Have we been looking at Alzheimer’s disease the wrong way?

Alzheimer’s… Imagine that you had a task to complete that you couldn’t get right. No matter how many times you tried, it just didn’t work. Would you keep plugging away, stubbornly determined that you were going to get this thing to work if it was the last thing you did? Or would you try a different approach?

In this article, I explain why we need to change the approach we’ve been taking in finding an effective treatment for Alzheimer’s disease.

Why does Alzheimer’s affect some people and not others?

Until quite recently, the brain was very difficult to examine – at least while its owner was still using it. It hasn’t been possible to simply take some blood to diagnose Alzheimer’s disease. Even taking a decent picture of the brain has only been possible in the last decade, with the introduction of PET scans. This means that by the time the damage to the brain is obvious, when the symptoms of Alzheimer’s become noticeable, its likely that the disease has been quietly progressing in the background for at least 10 to 15 years (you can learn more about your brain in our article here).

We still don’t fully understand how or why Alzheimer’s develops.

Why does Alzheimer’s affect some people and not others? We know that in some cases it is due to a genetic alteration, but this only applies to a small subset of patients and having the genetic alteration does not guarantee a person will get the disease (although it does increase their risk considerably). This fundamental lack of knowledge about the disease’s ‘aetiology’ – the ‘how and why’ – has had a huge impact on our ability to find an effective treatment.

we now have better tools to diagnose the disease

The discovery in the mid-1980s that beta-amyloid, an abnormal protein found at high levels in brains of patients with Alzheimer’s, was heralded as a medical breakthrough. Billions of dollars have since been spent on research to find drugs that either prevent amyloid from forming in the brain or remove it before it causes too much damage. However, in the last 30 years, only a handful of drugs have proven to be effective. Many hundreds have been labelled as ‘promising’, only to fail when trialled in patients.

2 obvious questions…

This leaves two obvious questions. Why have so many promising drugs failed? Secondly, why do we continue to plug away using the same approach when it hasn’t worked?  The answers lie in the combination of not knowing enough about Alzheimer’s and not having a good set of tools to detect and measure its effect on the body. Clearly, a different approach, or many different approaches, are vital if we are to advance towards an effective treatment, perhaps even a cure.

The good news is that we now have better tools to diagnose the disease, including a blood test that will allow us to detect the disease before symptoms develop. We are also learning more about how lifestyle factors such as obesity and inflammation may play a role in the disease. I believe we are on the cusp of some very exciting breakthroughs and I’m hopeful that the next few years will see some significant advances in how we diagnose and treat Alzheimer’s disease.

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Dr Bill Ketelbey
Dr Ketelbey has more than 30 years’ experience in the healthcare, biotech and pharmaceutical industries, including senior medical and management roles in the Asia Pacific Region with global pharmaceutical company Pfizer. Dr Ketelbey has a solid track record of product development over his years in the industry leading to the successful registration, launch and commercialisation of numerous market leading medicines in a broad range of therapeutic areas, including in Alzheimer’s Disease. Dr Ketelbey led the local clinical development, and was involved in the commercialisation, of Aricept™ (donepezil), the market-leading Alzheimer’s disease therapy Dr Ketelbey is a medical graduate from the University of the Witwatersrand, South Africa and a Fellow of the Faculty of Pharmaceutical Physicians from the Royal College of Physicians in the United Kingdom. He also has an MBA from Macquarie Graduate School of Management, Australia, and is a Graduate of the Australian Institute of Company Directors. Dr. Ketelbey is also a director of the Westmead Institute of Medical Research.

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