Emerging Therapies in Alzheimer’s Disease

Alzheimer’s disease has been in the news recently because of a new medication approved by the FDA, but there are many other emerging therapies.

September is World Alzheimer’s Month, a health holiday created to bring awareness to the global problem of Alzheimer’s dementia. Experts estimate that more than 50 million people around the world struggle with dementia. Although there are many types of dementia, Alzheimer’s is the most common form.

You may have heard about a new therapy for Alzheimer’s disease recently approved by the US Food and Drug Administration (FDA)—Aduhelm (aducanumab). This was a fascinating development in the world of Alzheimer’s treatments because it had been several years since a new drug had been approved. However, there are many other current and emerging therapies available to help people who are struggling with Alzheimer’s disease.

At Lompoc Valley Medical Center, we are devoted to staying up to date on established treatment methods for our patients, as well as on emerging therapies. Here is what you need to know about Alzheimer’s disease and the therapies that are available today, as well as those that may be available in the future.

What is Alzheimer’s disease?

Alzheimer’s disease is the most common type of dementia in the world. People who have Alzheimer’s disease have changes in their brains. They may have “amyloid plaques” that collect on their nerve cells or twisted nerve cells called “tangles.” Both plaques and tangles can cause damage to the brain, which can cause the brain to shrink. As the brain shrinks, a person can begin to have difficulties with their memory, and they may have other symptoms, too. Alzheimer’s dementia can cause personality changes, difficulty learning new things, difficulty planning, and even difficulty speaking. The changes that Alzheimer’s triggers within the brain tend to occur very slowly—often, it can take many years before a person with Alzheimer’s disease starts showing symptoms.

Who is most likely to get Alzheimer’s disease?

Alzheimer’s disease is more likely to occur in people who are age 65 or older. However, it is possible to get Alzheimer’s disease at a younger age (this is called “early-onset Alzheimer’s”). You may be more likely to get Alzheimer’s disease if a sibling or parent has had the condition, although people can get Alzheimer’s disease without a positive family history.

What’s the difference between Alzheimer’s disease and age-related memory loss?

Although having trouble with memory is a normal part of getting older, the types of symptoms that occur with Alzheimer’s dementia are more pronounced and can make it difficult to perform daily activities. Alzheimer’s disease causes specific physical changes in the brain (plaques and tangles), which scientists focus on when developing new therapies to help people with Alzheimer’s disease.

What are the signs of Alzheimer’s disease?

According to the Alzheimer’s Association, there are ten classic early signs of Alzheimer’s dementia.

These include:

• Short-term memory loss
• Difficulty sticking to a schedule
• Problems completing a routine task (like making a grocery list)
• Getting confused about time or place
• Struggling to see well enough to read or stay balanced
• Problems following a conversation
• Frequently losing or misplacing items without being able to retrace one’s steps
• Declining judgment or deteriorating hygiene
• Losing interest in work or social life
• Personality changes, such as becoming suspicious, angry, or afraid

These signs of Alzheimer’s disease can also occur in many other illnesses, as well. This is why it is important to see a medical provider if you or a loved one begin to have changes that make you concerned for dementia.

How is Alzheimer’s disease diagnosed?

A medical provider may start to suspect Alzheimer’s disease after conducting a medical interview and detailed physical exam. There are special types of tests—known as neurocognitive assessments—that can help a medical provider make an Alzheimer’s diagnosis. Some computerized tests have been approved by the FDA to help diagnose Alzheimer’s disease.

It is not easy to diagnose Alzheimer’s through a specific blood test or a picture of the brain. Still, these additional tests can help a medical provider rule out other causes of dementia symptoms. An MRI study of the brain may be required before starting certain treatments for Alzheimer’s disease, such as the new FDA-approved medication, Aduhelm. If you have a significant family history of Alzheimer’s disease, a medical provider may also consider a genetic test.

What kinds of treatments are available for Alzheimer’s disease?

Alzheimer’s disease does not have a cure. However, many different kinds of treatments are available to help people with Alzheimer’s disease have a better quality of life and experience fewer symptoms.

The general types of treatments for Alzheimer’s disease include:

• Medications to help change the course of the disease
• Medications to help with symptoms related to memory and thinking
• Medications to help with behavioral symptoms (like hallucinations or agitation)
• Medications to help with sleep disturbances

Often, a medical provider who specializes in helping patients with Alzheimer’s disease will use a combination of medications to help patients optimize their quality of life.

What are the most common ways that Alzheimer’s disease is treated?

Once a person is diagnosed with Alzheimer’s, there are many treatment options available.

Cholinesterase inhibitors

A common Alzheimer’s medication known as a cholinesterase inhibitor (a drug class that includes names such as donepezil, rivastigmine, or galantamine) can help improve symptoms related to thinking. This type of medicine can help people think more clearly and have an easier time completing daily activities. It may also help with behavioral symptoms. Cholinesterase inhibitors can help people with mild to moderate Alzheimer’s disease.

Memantine (Namenda)

Another common medication used in Alzheimer’s disease—and may be added to a cholinesterase inhibitor—is memantine (Namenda). This type of medicine can also help a person with Alzheimer’s disease think more clearly, and it may slow the speed of their disease progression. Memantine is typically more helpful for people with advancing Alzheimer’s disease.

Antioxidants

Certain antioxidant vitamins—such as Vitamin E—may also help with Alzheimer’s disease. Before starting any sort of vitamin, however, it is very important to check in with your medical provider.

Lifestyle modifications

Many people with Alzheimer’s disease benefit from specific nutritional and exercise plans. A specific memory rehabilitation program, or occupational therapy program, can help with symptoms and behaviors, as well. Depending on how Alzheimer’s disease is progressing, behavioral therapy may also be very helpful.

What is the newest therapy for Alzheimer’s disease?

In June of 2021, the FDA approved a new Alzheimer’s medication known as Aduhelm (aducanumab). This medicine uses a type of antibody to directly fight against the creation of the amyloid plaques in the brain that can lead to brain damage and shrinking. This can help slow the progression of early-stage Alzheimer’s disease.

Aduhelm has only been approved for Alzheimer’s patients with mild cognitive impairment and mild dementia. However, scientists are still studying its impact on people with more severe forms of the disease. Aduhelm is different from other types of Alzheimer’s medications because, instead of being in pill form, it is given through an IV, with periodic doses over several weeks. During treatment with Aduhelm, medical providers will monitor the brain by doing periodic MRI imaging tests.

Because Aduhelm is a new medication, there is a lot of excitement surrounding it. However, there are also many unknowns, such as how insurance companies may manage the cost of treatment. Medical providers will take into account all available information to determine whether Aduhelm therapy may be appropriate for their patients.

What kinds of treatments for Alzheimer’s disease may be available in the future?

One of the most exciting aspects of Alzheimer’s care is its emerging therapies. The National Institute on Aging (NIA) is currently supporting 271 ongoing research projects devoted to Alzheimer’s disease and other related forms of dementia.

Like Aduhelm, many emerging Alzheimer’s medications target the amyloid plaques involved in Alzheimer’s disease. Some drug developers are focusing their new treatments on another type of protein (“tau”) that causes tangles within the brain of Alzheimer’s patients.

Other emerging therapies for Alzheimer’s disease may include:

• Anti-inflammatory medicines
• Cardiovascular disease medicines
• Insulin resistance medicines
• Cancer treatments
• Vitamins
• Hormonal medicine
• Antiviral medications
• Seizure medications

Not all emerging Alzheimer’s therapies are pharmacologic medications. Instead, scientists have found that using light and sound waves to stimulate the brains of people with Alzheimer’s disease can help improve their memory and thinking. The company that created this futuristic technology describes it as like a strobe light, but much faster.

Other non-drug emerging therapies for Alzheimer’s disease include magnetic brain stimulation, smartphone technologies, digital communication technologies, social engagement technologies, and robots. The future of Alzheimer’s therapies is bright, especially as researchers learn more about the disease.

How to prevent Alzheimer’s disease

Even though there are several current therapies (and many emerging therapies) available to help people with Alzheimer’s disease, preventing yourself from getting Alzheimer’s disease in the first place may be your very best form of action.

Here are some of the things that experts at the Alzheimer’s Association recommend for Alzheimer’s prevention:

• Get regular physical activity
• Eat heart-healthy foods, such as the DASH diet or Mediterranean diet, as these may also benefit the brain
• Maintain social connections
• Keep your brain stimulated with intellectual activities
• Avoid head trauma by wearing a seatbelt, using a helmet, and making sure that your home is free from items or clutter that could cause you to fall

The biggest risk factor for Alzheimer’s disease is age, which is something that you cannot control. However, by adopting healthy lifestyle habits, you can do your part to reduce your risk of Alzheimer’s disease—and many other chronic health conditions.

What to do if you are concerned about developing Alzheimer’s disease

Alzheimer’s disease affects many people worldwide—as well as their families and other loved ones. However, scientists are researching new therapies to help people with Alzheimer’s disease. At Lompoc Valley Medical Center, we are devoted to helping you and your loved ones live fully, and we offer state-of-the-art ways of detecting and managing dementia.

If you or a loved one is struggling with signs of dementia, contact us to schedule an appointment today.