What’s Happening on the Alzheimer’s/Dementia Front?

Doc Gumshoe checks in on the Gray Plague

By Michael Jorrin, "Doc Gumshoe", November 14, 2017

[ed. note: Michael Jorrin, who I dubbed “Doc Gumshoe” years ago, is a longtime medical writer (not a doctor) who writes for us a couple times a month about health issues and trends. He does not typically focus on specific investment opportunities, but has agreed to our trading restrictions… as with all of our authors, he chooses his own topics and his words and opinions are his alone]

I don’t know about you folks out there in Gumshoe Nation, but I get the strong feeling that most people don’t want to talk about Alzheimer’s disease (AD).   It just looms over us.   We have seen people who have succumbed to AD, and the picture is not pretty.  And there is a general sense that medical science doesn’t have a whole lot of ammunition on hand to combat it.   But never fear, Doc Gumshoe is not going to devote this piece to reiterating the disappointing news items about Alzheimer’s.   Instead, I’m trying to accentuate the positive and latch on to the affirmative, but  without totally eliminating the negative.

The generally gloomy view is at least in part a result of a widespread expectation that there should be “miracle cures” for all manner of diseases and conditions.   The absence of such a cure is equivalent to failure.   We hear that medical science and Big Pharma have utterly failed in their quest to find a cure for cancer.   If the only indication of success were a “miracle cure,” a drug or treatment that stopped every form of cancer and resulted in decades of totally disease-free survival for all patients, then, indeed, all efforts have resulted in failure.   But as I have repeatedly stated in these pieces, remission rates for many cancers, including the most common cancers, have improved significantly, and many millions of people, here and elsewhere, are enjoying symptom-free lives due to these many non-miraculous treatment modalities.   I do not consider that a failure.

But negative news keeps trickling out.   For example, it was announced a few days ago that Novartis, Amgen, and the Banner Alzheimer’s Institute are going to work together on a program aimed at preventing AD by means of a drug in a class called BACE inhibitors, which I discussed in a previous post about AD, back on December 21, 2015.   BACE 1 (beta-site amyloid precursor protein cleaving enzyme 1) is thought to lead to the formation of beta amyloid in the brain, which in turn is thought to lead to the cognitive disability that characterizes Alzheimer’s.   Therefore, inhibition of this enzyme should prevent or delay the symptoms of AD.   However, previous trials of BACE inhibitors have not been successful, and the news of this collaboration was generally met with a distinct lack of enthusiasm.   In fact, even before any results were announced, failure was anticipated.

This kind of response gets around and shapes people’s views.   Quite naturally, lots of us are concerned about the possibility that we will develop Alzheimer’s disease.   Any time we forget anything, we think, is that the dreaded Alzheimer’s plague getting ready to strike?   A few days ago, for no reason whatever, I was trying to remember the name of the woman who sang “Monotonous” in the show “New Faces of 1952.”   It was of no importance, of course.   I was hardly going to cheat by resorting to Google.   I tried to put it out of my mind, but it kept nibbling at me.   I could hear the song in my head – “I met a Rajah, amusing fool, when on my way to Istanbul, bought me the Black Sea for a swimming pool.”    After a couple of days of intermittent itching, her name popped into my head – Eartha Kitt!   Excellent!   I am not slipping into Alzheimer’s, at least, not yet.

Then along came a piece of genuinely good news.   Persons who experience occasional memory lapses or blanks and are aware of their episodes of forgetfulness are not any more likely to develop dementia than the rest of the population.   The behavior that is much more likely to be a precursor of dementia is forgetfulness that the person is not aware of.   They go about their lives happily unaware of what they have forgotten.   The blanks in their minds do not cause them any distress.   I remember that for years I had to struggle to remember the word “refractory,” and had to recollect it by thinking of surfaces – those that absorb light, those that are transparent, those that reflect, and – aha! – those that refract!   That certainly troubled me.   Was I slipping into dementia?   Would I have to poke and prod at the contents of my noggin to bring to mind the words I needed?   But apparently that type of forgetfulness affects great numbers of people who do not go on to develop dementia.   The mechanism of ordinary forgetfulness is similar to minor traffic nuisances in the network of neurons.   The destination is there, but the street is temporarily obstructed because the school in the middle of the block is having a street fair.   One has to find another route, as I did with “refractory.”

Obstructions in the neuronal pathways leading to “Eartha Kitt” or “refractory” do not come close to what happens in Alzheimer’s, which is more like an epic snowstorm that clogs all the roads and streets and eventually – over years – renders them impassable.   The person with Alzheimer’s is unable to recall simple everyday words – the wife of a good friend would forget the word “floor” and helplessly point downward to try to indicate what she was talking about.   And the avenues that convey the signals that tell us to eat and breathe also become obstructed by this blizzard in our brains, with fatal results.   The brain blizzard that blocks the way to simple words eventually also clogs other brain functions – no mail deliveries, no ambulances or fire trucks, no food deliveries to the grocery store.

Some possibly good news about Alzheimer’s

The discouraging statistic that has rocketed about the news media is that an overwhelming proportion of all the proposed drugs to treat Alzheimer’s disease fail in the clinical trial stage.   The usual headline is “99.5 % of Alzheimer’s drugs fail!”   So, in that context, what good news could there possibly be?

An organization called “ResearchersAgainstAlzheimer’s” has a more hopeful perspective.   Here’s their “Statement of Beliefs:”

“We have heard some say that Alzheimer’s disease is an inevitable part of aging. Others have claimed that it simply cannot be prevented or effectively treated anytime soon. Still others believe that we simply cannot afford to do what it would take to stop the disease. They are all wrong.

As men and women of science, we are united by a simple but bold belief: It is possible to prevent and effectively treat Alzheimer’s disease within our lifetimes, but only if our nation does what is necessary:

  1. Set an aggressive goal of stopping Alzheimer’s disease by 2025, because it will focus the energies of the research community;
  2. Invest significant resources in Alz