There’s good news and there’s bad news in the latest findings regarding Alzheimer’s disease — the heart-breaking degenerative brain illness that affects approximately 5 million Americans annually.
First, the bad news. Scientists appear close to giving up on the idea that Alzheimer’s can be reversed or cured. After several decades of intensive research, no single cause of Alzheimer’s has been found.
Once a debilitating sequence of changes in the brain is fully underway, there is little modern medicine can do to prevent it from running its inevitable course, including death.
The good news is that science is now focused intensively on Alzheimer’s prevention — how to shore up a healthy brain and prevent it from degenerating – and how to slow the disease’s progress once it starts.
Last July, researchers at the University of Southern California’s Dornsife campus presented their latest findings on the mix of biological, environmental and psychological factors they believe raise the risk for Alzheimer’s. If they’re right, these factors could become primary targets for intervention to stave off the disease.
The broad mix of factors behind Alzheimer’s is indicative of the need for a cross-disciplinary approach. One researcher, for example, has found that anxiety raises the risk for the disease. In addition, people that develop type 2 diabetes in middle age are significantly more likely to develop Alzheimer’s.
Another researcher found that pollution exposure raises the risk of developing Alzheimer’s, particularly among older women.
And what about genetics? Two genes, in particular, can raise the risk. One is known as the ApoE4 gene. Combined with cardiovascular disease, it significantly increases the risk of developing Alzheimer’s. However, another gene, TOMM40, may be even more influential in causing memory loss, according to work by Carol Prescott, professor of psychology and gerontology at USC Dornsife, and T. Em Arpawong of USC Leonard Davis School.
While genetics – and heredity – may be critical background factors, USC researchers say that no one is destined from birth to end up with Alzheimer’s – or to be immune, either. Strong correlations have been found with a sufferer’s work life, work environment, type of work and even years of schooling.
Ultimately it’s the intersection of genetic and environmental risks that seems to trigger the onset of the disease.
Presently there are diagnostic tests for Alzheimer’s – MRIs and a spinal tap — that can reliably detect its onset long before actual dementia sets in. However, the tests have raised some ethical issues. How soon should future sufferers – presently without hope of treatment — be told? And what if the test is wrong?
Doctors at a major hospital that conduct Alzheimer’s scans are facing this dilemma. Presently, they only tell patients in broad terms what the likelihood of their developing is – but they don’t reveal actual diagnostic scores, which may not be completely accurate anyway.
Some patients come with memory and brain functioning issues that their doctors have dismissed. Others come from families with a history of dementia. Many are still in their 40s and simply want to reduce the uncertainty – and if necessary, prepare for the inevitable.
Meanwhile, researchers are pushing ahead with efforts at early intervention techniques. No area of possible correlation – and treatment – is being overlooked.
For example, a 2017 study of caffeine revealed that it may have major brain protection properties. Researchers at Indiana University in Bloomington found that caffeine was among some 24 compounds that could delay the onset of dementia by boosting a brain enzyme known as NMNAT2.
Of the 24 compounds tested, caffeine had the strongest NMNAT2-boosting effect.
Currently, treatments for early-onset Alzheimer’s include special diet supplements and a handful of FDA-approved medications such as donepezil and galantamine. Another 80 medications are still under investigation at two dozen NIH-supported research facilities nationwide. Federal funding for Alzheimer’s research – about $2.3 billion in 2019 — has quadrupled since 2011.
With the aging of the Baby Boomer generation, the prevalence of Alzheimer’s will only rise in the coming years. 14 million cases are expected by the year 2050 – almost triple the current number.
The race for a “cure” may be over, but stopping Alzheimer’s before it starts is a brand new competition.