Why Is Alzheimers's So Difficult to Treat?

Despite being a widespread condition, Alzheimer's is notoriously difficult to diagnose and treat. Learn why (plus how researchers hope to make it easier) in this episode of BrainStuff.

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Episode Transcript

Speaker 1 (00:02):
Welcome to brain Stuff from how Stuff Works, Hey, brain Stuff,
Lauren vocal bomb. Here. People are living longer now than
ever before. But with this triumph comes a truly unfortunate foe,
Alzheimer's disease. Symptoms of the progressive brain disorder, which is
the most common cause of dementia for older adults, typically

(00:22):
start to show up around the age of sixty five,
just when many people retire and plan to start enjoying
their golden years. The disease is incurable and is listed
as the sixth leading cause of death for older people
in the United States, but the National Institutes of Health
says more recent estimates indicate it should rank third, behind
only cancer and heart disease, because many cases are not

(00:43):
reported correctly. Worse, Alzheimer's is the only disease in the
top ten causes of death United States for which there
is neither a cure, nor means of prevention nor treatment
to slow down the disease. We spoke via email with
David Lusk, founder of an issue advocacy can salting company
called Key Advocacy. Lusk's mother, at age sixty five, began

(01:04):
exhibiting symptoms like short term memory loss, struggling with basic
paperwork and making decisions with difficulty, but she was not
diagnosed until age seventy. In two thou eight, Lusk said,
by early twelve, my mother no longer believed I was
her son. It was crushing to have my own mother
thinks she wasn't my mother, and she even stopped saying
I love you. That is the most painful thing to

(01:25):
ever endure, never hearing your own mother saying she loves
you ever again. Lusk's mother died in after following a
pattern of cognitive and emotional decline that has become sadly
familiar for people dealing with Alzheimer's. Lusk wonders if he
will get the disease himself someday, as it tends to
run in families. He said that back of your mind concern.

(01:46):
I try to ignore it, but there's also a part
of me that wonders if I'm not already walking down
the dark fatal path. So many millions have and will
as the numbers of people with Alzheimer's skyrockets, it's troublesome
that a cure or effective treatment hasn't been ound after
so many years of research. It's not for lack of effort.
In fact, more than one hundred drugs have been studied
in clinical trials since two thousand two, to the tune

(02:08):
of billions of dollars in funding, but none of these
have proved effective enough for patient use. So what gives?
Why is it so hard to find treatment for Alzheimer's.
We also spoke with Rebecca edelbay Or, PhD, Director of
Scientific Engagement for the Alzheimer's Association. She said, some of
the difficulty has been in being able to identify really

(02:29):
what the initiation of the disease is in people. We've
learned that some of the changes are occurring maybe ten
to twenty years before they're experiencing the cognitive difficulty. That's
the crux. We need to understand what's happening in the
brain before you're experiencing symptoms. We're really trying to understand
the biology underpinnings of the disease. This is where researchers
are most focused at the moment. Part of the problem

(02:52):
is figuring out which people to study ten years before
they're showing any signs of dementia. Edelmayer said, we're trying
to i d people believed to be at risk, and
maybe the candidates have a primary relative that had full
blown Alzheimer's. Maybe they have risk factors poor cardiovascular health,
or difficulties with their sleep. All of these things put
you at risk for being someone to develop Alzheimer's. Of course,

(03:15):
not everyone with poor heart health gets Alzheimer's, and al
Mayor notes that one of the ways to try to
find people at risk is through biomarkers, which are measurable
substances that show up in a living thing when a
particular event is occurring. Checking people who aren't yet symptomatic
over a period of years and comparing them against people
with Alzheimer's and varying stages can shine light on which

(03:35):
biomarkers to look out for. Some potential biomarkers which could
eventually help to pinpoint those at risk of Alzheimer's include
blood and urine tests, genetic profiles, brain imaging, and proteins
in cerebral spinal fluid. Identifying some of these biomarkers might
even lead to the development of preventative measures. New evidence
from one of the largest clinical trials of its kind

(03:56):
revealed in July the people who aggressively lower their stolic
blood pressure to below one twenty may reduce risk of
cognitive impairment. Edel Mayer said, we can modify some of
our risk factors by very significantly controlling cardiovascular health. What's
good for your heart is going to be good for
your brain. Other modifiable risk factors could be related to diet, exercise,

(04:18):
drugs that harm the brain, and even sleep quality, but
those require more study before definitive recommendations can be made.
In the meantime, continuing efforts are underway to find a treatment.
Edel Mayer says that it's crucial to figure out how
to quote remove those built up proteins in the brain
that we believe are inhibiting neuronal communication in the brain.

(04:38):
An additional area of study focuses on better managing the
behavioral systems of Alzheimer's that can be so disruptive in
day to day life, like sleep problems, agitation, or even
bouts of aggression. Better management of these symptoms would mean
a better quality of life for patients and their families.
To improve detection, the Alzheimer's Association is planning to release
twenty recommendations to help doctors make timely diagnoses and establish

(05:02):
best practice protocols for how Alzheimer's should be handled. These
guidelines are expected to be published in late For Lusk's part,
he says that if a treatment or cure for this
disease was discovered, he'd feel amazingly relieved to not have
to dread a diagnosis of Alzheimer's, he said, to no
longer have to worry about that and have that concern.

(05:23):
That would be a huge weight lifted off my shoulders.
Today's episode was written by Aliya Hoyt and produced by
Tyler Clang. If you enjoy our show and want to
support us directly, visit our online shop at te public
dot com slash brain stuff, and of course, for more
on this and lots of other hopeful topics, visit our

(05:43):
home planet, how stuff works dot com