New Hope for Alzheimer's Patients

Advances in treatment may slow dementia's progression

Watching a loved one slowly succumb to the memory-robbing illness known as Alzheimer's disease can be devastating.

Although there's no known cure for this type of dementia, recent therapeutic treatments and future drug innovations promise to improve sufferers' quality of life.

"Americans love what I call the silver bullet approach to medicine," said Dr. Richard Powers, an associate professor at the University of Alabama at Birmingham and director of geriatric psychiatry at the Alabama Department of Mental Health. "There ain't going to be no silvers bullets with Alzheimer's."

Yet, early detection and aggressive treatment will help people with Alzheimer's delay mental decline, Powers added. Even small improvements - a father who can recognize his son for another year or a mother who maintains urinary continence for a while longer - can provide comfort. "Keeping someone out of the nursing home is a major event for families," he said.

Meanwhile, new research may further scientists' understanding of why Alzheimer's occurs and who is most at risk of developing it. That's reason to be encouraged this November, which marks National Alzheimer's Disease Awareness Month.

An estimated 4.5 million Americans are afflicted with Alzheimer's disease, according to the National Institute on Aging. By 2050, total cases will reach 13.2 million unless new ways to prevent or treat the disease are discovered.

While the exact causes of Alzheimer's are not fully understood, the brains of people who've had the disease typically exhibit sticky "plaques" made of amyloid protein deposits and "tangles" made of another protein called tau. These plaques and tangles, the hallmark of Alzheimer's, remain key targets for drug interventions.

There's also a theory that interruptions in brain blood flow may contribute to Alzheimer's.

"The idea that there's just a single cause for dementia in the vast majority of individuals is not being substantiated by the pathologists, now that we have better tools for identifying the damage," Powers said.

Today, there are two classes of medicines for treating Alzheimer's. One is the cholinesterase inhibitors, which prevent the breakdown of an important chemical messenger in the brain called acetylcholine. This class includes the drugs Aricept (donepezil), Exelon (rivastigmine), and Reminyl (galantamine).

Namenda (memantine), approved last October, is the first drug in a new medication class that appears to work by protecting against the excess production of glutamate, an important chemical messenger in the brain that can become toxic in large quantities.

Today, drugs from each class often are prescribed in combination to lessen symptoms and slow progression of the disease.