We happened to encounter a flurry of postings and blogs
about Alzheimer’s disease on the web today.
The research these postings were based on was not new, but had generated
considerable enthusiasm on the web about possible breakthroughs in treatment of
Alzheimer’s. That would, of course, be
wonderful news. But as with much that is
written about Alzheimer’s disease, it can be hard to distinguish between
science and hype.
Article 1. The
headline of this blog read “Happy New Year!
Stanford May Have Just Cured Alzheimer’s.
Ok, we aren’t up to date on this blogger, and we don’t hold
Stanford University responsible for the content or title. The science behind this study is kind of
interesting. The premise is that Alzheimer’s
may be caused by the failure of cells that are part of the immune system and
clean out the brain of various substances that may lead to the damage found in
Alzheimer’s disease. Apparently, by
getting these immune cells working again, memory loss is reversed. In mice.
As you may know, mice don’t get Alzheimer’s disease, but to
study the disease, scientists have created a “mouse model” by introducing genes that cause changes similar to Alzheimer’s disease. Going from mouse to man is the issue. Mouse studies can provide interesting leads,
but since mice don’t get the disease normally, treatments like in this study
may help in an abnormal condition imposed unnaturally on mice, but not in
people. So far the translation to humans
of other results based on mouse models has not been encouraging.
Article 2. New
Alzheimer’s treatment fully restores memory function.
This is an Australian study reported in March. According to the article, which was published
in the prestigious journal, Science
Translational Medicine, ultrasound removes amyloid-β, one of the main types of pathology found
in Alzheimer’s. And memory
improves. In mice.
One of the authors is quoted on the web as saying that the
word “breakthrough” is overused, but he believes this is one. Maybe this treatment will pan out in humans,
but the plaque busting drugs that worked well in mice have bombed in
humans. Even when these medications eliminate amyloid
plaques in the brain, memory does not seem to improve. And they are not without nasty side effects.
Article 3. How Can We
Detect Alzheimer’s Early
A longstanding goal in research has been to be able to detect
Alzheimer’s early, and treat it before too much damage occurs in the
brain. How to detect Alzheimer’s early
remains a problem, and there is much controversy over the meaning of findings
of amyloid plaques and mild memory loss found in humans. Do these kinds of changes signify early
Alzheimer’s or not?
Now comes an answer to identifying early cases. We have to admit we overlooked this report
when it burst upon the scene two years ago.
According to researchers at University of Florida, you can tell who is
going to get Alzheimer’s disease by their ability to smell peanut butter! We couldn’t bear to track down the original
papers from that study. The literature
is filled with studies that claim that one single factor will tell us who will
get Alzheimer’s or who has it, and these studies never pan out. Alzheimer’s is too complicated and varied for any single marker to always indicate the disease in a reliable way. But on second thought, maybe there is
something to peanut butter. We use it to
bait our mouse traps and we can attest that mice are able to smell it. And they don’t have Alzheimer’s. Makes you wonder about the mice who are given
the Alzheimer changes…maybe someone needs to do a study to see if they lose
their ability to smell peanut butter.
Article 4. Memory
Loss Associated with Alzheimer’s Reverse for First Time
This is the headline of a news release from UCLA from a year
ago. The release is based on a paper
published in the on-line journal, Aging. Here, the idea was to give people multiple
treatments in the hope that something would change. There were 36 parts to the treatment including
diet changes, brain stimulation, exercise, increasing sleep, medications and
supplements.
The idea of using multiple treatments is appealing. There may be factors that slow the disease a
little bit. Exercise, weight control,
and cognitive stimulation are the most promising of these factors. The idea of multiple treatments is that if
you put all of the things together that might work, they might add up to
something useful.
Ten people participated in the UCLA study. Case studies are presented on three of those
people and subjective information along with some lab tests are reported. But what is not clear is how many of the
people actually have Alzheimer’s disease.
One person is described as having severe Alzheimer’s and did not improve
during the treatment. Diagnostic
information is not presented about any of the others. Instead, they are described as suffering from
mild cognitive impairment or subjective cognitive impairment, that is, they
report a problem with memory but it was not actually confirmed. Though the article
claims their memory improved, that is again apparently based on self-reports
and there are no objective tests showing improvement. Maybe the treatment works, but maybe the
people who elect to participate in an intensive study where they make a lot of lifestyle and diet changes and get lots of attention and are expected to improve are going to report that
they are doing better, whether they do or not. Did we say there
was no control group? There was
none. To claim Alzheimer’s has been
reversed for the first time is rather overstated. In fairness, one of the authors is quoted as
calling the findings “anecdotal.” He got
that right.
All the fear that has been created around Alzheimer’s
disease in recent years means that people will grasp at anything positive that
comes along. The media and internet fan
the flames, because they know it gets attention.
Maybe it doesn’t matter, but it seems wrong to us to raise
fears and false hopes about a terrible and heartbreaking disease like
Alzheimer’s. There are serious studies
going on that are incrementally increasing our understanding of Alzheimer’s and
other forms of dementia. We hope someday
this research will give us treatments to ease the symptoms and maybe even
arrest the disease. Maybe the studies we
looked at here will even contribute to that breakthrough. But, frankly, we don’t yet understand the
disease well enough to know where to look for those treatments. We’ve been like the proverbial man looking
for his car keys under the lamppost.
When asked if that was where he lost them, he replies “No, but it’s where
the light is.”
For now, we might better put our energy toward supporting
those families who are caring for someone with dementia. We can do things that help make each day
easier by being there, listening and helping out the caregiver and the person with
dementia.
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