A recent article by Zaven Khachaturian, PhD, titled “Is the Rising Storm of Alzheimer’s Disease Stoppable?” discusses the 40 year failure on Alzheimer’s disease (AD) therapy development and the course of a national initiative to prevent AD.
He points out that a crucial public health objective is to “promulgate national policices and programs to foster prevention.”
Khachaturian identifies two salient areas of discovery which should inform future research and initiatives. These include “age of onset symptoms” and “interventions that could improve symptom management”. Early studies revealed an age associated exponential increase in the prevalence of dementia, including AD after the age of 65. This increase appears to almost double the rate of the disease every 10 years of age, escalating from 10% at age 65 to 40% at age of 80. Regarding interventions, the research focuses on best practices in nursing care and patient management which can both improve and delay symptoms.
The article provides a history of national policy directed at AD with an emphasis on symptom onset delay and the ultimate prevention of the disease.
Khachaturian makes an interesting argument regarding the manner in which public policy goals for AD differ from those for cancer and AIDS due to the prolonged duration of progressive disability associated with AD.
The article suggests that a more realistic goal than eradication or even prevention of AD is the identification of interventions that will delay the onset of symptoms, prolong functional independence and postpone the total dependence on labor intensive care to sustain life.
In order to find a solution to the complex issue of this global public health crisis, a systems approach may be required. This would require a national commitment and should include the scientific community, various advocacy groups, policy makers, pharma-biotech companies, government agencies and Congress.
Evidently, vascular problems in midlife can contribute to adverse effects on the brain decades later. Studies looking at stroke, mild cardiovascular problems in middle age, diabetes, hypertension and smoking have found that all of these are modifiable risk factors for all-cause dementia. Other studies have shown that exercise, diet, nutrition and cognitive and social activities are all major factors in preserving cognitive health.
Despite the fact that the last 40 years and billions of dollars spent in research have failed to yield any significant therapy or definitive findings, Khachaturian finds a positive outcome. This outcome is a new found understanding of the neurobiology of chronic brain disorders. Some of the theories resulting from the research to date include “calcium hypothesis; neuroinflammation; metabolic or mitochondrial dysfunction; brain microvessel disease and lifestyle and risk factors.”