The statistics are staggering! Twelve million people worldwide currently suffer from Alzheimer's disease (AD), and by 2025 this number could surpass 22 million. In Canada, an estimated 300,000 people have AD, and by 2031 this number is expected to reach 750,000. Anyone with an interest in the field, or with an afflicted elderly relative, knows the heartbreaking reality: To date, most of the progress made in Alzheimer's research has been limited to the improvement of cognition in Alzheimer's patients. Researchers have met with limited success in their attempts to delay the progression of the disease or to find an actual cure. It is a relative certainty that progress in this field will only come through the collaborative efforts of clinicians, researchers and caregivers, from different institutions and different nations, meeting to pursue a common goal--to find a cure. In what is an unprecedented event in the history of this disease, leading Alzheimer's researchers from around the globe gathered in Washington D.C. in July to share their knowledge and to identify strategies that will lead to the elimination of AD. The First World Congress, a collaborative undertaking, was hosted by the Alzheimer's Association (USA), Alzheimer's Disease International and the Alzheimer society of Canada.
The news from Washington is heartening. It appears that very significant progress is being made in the search for a cure, as well as in the improvement of cognition in AD patients, in the delaying of the onset of the disease, in the diagnosis of AD, and in the care of patients with dementia. Possibly the most momentous data presented were from the phase 1 trial of a potential Alzheimer's vaccine. Researchers from Elan pharmaceuticals have discovered that injecting a synthetic form of the b-amyloid protein (the protein that has long been identified as the primary component of amyloid plaques) into patients with AD leads to an immune response that increases the clearance of b-amyloid plaques from the brain. In total, about 100 patients in the US and the UK will be involved in the phase 1 clinical trials. As yet, no obvious safety concerns have been identified.
Another therapy that shows promise is treatment with the drug memantine, which works by affecting the NMDA receptor. Assessments of cognitive function found that patients treated with memantine performed significantly better than a placebo group in terms of cognition and daily life activities.
Other results presented in the pivotal research section included data on dietary modifications that may help protect against Alzheimer's. Observational studies suggest that eating large amounts of vegetables, vitamin E and vitamin C is associated with lower risks for AD and other dementias. Researchers have also found that people with the apolipoprotein E (ApoE) e4 allele may decrease their risk of developing AD by consuming a lower fat diet.
Data from studies in Denmark may reassure those people with failing memories. A group of Danish scientists have focused their research on establishing a distinction between failing memory and signs of Alzheimer's disease or other dementias. Examination of 785 patients with memory problems revealed that only 43% actually had Alzheimer's or another form of dementia, while 28% actually had no serious cognitive deficit or amnesia. Overall, they found that 35% of the patients had a potentially treatable concomitant condition that influenced cognitive function, including depression, high blood pressure, thyroid disease, and hydrocephalus and alcohol dependence syndrome.
A major focus of the conference was the initiation of a dialogue between researcher s and primary care physicians and caregivers. These seminars educated physicians about the use of practical and controversial diagnostic tools, options and trends in drug therapy, and nonpharmacological treatments for patients with dementia. The creative care section covered a wide variety of topics, which ranged from discussions of entertainment activities for patients with dementia to developing care concepts that integrate nursing and architectural principles. Discussions of this nature facilitate patient care and recognize the human aspect of treating patients with AD. For more on the World Alzheimer Congress please see next month's issue of Geriatrics & Aging or visit our website at www.geriatricsandaging.com.
