As a grocery checker, Judy Mallon usually punched in product codes without hesitating. When new ones were added, though, she began having a hard time remembering them. Then, she had difficulty understanding the new customer check authorization system. When keeping her work schedule straight became a problem and local driving trips became confusing, Judy knew something just wasn’t right and she sought a physician for help. After a series of tests, a neurologist confirmed Judy had early onset Alzheimer’s disease.
Forgetting where you left your car keys or why you walked into a room is a common occurrence as we age. Sometimes it’s just a matter of stress. But when the forgetfulness becomes more profound—losing a lifetime of memories, changes in personality and delusions – then the reality of Alzheimer’s disease suddenly sets in.
The realism of Alzheimer’s disease as a health care crisis has gained significant momentum in the last few years to a point of reaching epidemic proportions; it’s now the seventh leading cause of death in the United States. The statistics are staggering:
- More than 26 million people worldwide—including about 5 million Americans—have Alzheimer’s
- As the 78 million U.S. baby boomers pass age 65, the number of Alzheimer’s patients is expected to reach up to 12 million
- If no treatment or cure is found, as many as 106 million people worldwide may have Alzheimer’s by 2050, experts say
These numbers may seem overwhelming, but researchers have been working diligently to understand the disease and find better treatments. “We are just now, at the end of 25 years of modern research, learning about the disease and looking for ways to intervene. The fact is, we are poised for the development of second generation medications,” says Bill Thies, Ph.D., vice president of Medical and Scientific Relations for the Alzheimer’s Association, which is based in Chicago.
Finding a cure is a priority for Mallon, who was faced with the diagnosis of early onset Alzheimer’s disease at age 58. At that time, Judy and her husband Larry, of Aurora, Ill., participated in a yearlong double-blinded clinical trial testing an oral medication for nine months. Larry said they saw some improvement. Now, Judy is 63 years old and was recently selected to go through screening and testing to participate in a three-and-a-half year study for an Alzheimer’s vaccine.
“This vaccine is cutting-edge therapy, which has had some success with mice and monkeys. Our family all agree to be aggressive and cutting edge,” says Larry. Judy adds, “I’ll do anything I can for future research.” They admit they are a little selfish in wanting to help themselves, but know a lot of people are suffering too and feel the trial will benefit everyone.
Today’s treatment options
In the 1970s, pathologists found amyloid plaques (gooey clusters that form between nerve cells) and tangles of protein fragments present on the brain’s nerve cells, causing them to degenerate. Now, the challenge is to understand why these plaques and tangles form, then stop them from forming and damaging nerves. Clinicians currently manage Alzheimer’s by using modern medications which give some patients modest, but limited, benefits. What they fail to do is get at the cause of the disease; treating the symptoms but not modifying the disease.
Two classes of medications the U.S. Food and Drug Administration approved for use include cholinesterase inhibitors and memantine. “Cholinesterase inhibitors block the breakdown of a chemical neurotransmitter in the brain that becomes deficient early in Alzheimer’s,” says Dr. Sam Gandy, associate director of Mount Sinai’s Alzheimer’s Disease Research Center in New York City and chair of the Alzheimer Association’s Medical and Scientific Advisory Council. “They act by helping the brain compensate for early chemical deficiency. They turn the clock back for about six months for some patients, but the clock keeps ticking.”
Namenda, the other medication currently being used for Alzheimer’s, blocks the poisonous chemical in the brain that becomes potent with the presence of amyloid plaques.