Today the World Health Organization released a downbeat report on dementia that says there is a new case every four seconds somewhere in the world, and that predicts the number of cases worldwide will roughly triple by 2050 (PDF). There is a fatalistic tone to the document, in that it focuses on coping with the disease rather than preventing it. The WHO recommends early diagnosis; raising public awareness and reducing stigma; and providing better care as well as more support to caregivers.
The closest the report comes to calling for a cure is near the end. In the leaden language of international bureaucrats, the report says, “A balance must be struck between research into treatment, care and cure on the one hand and pharmacological and psychosocial intervention approaches on the other.”
Since research suggests that vascular disease predisposes people to Alzheimer’s disease and vascular dementia, the WHO called for action to treat or prevent vascular disease. Smoking, diabetes, hypertension, and obesity are all risk factors for vascular disease. Dementia is less prevalent among people who stay mentally active, at least in rich countries, the WHO said.
The health organization missed an opportunity to discuss some of the promising research on the causes of dementia, and possible treatments.
The Feb. 9 issue of the journal Science reported that a cancer drug called bexarotene can sweep a plaque-forming protein associated with Alzheimer’s from mouse brains in hours. “This is a pretty fantastic drug,” Paige Cramer of Case Western Reserve University School of Medicine in Cleveland told Science News.
Discover magazine’s April issue reports on research at the University of Toronto’s Hospital for Sick Children. Sheena Josselyn, a neurobiologist, “reported that her lab improved memory in mice bred to have the equivalent of Alzheimer’s,” the magazine said. Josselyn “boosted an entire brain region, the hippocampus, known to be critical for forming long-term memories.”
Beta-amyloid is the chief component of the plaques in the brain that are characteristic of Alzheimer’s. “Researchers are developing medications aimed at virtually every point in amyloid processing.”
Tau protein is the chief component of tangles, the other hallmark brain abnormality. “Researchers are investigating strategies to keep tau molecules from collapsing and twisting into tangles, a process that destroys a vital cell transport system.”
Inflammation is also a factor in Alzheimer’s. “Scientists … are working to better understand specific aspects of inflammation most active in the brain. ”
Insulin resistance may be linked to Alzheimer’s disease. “Researchers are exploring the role of insulin in the brain and closely related questions of how brain cells use sugar and produce energy.”
Biomarkers in the blood or spinal fluid may one day allow doctors “to diagnose Alzheimer’s disease in its earliest, most treatable stages—possibly even before symptoms appear.”
There’s nothing wrong with increasing public awareness about dementia and decreasing stigma, as the WHO advocates. But it would be far better to cure this terrible disease. That will take a major global commitment of brains and money.