s disease. Some people with the gene live to 90, and 40 percent of people who get Alzheimer’s do not have the gene.”
Amid all the bad news and daunting statistics surrounding Alzheimer’s disease, Sperling has some good news. “There is some evidence that the rates of dementia are getting lower or at least slowing the rate of increase because of good health care and diet. What a heart-healthy diet and exercise seem to be doing is making people more resistant to developing the Alzheimer’s pathology,” she said. “Living heart-healthy is good for the brain, too.”
But it’s not enough, she said. “It will be a combination of healthy lifestyle and biologically active agents that will tip the odds in our favor. I do think we’re making progress. I wish it could go faster. It’s incredibly sad for me that we couldn’t in time to help my dad, but I hope that my kids won’t have to go through what I and my mom did,” Sperling stated. “I hope that people who watch the film get excited and motivated to join the fight.”
NOVA’s “Can Alzheimer's Be Stopped?” premieres Apr. 13 on PBS.
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