12 Jan Think You’re Too Young To Prevent Alzheimer’s? Think Again
Last month, the federal government announced it would provide a $33 million grant to help underwrite a clinical trial to develop a pharmaceutical approach to preventing Alzheimer’s disease.
This news comes on the heels of a report that the latest candidate in the pipeline of drugs designed to treat Alzheimer’s disease had failed, miserably. In fact, the drug, semgacestat, actually hastened the cognitive decline of people who received it, according to research published in The New England Journal of Medicine.
While the idea of creating a drug to prevent Alzheimer’s seems honorable, it’s important to consider that the development of such a drug means big business beyond measure. Deutsche Bank estimates that the development of an efficacious drug treatment for the disease once it has taken hold could generate $20 billion in annual sales. But the value of a drug employed to treat people before there is any evidence of dementia—a far larger treatment group compared to those already afflicted—would be staggering.
New York Times writer Pam Belluck reported that the goal of this grant would be to develop a preventive treatment using a strategy much like the one for heart disease. Belluck quoted Laurie Ryan, program director for the Alzheimer’s clinical trials at the National Institute on Aging, who said, “We’re going to look at people at risk, just like we do with people who have high cholesterol and are at risk for cardiovascular disease.”
For now, let’s ignore the comparisons with cholesterol, which is a fundamental component in the protection of brain cells, and let’s focus on the attempt to develop an Alzheimer’s prevention pill. What’s ironic is the fact that well-respected neuroscience research clearly defines the powerful role of modifiable lifestyle factors in dramatically reducing the risk for this disease—a disease now costing Americans some $200 billion annually. That’s almost triple what we spend on treating patients with heart disease, according to a recent RAND report published in the New England Journal of Medicine.
What’s so desperately challenging is the recognition that the science supporting the powerful relationship between lifestyle choices and risk for Alzheimer’s, an incurable condition, is all but ignored. After all, these lifestyle choices cannot be monetized. They cannot be manipulated in the quest for the brass ring.
As a practicing neurologist specializing in neurodegenerative conditions, I’m face to face with the devastation not just of the individual, but of the families and friends of Alzheimer’s patients every day. And while the RAND report quantifies the monetary expense of this condition, there is no metric for the emotional impact on those who must helplessly observe the merciless progressive cognitive decline in someone they love.
Beyond their grief lies a fear in the children of Alzheimer’s patients that no doubt will play into the hands of those involved in developing the prevention drug. This fear is so often confided to me after I’ve evaluated a patient when a son or daughter pulls me aside and asks what they can be doing so that they don’t “end up like dad.” This is often followed by a statement like, “This is so tough. You just can’t imagine what it’s like.”
It’s then that I explain that in fact there’s a lot that they can do to meaningfully impact their risk for Alzheimer’s disease and it’s not in the form of anything purveyed on a prescription pad.
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