With appropriate fanfare, a national Alzheimer's plan was announced last week. Its goal is nothing less than to find prevention and treatment approaches for the devastating illness by 2025. That's a very hopeful timetable and reflects growing optimism that we are close to finding effective strategies.
The plan's aggressive blueprint is particularly relevant to aging baby boomers. Millions of them are likely to develop Alzheimer's and other dementia-related conditions during the next 10 to 15 years. Symptoms of memory loss and other behavioral problems tend to show up after people turn 65, and the incidence of the illness becomes more prevalent after that.
An aggressive and optimistic program to attack the disease is welcome. But it's not clear what its current effect will be on people, and their caregivers, who are worried about contracting the illness or are in some stage of it. Does the plan mean anything to them? More to the point, should they do anything differently because of it?
Last week's announcement was accompanied by details of two promising clinical trials. One will target a group of people, primarily members of the same extended South American family in Columbia. They are genetically predisposed to get Alzheimer's at unusually early ages and will be given a drug--crenezumab--that reduces the amyloid plaques thought by many scientists to be a cause, if not the cause, of Alzheimer's. The second trial involves an insulin nasal spray that has been connected with improved brain function.
Mainstream science takes time, and so will these trials. It also takes money, and the national Alzheimer's plan can't be successfully implemented without enormous increases in research funding. "It is going to be a resource-intensive process," says Dr. Ronald Petersen, who heads the Mayo Clinic's Alzheimer's Disease Research Center, and helped lead efforts to create the national plan.
One of the big dividends of the plan is its mere existence as a powerful focus, drawing the attention and efforts of diverse private and government groups to support expanded visibility and funding of Alzheimer's research. Anyone who's been touched personally by Alzheimer's understands why it merits its own version of the "race to the cure" that has been hugely helpful to breast cancer research.
Mobilizing the Alzheimer's advocacy community will be essential to funding the plan, Petersen says. Passionate individuals can make a difference today by becoming involved. "This is a time for the general community to recognize that none of this will go anyplace without the resources," he says of the plan. "We can't wait until the [federal] budget situation is more amenable. We have to do it now."
Beyond money and expanded communications efforts, perhaps the biggest thing holding back Alzheimer's research has been the difficulty in recruiting participants for the growing number of clinical studies involving some aspect of the disease.
"The biggest roadblock to developing clinical trials right now is the enrollment of people into these trials," Petersen says. Trials require a full range of participants, from people who have full-blown Alzheimer's symptoms to those with no symptoms whatsoever. It's been hard to find participants to date, and the sizable expansion of research envisioned in the national plan will require more trials. "They always take much longer than is hoped for," he observes.
The nonprofit Alzheimer's Association has a service called Trial Match to pair interested people with clinical trials. The National Institutes of Health maintains a clinical trials database that now includes more than 900 Alzheimer's clinical trials.
Meanwhile, Petersen says, he counsels his own patients that adopting healthy lifestyles is the single best thing they should be doing today to defer or avoid Alzheimer's. While the link between lifestyle and Alzheimer's has not been proven definitely, the relationship is very persuasive to many researchers. Research released last year identified the major modifiable Alzheimer's risk factors in the United States and the proportion of cases potentially attributable to each factor:
Physical inactivity: 21 percent
Depression: 15 percent
Smoking: 11 percent
Mid-life hypertension: 8 percent
Mid-life obesity: 7 percent
Low education: 7 percent
Diabetes: 3 percent
Physical exercise and activities that provide mental stimulation "are very 'mom and pop' things to do but they're still real," Petersen says. "Are they going to stop the disease? Probably not. But we can have an impact."
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