America has declared war on Alzheimer's disease. Medical experts and policy makers gathering in Washington this week hope to formulate a plan to put the degenerative brain disease out of the killing business. So far, the disease has been winning.
More than 5.4 million Americans have Alzheimer's, which kills about 83,000 a year. By 2050, 13 to 16 million Americans are projected to have that form of dementia. It affects 1 in 8 Americans over age 65 and there are neither cures nor survivors, according to the Alzheimer's Association.
Last year, Congress passed and President Obama signed the Alzheimer's Project Act, which aims to find better treatments and even prevention by 2025. Some of those attending the conference hope the goal can be moved up to 2020.
Among its aims is more timely diagnosis, better support and training for families, preventing and effectively treating Alzheimer's by 2025, enhancing care quality, increasing public awareness and improving data to track progress.
What's missing from the list of goals, according to an Associated Press story, is details on how to fund the efforts. It notes that modern treatments "only temporarily ease some dementia symptoms and work to find better ones has been frustratingly slow."
In its briefing on the NAPA plan, the association notes that developing new treatments is both expensive and slow — and there are no guarantees an investigational drug will be proven effective. "Therapies to treat the central nervous system can take 15-20 years to develop, longer than any other class of drugs. In recent years, many Alzheimer's drug candidates that were thought to be promising failed during clinical trials, highlighting the need to improve the drug development process by investing in research to understand the basic biology of the disease."
Meanwhile, the Wall Street Journal reported that yet another medication being tested as a treatment for Alzheimer's failed to meet its study goals.
Medivation Inc. said that the investigational drug dimebon didn't meet either the endpoint for cognition or daily function in its Phase 3 clinical trial, being conducted with Pfizer Inc. It had earlier failed meeting endpoints of cognition and mobility in treating Huntington's disease.
Medications that have successfully made it to pharmacy shelves to treat Alzheimer's, such as donepezil (marketed as Aricept), are generally considered only mildly effective against the disease. A study published by the College of Family Physicians in Canada noted little proof that the drug or similar ones change the course or progression of Alzheimer's disease, but it did find modest benefits in cognition or behavior over a fairly short haul.
While hope for the new effort is high, no one thinks it will be simple. As a U.S. News and World Report blog by Phillip Moeller noted of efforts in 2010, hopes were "dashed" when experts at a major conference on Alzheimer's released a draft report that said, in part, "There is currently no evidence considered to be of even moderate scientific quality supporting the association of any modifiable factor (nutritional supplements, herbal preparations, dietary factors, prescription or nonprescription drugs, social or economic factors, medical condition, toxins, environmental exposures) with reduced risk of Alzheimer's disease."
Other experts, Moeller said, quickly noted that lack of scientific-quality proof "does not mean that there is no way to halt or avoid the disease. Rising evidence points to great promise from changing physical and mental lifestyle behaviors. In the near future, it's expected that this evidence will be developed into acceptable scientific proof of steps that can be taken to combat various forms of cognitive impairment."
As for who will fund the needed research to change America's future with Alzheimer's, an article in USA Today says that the National Institutes of Health "oversees the bulk of the groundbreaking research against diseases. Francis Collins, director of the NIH, told USA TODAY in July that the agency's budget was cut $321 million in the fiscal year, the second time in 40 years the NIH has had a budget that was less than the preceding year."
It notes that the government spent a half-billion dollars last year on Alzheimer's and related dementias, about $521 million on complementary and alternative medicine and $$823 million on obesity. Cancer drew a $6 billion check in 2011 for starters, with additional funding allocated for breast, brain and lung cancers.
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