Is the Rising Storm of Alzheimer's Disease Stoppable?

In MedPage Today , Dr. Zaven S. Khachaturian, editor-in­-chief of Alzheimer's & Dementia , describes the 40-year struggle to grapple with Alzheimer's disease (AD) and the important milestones achieved in the efforts to address it. He details the struggles to promulgate national policies and programs to foster prevention as a strategic public health objective. Despite the well-publicized failures of some clinical trials, he notes there are reasons for optimism about future prospects of more effective interventions being developed. "During these four decades, remarkable progress has been made to understand the neurobiology of an unknown chronic brain disorder that has now become a central contributor to a global crisis for healthcare systems," he writes. "The new knowledge generated from potential origins of neurodegenerative disorders/dementia/AD now are poised to be utilized for adaptation into the development and testing of novel therapeutic targets and strategies for treatments." The therapeutic paradigm in AD has already begun to shift towards secondary prevention, namely aiming for intervention to delay the onset of symptoms in pre-symptomatic individuals at risk of developing dementia. There is also growing evidence strongly supporting the proposition that vascular problems in midlife can take their toll on the brain decades down the line. Another promising array of new ideas to focus on "prevention" stems from the general consensus among researchers that engagement in various forms of activities to stimulate the brain, from exercise to social activities, are major factors in preserving cognitive health in older adults. Khachaturian concludes that even "the recent failure of clinical trials based on prevailing scientific orthodoxy has been a blessing in disguise, by opening the door for new thinking and alternative conceptual models."