Our understanding of Alzheimer's disease (AD) and related dementias has been a long journey. Before the discovery of AD, the medical community often attributed symptoms of dementia to senility or age-related decline, with little understanding of the underlying neurodegenerative processes.
Dr. Alois Alzheimer, a German psychiatrist with expertise in neuropathology, is credited with discovering AD. In 1901, he treated a 51-year-old patient, Auguste Deter, who displayed symptoms of memory loss, paranoia, and psychological changes. After her death in 1906, Dr. Alzheimer’s post-mortem examination revealed two unique brain abnormalities: “plaques and tangles,” which today we know as beta-amyloid plaques and tau tangles. This marked the beginning of our understanding of Alzheimer's Disease as a medical condition of the brain that warranted treatment.
In the 1960s and 70s, Alzheimer's disease emerged as a recognized cause of dementia, leading to an intense focus on research, improved diagnostic techniques, and understanding of dementia and its causes. The 1980s witnessed significant discoveries about the role of abnormal protein deposits in causing neuronal damage and cognitive decline. In the 1990s, new imaging techniques allowed earlier detection of the disease, providing a window of opportunity for intervention and treatment. Identification of risk factors such as age, genetics, family history, and lifestyle also contributed to the development of preventive strategies.
While a universal cure remains elusive, multiple clinical trials are testing various approaches, such as targeting plaques and tangles, inflammation, and cognitive stimulation. Other studies are delving into the potential benefits of lifestyle interventions in slowing or halting cognitive decline.
A landmark in this journey is the development of drugs that alleviate Alzheimer's symptoms and enhance patients' quality of life. Drugs like donepezil, rivastigmine, and memantine have been tested, but the game-changer trials have been aducanumab and lecanemab, which received accelerated FDA approval in 2021 and 2023, respectively. Both drugs target amyloids, but while aducanumab eliminates amyloid buildup, lecanemab prevents the further accumulation of amyloid-beta proteins. Their moderate yet encouraging success rates and side effects are still being studied to enhance their efficacy, safety, and affordability.
While there are not yet any definitive cures for Alzheimer's disease and dementia, early detection and intervention can significantly improve the quality of life for those living with dementia and their loved ones. By educating oneself about the disease and supporting those affected by it, we can create a more informed and compassionate society that is better equipped to help those affected by Alzheimer's disease. Those interested can consult their primary healthcare providers, reach out to ATRI, or search for ongoing trials in their area to continue to move the research forward.