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.
The photo is Lake Vättern in Sweden, a very lovely and peaceful place.