When you hear about a G8 Summit, you most likely envision important world leaders meeting to discuss contemporary global issues such as the world economy or climate change. Dementia was actually the focus this time at the first-ever G8 Dementia Summit held last month in London, where leaders committed to finding a treatment or cure for Alzheimer's disease by 2025.
According to the World Health Organization (WHO) there are nearly 35.6 million people living with dementia and the number is expected to double by 2030 to 65.7 million. It is expected to more than triple by 2050 to 115.4 million. Global costs for treating and caring for people with dementia currently exceeds $604 billion per year.
In the U.S., Alzheimer's disease is the sixth leading cause of death, and more than 5 million Americans are currently living with Alzheimer's. The National Alzheimer's Project Act was signed into law by President Obama in 2011. In May 2012, U.S. Secretary of Health and Human Services Kathleen Sebelius released the National Plan to Address Alzheimer's Disease with the goal of not only better meeting the needs of those who are currently fighting the disease, but also preventing future cases.
These international and national initiatives indicate strong momentum with scientists making progress in the fight to end Alzheimer's. Promising research is underway in the following areas, which gives us hope that new treatments may be on the horizon:
1. Genetics
Genes play a role in the development of Alzheimer's, and scientists have found genetic links to both early-onset Alzheimer's, a rare form which occurs in a person's 30s, 40s or 50s, as well as late-onset Alzheimer's which occurs late in life.
The National Institutes of Health reported that:
Genome sequencing -- determining the order of chemical letters in a cell's DNA -- is considered a key strategy to identifying new clues to the fundamental cause of Alzheimer's disease and the development of new diagnostics and treatments. The clues come from differences in the order of DNA letters in Alzheimer's patients compared to control groups.
In October 2013, scientists reported that there are 11 additional genes linked to the disease. Having an understanding of the cause gives us a better chance of finding a cure.
2. The role of insulin in memory
Among the research initiatives of the National Plan to Address Alzheimer's Disease is a $7.9 million effort to test an insulin nasal spray for treating Alzheimer's disease. Researchers hypothesize that decreased action of insulin in the brain could be a contributing factor to memory loss. Some small studies have suggested that when delivered by a nasal spray, insulin is better able to reach the brain and can improve memory.
3. Alzheimer's investigational drugs
Currently, there are five FDA-approved Alzheimer's drugs that treat some of the symptoms, but have no effect on reversing the disease. Alzheimer's is identified by the accumulation of hallmark plaques and tangles in the brain. Plaques are the result of a build-up of beta-amyloid protein and tangles resulting from tau protein. Scientists are now developing investigational drugs that target those specific components and processes with hopes of slowing down the progress of the disease. Many researchers tell us that it will require more than one drug, or a cocktail of drugs aimed at different processes.
4. Improving diagnosis through biomarkers
Scientists report that changes in the brain may begin as many as 20 years prior to the occurrence of symptoms; therefore, they are working to discover treatments that could target the disease as early as possible. Neuroimaging through methods such as magnetic resonance imaging (MRI) or positron emission tomography (PET) can be instrumental in providing early detection. Radiotracers like the Pittsburgh compound B (PIB) highlight beta-amyloid making it visible with a PET scan, helping to detect Alzheimer's disease and rule out other conditions.
In the U.K., doctors have begun using a diagnostic tool developed by Lilly to visualize plaque in the brain. It will be helpful in determining if patients entering clinical trials using amyloid-targeting drugs are appropriate for the trial.
5. Prevention
Studies indicate that what is good for the heart is good for the brain. Eating a heart-healthy diet rich in fruits, green leafy vegetables and low in saturated fats is equally good for the brain.
According to the National Institutes of Aging, "Epidemiological studies and some intervention studies suggest that physical exercise may also play a role in reducing risk for Alzheimer's disease and age-related cognitive decline." Studies are currently underway to determine if exercise can delay the development of Alzheimer's disease in people with mild cognitive impairment (MCI).
Finally, let's not underestimate the power of social engagement. Remaining socially engaged and involved in activities that bring a person meaning and purpose in life can be beneficial to a person's well-being and may even help to improve cognition.
This global effort brings great promise for better treatments and a renewed hope for a cure. In the meantime, we must continue to focus on providing the best possible person-centered memory care and empathetic communication to support those with Alzheimer's disease and their families.