amna: After years of work, there
has been some progress in the
fight against Alzheimer's
disease, the incurable brain
condition that affects more than
6 million Americans.
Several new drugs have shown
small but positive result in
reducing the cognitive decline
associated with the disease.
William bring them has our look
at the breakthroughs and what
they could mean.
William: An fda advisory panel
earlier this month agreed that
the drug known as look can be
modestly slowed the progression
of Alzheimer's.
A similar drug has shown promise
in clinical trials.
It could see fda approval as
soon as this year.
The results from these drugs are
modest, and there are concerns
about side effects like brain
swelling and bleeding, so for
more on these drugs, we are
joined by the longtime director
of the national institute on
aging at the national institutes
of health.
Doctor, so good to have you on
the program.
Researchers have been trying for
decades to find some crack in
Alzheimer's armor.
Now we have some hope.
When you look at the results,
how promising do they seem to
you?
>> You put it well in context.
For the first time, this is a
set of results that in the
analysis of experts is a clear,
significant impact on slowing
the course of the disease.
Where I think we would all agree
is that this is an important
first step, working upon this
foundational, initial finding to
get an even better ratio of
positive effects, prevention
treatment, and side effects,
which is a significant point of
data in these findings.
>> You mentioned that these
drugs seem to slow the progress
of the disease.
Explain why it is significant.
>> Alzheimer's disease, we
recognize, is a slowly
progressing disease.
The findings of abnormalities in
the brain actually begin years
before the appearance of
symptoms, and then there is a
slow progression that varies
from individual to individual.
If these treatments were capable
of not just curing the disease
but slowing it to the point
where people retain their
function, have a meaningful life
of high quality, this would be
an important outcome.
>> You mentioned this issue of
side effects, and I know there
is this debate about whether
medicare should cover the
treatments.
>> What we need to do going
forward is understand which
individuals are most likely to
profit from the treatment, which
individuals are higher risk.
Then families and care providers
can make a judgment about the
cost-risk-benefit.
This kind of research is already
ongoing.
>> There are still so many
questions and mysteries about
this disease about who gets it
and why, but we are learning
more about risk factors and
prevention.
What is the best knowledge on
that front?
>> In addition to looking for
cures and treatment, the ability
to decrease risk is important.
A few years ago, we had a study
commissioned about what we knew
about risk factors and what we
could do to reduce the risk, and
the risk factors for which there
is the best evidence
intervention could help were
three.
One, control of blood pressure.
The other, maintaining cognitive
activity.
Third, physical activity.
Since the time of that report,
one of them, blood pressure
control, has been shown in a
randomized clinical trial, which
is the gold standard, that by
more intensively controlling
blood pressure for people in mid
age and lower age, there was a
decrease in the appearance of
lesions in the brain, which are
seen in Alzheimer's disease, and
cognitive impairment, a stage
that precedes dementia.
In the meantime, there are
ongoing trials to see whether
controlling diet for physical
activity or cognitive training
will have a similar effect.
>> You've spoken about the need
to increase the racial diversity
amongst the people knew
researched with.
Why is that important?
>> We could start with the
ethical impairment -- imperative
that we need to do research that
benefits all people in the
country, and for that matter,
globally.
We need inclusion of that
diversity in our clinical
studies.
This is not just hypothetical.
We have compelling findings to
demonstrate that the risk in the
genetic variant does not have
the same risk in
African-American populations.
There are differences in
genetics and experience that
mean individuals of different
parts of the population are
likely to have different
pathways to Alzheimer's disease
and will likely benefit
differently from treatment.
We will only know that if we
include a diverse population in
our research.
Geoff:geoff: The director of the
national institutes of aging,
thank you for your time.
>> Thank you for the opportunity
to speak with you.