At this summer’s International Conference on Alzheimer’s Disease, it was clear that the focus of Alzheimer’s research is shifting away from treating symptoms and towards prevention.
This fall, two large prevention efforts are in the spotlight. The first is the Alzheimer’s Study Group (ASG), a taskforce of researchers, advocacy group executives and other experts working on an Alzheimer's National Strategic Plan to be presented to the U.S. Congress in March 2009.
The second effort, by Greater Boston Physicians for Social Responsibility (GBPSR) together with the Science and Environmental Health Network (SEHN), has resulted in a new report called Environmental Threats to Healthy Aging (With a Closer Look at Alzheimer’s and Parkinson’s Diseases).
The ASG draft proposals and the recommendations in the GBPSR/SEHN report represent two different approaches to Alzheimer’s prevention.
Alzheimer’s Study Group Draft Proposals
In late October, the Alzheimer Research Forum hosted a webinar on prevention to get input from researchers on the prevention aspects of the ASG’s National Strategic Plan. During the webinar, Alzheimer’s researchers and an ASG representative reviewed and discussed the ASG’s draft proposals. These proposals involve changes to the structure and funding of government agencies to make it easier to develop and commercialize new drugs.
Specific proposals include:
- Require the U.S. National Institutes of Health [NIH] to fund programs to help scientists translate lab discoveries into potential medicines
- Require the NIH and the U.S. Centers for Disease Control and Prevention to set up a nationwide registry of people who can participate in prevention studies
- Require the U.S. Food and Drug Administration to create a new office for neurological therapies
- Require the FDA to consider changes in biomarkers as a possible proof of effectiveness when approving Alzheimer’s prevention medicines. Biomarkers (such as substances in blood or spinal fluid, or abnormal protein deposits shown in brain scans) are supposed to indicate the presence of a disease. At this point, there isn’t enough evidence to tie any one biomarker to Alzheimer’s, so the appropriate biomarkers would be determined by a panel of experts under this proposal.
- Find ways for Medicare and Medicaid to fund research and clinical trials on prevention of Alzheimer’s
- Change patent law to increase the reward for development of drugs to prevent Alzheimer’s
- Provide tax credits for developing medicines for treatment and prevention of Alzheimer's.
Most researchers participating in the webinar spoke in support of these ideas. Many see patients in clinics as well as work in their labs. They know our ability to care for people with Alzheimer’s is inadequate, and they’re eager to bring potential prevention medicines to market.
But a couple of the scientists on the webinar seemed to question the assumptions underlying the draft proposals. “We still have to have a better idea of what Alzheimer’s is,” said one researcher, “and a better concept of what we mean by prevention. Is it killing underlying pathology or delaying onset?”
Another scientist said that it won’t work to look at just one disease outcome or biomarker. Many diseases are related to Alzheimer’s, he said, and he thinks the hypothesis that Alzheimer’s is simply premature aging (although “way out”) should be considered. If that hypothesis is true, he noted, prevention of Alzheimer’s is really prevention of premature aging. That is where the Environmental Threats to Healthy Aging report comes in (see Part 2 of this series).