Alzheimer's treatments: What's on the horizon?

Despite many promising leads, new treatments for Alzheimer's are slow to emerge.

By Mayo Clinic staff

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Alzheimer's treatments currently work by temporarily improving symptoms of memory loss and problems with thinking and reasoning.

These Alzheimer's treatments boost performance of chemicals in the brain that carry information from one brain cell to another. However, these treatments don't stop the underlying decline and death of brain cells. As more cells die, Alzheimer's continues to progress.

Experts are cautiously hopeful about developing Alzheimer's treatments that can stop or significantly delay the progression of Alzheimer's. A growing understanding of how the disease disrupts the brain has led to potential Alzheimer's treatments that short-circuit fundamental disease processes.

Future Alzheimer's treatments may focus on combinations of medications like those used for many cancers and AIDS rather than a single compound. The following treatment options are among the strategies currently being studied.

Taking aim at plaques

Some of the new Alzheimer's treatments in development target microscopic clumps of the protein beta-amyloid (plaques). Plaques have long been considered a sign of Alzheimer's disease.

Two strategies aimed at beta-amyloid include immunizing the body against it and blocking its production:

  • Immunization strategies may prevent beta-amyloid from clumping into plaques and help the body clear the beta-amyloid from the brain. An early Alzheimer's vaccine to reach clinical trials mobilized a person's own immune system to attack beta-amyloid.

    Researchers stopped this study ahead of time when some participants developed acute brain inflammation. Although the trial ended before researchers could fully assess the vaccine's effectiveness, the study demonstrated that beta-amyloid immunization could have a powerful effect on the brain.

    Most current immunization studies focus on administering antibodies against beta-amyloid from outside sources instead of enhancing a person's immune system.

    One large research effort is exploring the value of intravenous (IV) infusions of a product derived from donated blood. This product contains naturally occurring anti-amyloid antibodies from the donors. Other studies are investigating laboratory-engineered (monoclonal) antibodies.

  • Production blockers may reduce the amount of beta-amyloid formed in the brain. Research has shown that beta-amyloid is produced from a "parent protein" in two steps performed by two different enzymes. Several experimental drugs aim to block the activity of the two enzymes.

Keeping tau from tangling

A vital brain cell transport system collapses when a protein called tau twists into microscopic fibers called tangles, which are another common brain abnormality of Alzheimer's. Researchers are looking at a way to prevent tau from forming tangles.

Reducing inflammation

Alzheimer's causes chronic, low-level brain cell inflammation. Researchers are studying ways to treat inflammatory processes at work in Alzheimer's disease.

Studies in nonsteroidal anti-inflammatory drugs have had varying results, but haven't confirmed that these drugs prevent or delay progress of Alzheimer's.

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References
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  2. Treatment horizon. Alzheimer's Association. http://www.alz.org/research/science/alzheimers_treatment_horizon.asp. Accessed Jan. 3, 2013.
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  6. Coalition against major diseases (CAMD). U.S. Food and Drug Administration. http://www.fda.gov/AboutFDA/PartnershipsCollaborations/PublicPrivatePartnershipProgram/ucm231134.htm. Accessed Jan. 4, 2013.
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AZ00048 March 6, 2013

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