DECEMBER 10, 2014—There is more reason to feel hopeful about future prospects for Alzheimer’s treatment and prevention as research continues to yield important new insights about the disease, Georgetown University Medical Center (GUMC) experts agreed at a recent event.
Alzheimer’s, the most common cause of dementia, currently has no cure, and the number of people with the disease is growing exponentially—from 35.6 million worldwide today to an estimated 115.4 million by 2050. There are four FDA-approved drugs for the symptoms of Alzheimer’s, but nothing yet that can delay or halt its progression in the brain.
At a Dec. 3 panel discussion hosted by GUMC, part of the Doctors Speak Out quarterly lunch education series, experts struck a hopeful chord as they described new research in the lab and in the clinic.
“I am very bullish on the future. I can’t tell you for certain if it’s going to be in 10 or 20 years, but I think … you should be very optimistic that this future is going to be a brighter one for those who are at risk for the disease, and even for those who currently have the disease,” said Howard J. Federoff, MD, PhD, a neurologist who is also executive vice president for health sciences at GUMC, and executive dean of the medical school.
Federoff, an Alzheimer’s researcher, joined panelists Kevin FitzGerald, SJ, PhD, associate professor of oncology and the Dr. David P. Lauler Chair for Catholic Health Care Ethics, and R. Scott Turner, MD, PhD, professor of neurology and director of GUMC’s Memory Disorders Program.
Betsy Agnvall, features editor for health at AARP media, moderated the panel.
New Treatment Strategies
Turner’s Memory Disorders program currently has several studies looking at predictors of the disease as well as clinical trials looking for more effective treatments—as well as a new prevention study. He said that there are some promising new treatment strategies under investigation, including new preclinical research at Georgetown by Charbel Moussa, MB, PhD, who is repurposing cancer drugs for neurodegenerative diseases including Alzheimer’s.
Turner noted that, while age and family history and genetics are the biggest risk factors, lifestyle factors within people’s control also play a role, such as maintaining an ideal body weight, avoiding head trauma, doing regular exercise and adhering to a Mediterranean diet.
“Remaining mentally, physically and socially active preserves brain health. There is still a possibility you can get [Alzheimer’s] but this could help delay or even prevent it,” Turner said.
Predicting the Disease
Researchers are also breaking new ground with predictive technologies.
Federoff described his lab’s groundbreaking research, released in March of this year, which found a new blood test that can predict who will experience cognitive decline or develop Alzheimer’s with 90 percent accuracy. His team is working on moving that accuracy to more than 99 percent for the test, which needs external validation in large-scale clinical studies.
The finding made international news and heralded a new era in which people could know in advance that they will get the disease. It also raised ethical questions regarding what people would do with that information once they have it, in light of the lack of treatment options.
Fitzgerald, the bioethicist, said that this breakthrough and others offer patients, their families and society as a whole “the incentive to start to address some of these ethical issues.” And the ethical conundrum is not unprecedented, he said; we can look to other conditions such as Huntington’s disease and even cancer to see how people who learn of their likelihood of getting a devastating disease handle that information.
“What will we do if we know? How will we treat one another? How can we look at ways we can reduce the stress and the depression? How can we better care for one another now to better prevent the types of decline we want to avoid?” FitzGerald queried.
“Here is another opportunity to say: ‘How can we use this information that could possibly be beneficial?’ There is a whole range of possibilities,” he added.
Since advance knowledge of the disease could provoke discrimination in terms of insurance coverage, employment or other areas, it is imperative to get ahead of this discussion, Federoff said.
“It is essential that we ensure there is no overt discrimination. If a test discloses that someone has a risk in a period of time to become an Alzheimer’s patient, we have to make sure they can get long-term care insurance and life insurance,” Federoff said.
The Memory Disorders program seeks volunteers who are cognitively normal (especially ages 75-85) or have mild memory problems or early Alzheimer’s to join research studies. For more information, go to memory.georgetown.edu.
By Lauren Wolkoff