Alzheimer’s disease now affects 5.8 million Americans, according to the Alzheimer’s Association. Yet while the disease marches on, researchers are gaining ground, and some of the most important work in the field is being done in St. Louis.
The Charles F. and Joanne Knight Alzheimer’s Disease Research Center, part of the department of neurology at Washington University School of Medicine, is one of the largest and most influential Alzheimer’s research centers in the world. “Many of the major advances in the field, from spinal fluid biomarkers to imaging to genetics of AD, all the way to a new blood test for AD that is in the works, come from the Knight ADRC,” says Dr. Erik Musiek, a Washington University neurologist and Knight researcher.
In late October, Musiek says, pharmaceutical company Biogen announced some encouraging results from an experimental drug study of aducanumab, a type of human antibody.
“The company initially announced that the trial of the drug had failed, but they have now analyzed more data and have found some evidence that may work,” Musiek says. “The company is planning to seek approval from the FDA [Food and Drug Administration] for this drug to treat Alzheimer’s.”
Musiek expands that aducanumab can remove amyloid plaques from the brain that may slow the progression of the disease.
“If it is approved, it would be the first drug which may slow the disease progression, which is a major step,” Musiek adds. “However, the trial data is complicated, and it is not a sure thing that is will be approved. But at the very least, there is renewed cause for optimism!”
Besides this breaking news, Musiek says researchers learned that the brain changes associated with Alzheimer’s begin to accumulate about 20 years before any memory loss occurs. “This is really important, as it suggests that we have a big window to potentially stop this disease before it causes symptoms,” he notes.
Researchers can detect these early changes by sampling spinal fluid and measuring levels of Alzheimer’s-related proteins (specifically, amyloid beta and tau) and by using special brain scans (amyloid PET scans). “This changes everything, as we can now test new drugs to see if they can stop the disease before people even know they have it,” Musiek adds. “Several ongoing drug trials are treating people who have no symptoms but have positive biomarkers, including the landmark DIAN (Dominantly Inherited Alzheimer Network) trial here at Washington University.”
While Musiek notes that many drugs are being tested, he admits that drug trial failures are common. However, this data is crucial to researchers as they continue to move forward in the search for a cure.
“In general, it seems that treating as early as possible is the most likely strategy for success,” Musiek says. “I tell patients that it is a slow-moving disease and that there is hope that a therapy may come along that can slow the progression in the next few years. We’re making big strides all the time in understanding the disease and how to treat it, so success is hopefully not that far away.”
In the meantime, Musiek advises everyone to follow the tenets of a healthy lifestyle to help reduce risk. “It’s never too early to start taking steps to lower your risk,” he says. “There is no magic bullet, but regular exercise and a heart-healthy lifestyle, along with getting enough sleep and keeping your brain as active as possible, can all make a big impact later in life.”
He also points out that myths persist when it comes to Alzheimer’s. For example, having a family member diagnosed with Alzheimer’s does not mean an individual is destined to get it. In fact, family history has only a modest effect on overall risk, he says. Another example: the idea that exposure to aluminum cookware or packaging causes Alzheimer’s. “There were some theories about this years ago, but newer evidence does not support this idea,” Musiek says.
While everyone waits and hopes for a treatment and cure, the Greater Missouri Chapter of the Alzheimer’s Association provides many important services for those with the disease and their families. “Last year, the Alzheimer’s Association Greater Missouri Chapter served 9,800 individuals,” says Brenda Stewart, chief operations and development officer for the chapter. “Families use multiple services that the association provides, resulting in 24,405 service contacts.”
Among the most important services, the 24/7 help line (below) puts people in touch with a trained care consultant for decision-making support, crisis assistance and education.
“Many callers elect to meet with a social worker for a care consultation, which helps families at any stage of the disease process,” Stewart says. “In a care consultation, a person living with the disease and/or a caregiver meets with a dementia expert to develop a customized plan of care to help guide their journey. Families receive a thorough assessment of their needs, discuss available resources and support, and learn about legal and financial plans, end-of-life decisions and more.” All services are provided free of charge.
“If you or someone you know has been diagnosed with Alzheimer’s or another dementia, you are not alone,” Stewart adds. “The Alzheimer’s Association is the trusted resource for reliable information, education, referral and support to families affected by the disease.” Services, events and volunteer opportunities are available at the chapter’s website.
Alzheimer’s Association, 9370 Olive Blvd., St. Louis, (800) 272-3900, alz.org/greatermissouri
The Charles F. and Joanne Knight Alzheimer’s Disease Research Center, 4488 Forest Park Ave., St. Louis, 314-286-2881, knightadrc.wustl.edu