A roundup of recent advances in dementia treatment and prevention
A diagnosis of dementia is often doubly devastating. Not only is the disease life-altering, even life-threatening, in most cases, it’s incurable. Many patients are told, “There’s nothing we can do.” However, with funding for research at an all-time high, physicians and scientists are hopeful for the future. Here, we have gathered some of the latest developments in treatment and prevention of dementia in easy to understand language. As always, talk to your (or your loved one’s) physician about what treatment options are available to you.
New medications aim to slow the effects of dementia
The top headline in Alzheimer’s research in 2021 was the accelerated approval of Aducanumab (Aduhelm™) by the FDA as a treatment for Alzheimer’s disease. This is the first FDA-approved therapy to address the underlying biology of Alzheimer’s disease. It is the first therapy to demonstrate that removing beta-amyloid, one of the hallmarks of Alzheimer’s disease, from the brain may reduce cognitive and functional decline in patients with early Alzheimer’s. While aducanumab is not a cure, it could buy more time for patients to remain independent, stay actively engaged in daily life and to maintain memories longer -- underscoring the importance of early diagnosis and treatment.
Another promising development in 2021 was the phase 2 trial of another medication, donanemab, in early symptomatic Alzheimer’s disease. Compared to a placebo, donanemab resulted in a better composite score for cognition and an increased ability to perform activities of daily living.
Many other medications are in various stages of clinical trials in the U.S. A review of the research pipeline in the U.S. in early 2022 found that there were 143 agents in 172 clinical trials for Alzheimer’s disease. About 80% were disease-modifying therapies (aimed at slowing or stopping the progression of Alzheimer’s); the remaining were cognitive-enhancing treatments and drugs for the treatment of neuropsychiatric symptoms.
OUR TAKE:
“From a clinical approach, the progress is very encouraging,” says Susan Robbins, director of dementia training for The Arbor Company. With so many clinical trials taking place in dementia and Alzheimer's disease research, we recommend speaking to your doctor about the possibility of joining a trial and if it would be a good fit for your diagnosis. Here’s a list of 10 additional questions to ask your doctor following a dementia diagnosis, from The Arbor Company's Senior Living Blog.
Preventing dementia by reducing risk
Many seemingly promising drugs for dementia, unfortunately, have not panned out in clinical trials. For that reason, some public health experts and researchers are shifting the focus toward minimizing modifiable risks. They argue that the best current strategy is to emphasize eliminating or reducing the effects of risk factors linked to dementia, such as hearing loss, untreated high blood pressure, and smoking.
In 2017, the highly respected Lancet Commission, a panel of doctors, epidemiologists and public health experts, analyzed hundreds of high-quality studies and identified nine risk factors that account for a significant portion of cases of dementia worldwide: high blood pressure, lower education levels, impaired hearing, smoking, obesity, depression, physical inactivity, diabetes, and low levels of social contact. Hearing impairment was identified as the single most important factor. In 2020, the Commission added three more risk factors: excessive alcohol consumption, traumatic brain injuries, and air pollution. The commission calculated that 40% percent of dementia cases worldwide could theoretically be prevented or delayed if those factors were eliminated.
Research continues to offer new insights into lifestyle factors that may lead to dementia. Most recently, vision impairment was identified as another modifiable risk factor, according to a report published recently in JAMA Neurology.
Researchers are also noting a correlation between dementia and sleep issues. One recent study found that older adults who nap regularly for an hour or more a day had a 40% higher risk of developing Alzheimer’s disease. While daytime napping is a normal part of aging, it may also foreshadow Alzheimer’s disease and other dementias. This reflects earlier research which compared the postmortem brains of people with Alzheimer’s disease to those without cognitive impairment. Those with Alzheimer’s disease were found to have fewer wake-promoting neurons in three brain regions.
OUR TAKE:
It's never too early to watch for the signs of cognitive decline and start reducing your risk factors. In this episode of Senior Living LIVE!, Susan shares the early signs of dementia and how they differ from those of normal aging. The video also includes tips to help prepare a loved one who has received a dementia diagnosis.
A hopeful future for dementia treatment
Much progress has been made since Alzheimer's disease was first described in 1906 by Alois Alzheimer. Today, most experts are cautiously optimistic about the future, as scientists’ understanding of how the disease disrupts the brain deepens. Subscribe to The Arbor Company blog, and we will keep you updated as these new developments emerge.
Until a cure is found, Susan’s advice: “One of the best gifts you can give yourself and your loved one living with dementia is to be their friend, not their boss—no one likes to be told what to do. They are doing their best and need your validation to feel okay.”
1 Alzheimer’s funding reaches all-time high (2019)
https://www.alz.org/alzheimers-dementia/research_progress/milestones
2 https://www.alz.org/alzheimers-dementia/treatments/aducanumab
3 The Lancet – Neurology – Volume 1 , January 2022
https://www.thelancet.com/action/showPdf?pii=S1474-4422%2821%2900412-9
4 Alzheimer's disease drug development pipeline: 2022, May 4, 2022.
https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/trc2.12295
5 New Dementia Prevention Method May Be Behavioral, Not Prescribed, New York Times, July 3, 2022. https://archive.ph/fWD4j
6 Extended napping in seniors may signal dementia, March 17, 2022
https://psych.ucsf.edu/news/extended-napping-seniors-may-signal-dementia#:~:text=A%20new%20study%2C%20led%20by,Alzheimer's%20disease%20and%20other%20dementias
