In early 2011, the National Alzheimer’s Project was formed — a strategic plan aimed at addressing the looming health care crisis posed by the disease and the aging population. Its aim: to coordinate research efforts across the U.S. federal government with the goal of preventing or effectively treating Alzheimer’s Disease by 2025. Since then, 2025 has become a G8 nation goal post as well for finding an effective, approved disease-modifying therapy or cure for the disease, which experts project will affect nearly 75 million people by 2030.
That’s an ambitious aim, given the long timelines and high cost of drug development especially for diseases like Alzheimer’s that progress slowly over decades. So what can be done to help meet it?
In our previous posts on this topic, we talked about the move to test potential therapies earlier in the disease process (and the need for better markers to identify those most likely to benefit from any therapeutic breakthroughs in preventing Alzheimer’s dementia or slowing the deleterious brain changes that result in that condition). Several important clinical studies are underway, drawing on individuals from families who harbor certain genetic mutations closely associated with the development of Alzheimer’s Disease at an early age.
Given the number of failures of experimental drugs designed to target beta-amyloid or slow its deposition, the field of Alzheimer’s research may also benefit from exploring different targets related to the disease. Indeed, alternative hypotheses on causes and drivers of the disease are being put forward several different targets are already being investigated, including those affecting tau, the chief protein component of the second hallmark of Alzheimer’s — tangles; brain inflammation mediated by over-activated microglia; and the 5HT6 receptor involved in regulation of certain neurotransmitters.
Furthermore, it will be useful to better understand the processes underlying memory and cognition more generally, and not necessarily as part of a disease state. This might uncover important pathways that could be used to counter or at least slow down some of the most dramatic symptoms of the disease.
Finally, research in this field could benefit greatly from improvements in trial design and resources aimed at furthering both trial participant recruitment and data gathering/sharing. For example, disease registries of well-characterized participant cohorts could help with more rapid enrollment of appropriate trial participants. In addition to speeding up recruitment, the availability of advanced and well-characterized registries can also provide an opportunity for the generation, collection, and analysis of complex “big data” biomedical information.