Alzheimer's Disease Center
University of California, Davis

The Family Connection
Winter 2000

Alzheimer’s Disease: New Developments, New Hope

Anyone who has watched a beloved family member or friend steadily deteriorate from Alzheimer’s disease knows how devastating this illness can be. An estimated 5 to 10 percent of 65-year-olds and at least 30 percent of people aged 80 fall victim to it. As the baby boom generation ages and the impact on our society increases, the search for a cure has never been more pressing. And never more hopeful.

Three medications have now been FDA-approved for the treatment of Alzheimer’s. All work by increasing the availability of acetylcholine, a neurotransmitter essential for nerve-to-nerve communication within the brain. These medications, known as cholinesterase inhibitors, act by slowing acetylcholine’s breakdown in the brain.

The three medications, tacrine (Cognex), donepezil (Aricept) and the newly approved rivastigmine (Exelon), have made significant improvements in people’s lives. They increase mental acuity, make Alzheimer’s patients less apathetic, and in many cases, they even enhance day-to-day functioning.

Unfortunately however, these medications merely postpone, rather than completely stave off, the devastating progression of Alzheimer’s disease. They can make an important difference in keeping a person at home and functioning longer, but they are not a cure.

The good news is that Alzheimer’s disease is a high priority for medical researchers and is now being investigated on many fronts. One study conducted by the National Institute on Aging is looking at individuals with mild cognitive impairment (MCI), people who have noticeable memory lapses but are able to function well. MCI is believed to be a “pre-Alzheimer’s” condition in some patients. Many of these individuals are expected to progress to true Alzheimer’s disease, in which many aspects of thinking deteriorate.

Study participants at multiple sites throughout the country, including at UC Davis, will take either donepezil (one of the medications used for Alzheimer’s) and vitamin E (which has been demonstrated to have beneficial effects on Alzheimer’s patients) or a placebo (an inactive pill) over a three-year period. This important study will potentially determine effective methods to prevent or delay the onset of Alzheimer’s disease in people at the highest risk.

Another study, which is being undertaken at UC Davis Medical Center as part of a national clinical trial, examines the role of gingko biloba, a plant extract, in preventing the memory problems of MCI and Alzheimer’s disease in healthy older people. UC Davis Medical Center is also involved in a study examining the use of non-steroidal anti-inflammatory drugs (NSAIDs), which have been shown in some studies to reduce the risk of Alzheimer’s disease. For information on this study contact: (916) 734-4636.

In recent years, major breakthroughs have occurred in medical science’s knowledge of the molecular biology and chemistry of Alzheimer’s disease. Alzheimer’s patients develop characteristic changes in their brain that are evident microscopically. Neurons are lost and unusual features appear, including fibrous tangles inside neurons and “plaques” of abnormal proteins. This knowledge is enabling pharmaceutical companies to specifically target new drugs aimed at preventing these processes.

Medications that prevent plaque formation are now being investigated in animals and are very close to clinical trials for safety and efficacy in people. They have the potential to be the first medications that will offer a true cure for Alzheimer’s.

Numerous studies are ongoing across the nation, and anyone who is interested in participating should keep abreast of developments. Depending on the study, Alzheimer’s patients, people with memory problems, and healthy older people may be participants. People of minority groups are especially encouraged to participate, as they are often underrepresented in research studies and may show important differences in drug effects.

To find out about trials, contact the National Institute on Aging at (800) 438-4380 or check out their Web site at http://www.alzheimers.org. This site allows you to search a database of clinical trials on Alzheimer’s disease and dementia currently in progress at centers throughout the United States. For information about participating in UC Davis trials, call the UC Davis Alzheimer’s Disease Center at (916) 734-5496.