Scientists have made many breakthrough discoveries about the way Alzheimer's disease begins and progresses. Researchers have made tremendous strides in understanding the major pathological characteristics of AD in the brain, beta-amyloid plaques and neurofibrillary tangles, though our knowledge is still incomplete. The work being done now revolves around attaining a more thorough picture of how all the events involved in the Alzheimer's disease process fit together, and how the complex processes at work in AD have ripple effects throughout the brain, from neuronal overexcitation and inflammation to synaptic dysfunction and hippocampal hyperactivation. All this research into basic science is important because it opens up a variety of possibilities for treatment and prevention.
Each time a scientist clarifies a new aspect of the disease process, he or she may have found another chance to modify or change that process. For example, once researchers identified the two enzymes that cleave the APP protein to form beta-amyloid peptides (that can clump together to form plaques in the brain), drugs to block those enzymes were developed, and now some are being tested in clinical trials. Many more drugs in clinical trials have come out of basic science findings that illuminate various steps along the disease process. As we uncover more about the disease process, even more drug targets are certain to be identified.
Examining brain tissue taken on autopsy
Sister Alice Caulfield
Dr. Carl Cotman
Transgenic mouse used in AD research study
Dr. Craft comparing high-fat to low-fat diet
A Sun City resident hits the gym
Water maze tests the ability of the mouse to remember
Dr. Paul Aisen
Another major advance has been the emerging consensus that the processes that culminate in AD are set in motion long before symptoms appear, and that the ability to identify people at a pre-symptomatic stage increases the chance of having a positive drug effect before cognitive decline becomes life-changing. The ability to define mild cognitive impairment (MCI) as an early stage in functional decline represents another step forward in accurately delineating the boundaries between normal and impaired cognition that can progress to AD. Improved tools for early diagnosis will help scientists test drugs on the right populations, ideally early in the disease process before symptoms begin.
Both basic science and drug development have benefited from the groundbreaking advances in imaging technologies that have occurred in the last few years. Imaging tools currently used in research have allowed scientists to see the pathologies of AD in living brains, shedding new light on many aspects of the disease process. Imaging is now also a key element of many clinical trials, making it possible to start correlating physical changes in the brain with alterations in thinking and memory abilities.
Scientists are singling out and studying many possible contributing causes of AD, including risk factors such as vascular disease, diabetes and insulin resistance, and inflammation, all of which in turn can be influenced by inherited susceptibility genes. While we cannot do anything about our individual genome and age, research is suggesting that some lifestyle factors that are within our control may be important. There is accumulating evidence to suggest that exercise, diet, and cognitive stimulation may make a difference to the aging brain, particularly when maintained over the course of a lifetime. Scientists have also begun to explore the therapeutic implications of studies that have associated AD with vascular disease and diabetes.
Many people wonder why it is taking so long to develop drugs that can help their loved ones or decrease their own risk. Their impatience is perfectly understandable. But AD is a complicated disease, and the process by which a safe, effective drug can be brought to market is a difficult one to traverse. Developing a new drug takes a lot of time, money, scientists trained in many different disciplines, and research volunteers—not to mention scientific brilliance and a lot of luck. Fortunately, in the world of AD drug development, many scientists and organizations are working very hard to develop drugs that will make a difference.
The search for drug treatments begins with basic science and may well end with a new outcome for millions of people. We can chart a new path toward the future for AD research by supporting continued basic scientific inquiry and the advances in drug development and therapeutic strategies that will come from it. In the final chapters of this book, we step inside the laboratories and learn about the clinical trials that are bringing that future ever closer.
In a little more than twenty years, the science has come to a point where the expectation is now that a treatment will definitely be found to slow or even prevent the disease. "Our only sorrow," Dr. Steven DeKosky said, "is that we can't do it instantly."
Excerpted from THE ALZHEIMER'S PROJECT: MOMENTUM IN SCIENCE, published by Public Affairs, www.publicaffairsbooks.com.
In This Section
- Building Cognitive Reserve
- Brain Efficiency
- The Role of Education
- Brain Building
- Personality Factors and Social Networks
- Assessing the Potential Benefits of Exercise and Diet
- Exercise and the Brain
- Diet and the Brain
- Developing New Drug Treatments
- Drugs in Development
- Practical Challenges
Momentum in Science: The Supplementary Series
- Understanding and Attacking Alzheimer's 12 min
- How Far We Have Come in Alzheimer's Research 15 min
- Identifying Mild Cognitive Impairment 20 min
- The Role of Genetics in Alzheimer's 12 min
- Advances in Brain Imaging 11 min
- Looking Into the Future of Alzheimer's 6 min
- The Connection Between Insulin and Alzheimer's 21 min
- Inflammation, the Immune System, and Alzheimer's 29 min
- The Benefit of Diet and Exercise in Alzheimer's 16 min
- Cognitive Reserve: What the Religious Orders Study is Revealing about Alzheimer's 20 min
- Searching for an Alzheimer's Cure: The Story of Flurizan 30 min
- The Pulse of Drug Development 15 min
- The DeMoe Family: Early-Onset Alzheimer's Genetics 25 min
- The Nanney/Felts Family: Late-Onset Alzheimer's Genetics 20 min
- The Quest for Biomarkers 17 min
Video: Inside the Brain: Unraveling the Mystery of Alzheimer's Disease
This 4-minute captioned video shows the progression of Alzheimer's disease in the brain.
Inside the Brain: An Interactive Tour
The Brain Tour explains how the brain works and how Alzheimer's affects it.
Alzheimer's Disease: Unraveling the Mystery
This book explains what AD is, describes the main areas in which researchers are working, and highlights new approaches for helping families and friends care for people with AD.
- About The Scientists
Connect with Alzheimer's Research
Find out how you can participate in clinical trials or studies, find a research center, or get up-to-date information at 1-800-438-4380.
The Alzheimer's Association 24/7 Helpline provides reliable information and support to all those who need assistance. Call us toll-free anytime day or night at 1-800-272-3900.
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- Rapid advances in our knowledge about AD have led to the development of promising new drugs and treatment strategies. However, before these new strategies can be used in clinical practice, they must be shown to work in people. Advances in prevention and treatment are only possible thanks to volunteers who participate in clinical trials.
- Among those touched by Alzheimer's (excluding self), nearly one-third provide support as a friend or relative, another 3% provide support as a healthcare professional, and the remaining two-thirds provide no support to the person suffering from Alzheimer's. When support is provided, it most often entails emotional support, followed by care-giving support. While small in comparison, more than one person in ten is providing financial support. Read more.