The aging of the Baby Boom generation has been dubbed “the silver Tsunami” – but experts say the real tidal wave that could swamp our healthcare system will be dementia.
A recent report in the New England Journal of Medicine estimates that 3.8 million people over age 71 are living with dementia, a number expected to soar to 9.1 million by 2040. The 2010 tab of $379 to $511 billion for treating Alzheimer’s and other forms of dementia could more than double by then, according to the report by the RAND Corporation.
Does New Research Hold Promise?
President Obama recently announced an ambitious $100 million project to map the human brain and find new tools for detecting and treating diseases like dementia starting in 2014.
But will this effort, coupled with recent progress in Alzheimer’s research, be enough to stem the tide?
“This is a wonderful initial step toward improving neuroscience research.” says Robert A. Stern, PhD, a professor of neurology and neurosurgery who directs clinical research for the Boston University Alzheimer’s Disease Center. “However it does not address specific diseases in any way. If $100 million could be directed toward Alzheimer’s research it would be a start.”
Indeed, Dr. Stern adds, more funding to explore recent discoveries in genetics, biomarkers in spinal fluid and advances in brain imaging to help predict the course of the disease may make early intervention and treatment a real possibility.
The FDA announced in mid-March that it will now approve new Alzheimer’s drugs even if they show only small improvements in memory and cognitive function in the earliest stages of the disease.
What Are the Newest Avenues of Research?
Several new research projects are underway. Among them:
- Nerve growth factor A first-of-its-kind study of gene therapy to treat Alzheimer’s dementia, led by the University of California at San Diego, is underway at 10 sites across the US. It will examine the potential benefits of a compound called CERE-110, which contains a gene that will be injected into a key part of the brain affected by Alzheimer’s. The gene will tell brain cells to make more of a protein called Nerve Growth Factor to help neurons survive and grow properly – a process halted by the onslaught of Alzheimer’s. A total of 50 patients are being recruited for the placebo-controlled trial.
- Resveratrol The Memory Disorders Program at Georgetown University Hospital and Georgetown University Medical Center in Washington, DC, are conducting a clinical trial to determine whether high doses of the plant chemical resveratrol(found in red wine and grapes) can delay or prevent the development of Alzheimer’s. Experiments in mice suggest it can, due to its metabolic effects on the mechanisms of aging and its antioxidant properties, lead investigator R. Scott Turner, MD, PhD told a recent meeting of the Association of Health Care Journalists (AHCJ) in Boston. Patients will be given a dose of resveratrol equivalent to 1,000 bottles of red wine or a placebo in hopes of stopping Alzheimer’s progression.
- Amyloid imaging Investigators are testing imaging techniques to detect the presence of beta amyloid protein in key areas of the brain in studies funded by Alzheimer’s Association. Amyloid produces the plaques that cause brain cells to atrophy. Among the techniques are real-time or functional magnetic resonance imaging that could spot amyloid in the brain in the absence of symptoms or in mild cognitive impairment, helping to make for an early diagnosis together with other testing.
- Head Injuries Dr. Stern told the AHCJ meeting that it is investigating the Alzheimer’s-like disease Chronic Traumatic Encephalopathy, which is caused, in part, by repetitive brain trauma such as mild concussions from contact sports (or even repeated falls). CTE, like Alzheimer’s, is characterized by excess amounts of a protein called tau. A detection trial among former NFL players – who are at highest risk for CTE – has already begun. He hopes to determine other underlying risk factors for CTE, including genes, and start treatment and prevention trials.
- Genetic defects A study of 6,000 African Americans recently uncovered a variant of the gene ABCA7, which is involved in the production of cholesterol and other fats. Along with the cholesterol-associated gene APO-e4, ABCA7 almost doubles the risk of late-onset Alzheimer’s. Because imbalances in cholesterol and lipids lead to vascular disease, a search is on to validate the discovery and find treatments to target those risk factors and lessen or delay Alzheimer’s, says Richard Mayuex, MD, MS, professor and chair of Neurology at Columbia University Medical Center.
“We have to remember that Alzheimer’s is not a normal part of aging, it’s a neurodegenerative disease associated with aging. While one out of three seniors dies with Alzheimer’s, two out of three do not,” Dr. Stern stresses. “However, we are seeing it more often and in younger people, making our efforts to prevent and treat Alzheimer’s especially urgent.”