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Alzheimer's Disease
Brain scan comparison
| Alzheimer's disease (AD) is sometimes referred to as "The Long Goodbye." It affects not only the patient, but also family and friends who must watch the slow progression of the disease and often provide care for their loved ones. Just over ten years ago, there were no treatments for AD. Today, however, because of advances in pharmaceutical research, there are medicines available to treat AD and help slow its symptoms. These medicines have improved the quality of life for many patients and the loved ones who care for them. And new medicines are being studied that offer the hope that one day AD will be a treatable or preventable condition not to be feared as it is now.
What is Alzheimer's disease and who is affected?Alzheimer's disease is an illness that damages the nerves in the brain. It gradually destroys a person's memory, judgment, and overall ability to think. Due to these effects, people with AD may have a difficult time communicating and carrying out daily activities. As the disease progresses, patients eventually lose their short-term memory and independence.
An estimated 4.5 million Americans have AD. The number of Americans with the condition has more than doubled since 1980 and will continue to grow.1 When the Baby Boomer generation begins to reach the age of 65 in 2011, the number of Americans with Alzheimer's disease will increase to levels that may exceed our ability to cover the added costs of their care.2 By 2050, the number of individuals with Alzheimer's could reach 16 million.3
Medicines and health care spending related to AD
Today, half of all nursing home patients suffer from AD or a related disorder. The average cost for a patient's care in a nursing home is more than $40,000 per year, but can exceed $70,000 per year in some areas of the country.4 Available AD treatments have been shown to delay nursing home placement by an average of 30 months.5
Doctor reviews brain scans | Current treatments are improving quality of life
The search for AD treatments has focused on the basic biological processes that damage the brain of Alzheimer's disease patients. For example, we now know that those with AD experience a breakdown of certain chemicals in the brain. These chemicals carry messages between nerve cells and the brain, a process important for memory and other mental abilities. Medications help to make more of these chemicals available in the brain, thereby enabling people with AD to maintain a higher level of memory-related and cognitive functioning.
By late 2003, the U.S. Food and Drug Administration had approved five drugs to treat the symptoms of Alzheimer's disease. Of these, four are known as cholinesterase inhibitors.6 Cholinesterase inhibitors treat mild to moderate cases of AD by preventing the breakdown of certain chemicals, called neurotransmitters, in the brains of AD patients. Cholinesterase inhibitors help to improve cognitive functions by raising the level of these neurotransmitters. Tacrine was the first drug in this class. More recently, donepezil, galantamine, and rivastigmine have become available. These drugs improve some patients' abilities to carry out daily activities and may help people who suffer from Alzheimer's retain their memory, thinking, and speaking skills. Researchers are investigating ways to further improve communication between nerve cells, protect nerve cells from damage, and repair already damaged brain cells in those with AD.
In addition to the cholinesterase inhibitors, memantine is the first of a new type of drug to be approved in the United States for AD since tacrine. Unlike cholinesterase inhibitors, memantine protects the brain's nerve cells against damage caused by an excess amount of a chemical found in patients with AD. Memantine offers an important new therapeutic option for patients suffering from moderate to severe Alzheimer's disease. It is sometimes used in combination with cholinesterase inhibitors for an added benefit.
Current medications offer help and hope, but there is a critical need for new medicines to treat the growing Alzheimer's population. Like the strides made in heart disease, where better medicines have reduced the need for surgeries and hospitalizations, new medicines to treat Alzheimer's disease could potentially reduce the burden on families, the health care system, and society as a whole.
Drugs in Development
Although the treatments available today can alleviate the symptoms of Alzheimer's disease and slow progression, there is no treatment available that stops the progression of the disease. Current research is addressing what could be the underlying cause of Alzheimer's disease — the buildup of plaques that form in patients' brains. This buildup is believed to cause brain damage and memory loss. Immunotherapies (treatments that use the body's natural defenses to fight disease) aimed at stopping this plaque buildup are in clinical trials. These therapies may prevent the neurological deterioration that occurs in Alzheimer's patients.
Researchers are also studying statins, the common name for a class of drugs that lowers levels of low-density lipoprotein (LDL) cholesterol, as prevention or a treatment for Alzheimer's. Evidence suggests that there is a link between taking statins to reduce cholesterol levels and decreased occurrence of Alzheimer's disease.
Recent history has shown that significant increases in our understanding of the underlying causes of Alzheimer's disease provides a platform for the future development of promising treatments. Additional research and studies about AD offer the potential of new medical breakthroughs, and it is likely that someday we may be able to cure or prevent this disease.
We invite you to explore innovation.org to learn more about this disease, new medicines in development to treat it, and to read the real-life stories of patients who are benefiting from new medicines.
Related links:
Patient Stories
New Medicines Database
Patient Assistance Programs
1Hebert, LE; Scherr, PA; Bienias, JL; Bennett, DA; Evans, DA. "Alzheimer Disease in the U.S. Population: Prevalence Estimates Using the 2000 Census." Archives of Neurology August 2003; 60 (8): 1119 - 1122.
2Alzheimer's Association website: www.alz.org. Accessed April 1, 2005.
3Hebert, LE; Scherr, PA; Bienias, JL; Bennett, DA; Evans, DA. "Alzheimer Disease in the U.S. Population: Prevalence Estimates Using the 2000 Census." Archives of Neurology August 2003; 60 (8): 1119 - 1122.
4Alzheimer's Association website: www.alzwisc.org. Accessed April 1, 2005.
5G. Provenzano, "Delays in Nursing Home Placement for Patients with Alzheimer's Disease Associated with Donepezil May Have Care Cost Saving Implications." Value in Health 4 no. 2 (2001):158.
6Alzheimer's Association website: www.alz.org. Accessed April 1, 2005.
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