The forecast looms like a portent of doom. From 5.8 million people today, the number of Americans with Alzheimer’s disease is projected to reach 13.8 million by 2050, overwhelming caregivers and the health care system — a prospect that has produced alarm bordering on panic about an unstoppable Alzheimer’s tsunami.

Reality, however, is far more nuanced: Medical breakthroughs and other factors could dramatically reduce that number — though, paradoxically, such advances could also increase the prevalence of this most common form of dementia.

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  • Thank you for a very insightful article. Wiile it paints a clear future picture for the US, what is the situation of other countries? It is a well known fact that for example in Japan, the growth of elderly population is a lot faster and more dramatic there than in the US? We all know Eisai’s collaboration with Biogen for Alzheimer’s Disease drug research turned out to a big flop. So what are the Japanese government, docotors, healthcare institutions and elderly care organizations saying or planning?

  • Interesting projections for the number of people living with/or expected to develop Alzheimer’s disease. Underneath the statistics are real patients and their families suffering every day from the disease. And, they need real solutions sooner rather than later. New approaches for drug discovery and development are needed.

    At the Alzheimer’s Drug Discovery Foundation (ADDF) we are optimistic. Our optimism is based on what’s currently happening in a research landscape of diverse drug targets. Currently, there are about 100 potential treatments for Alzheimer’s disease in clinical development with the majority (74%) focused on a multitude of targets associated with aging biology – moving beyond traditional amyloid approaches, according to a recent ADDF clinical trial report. 63% of potential treatments are in Phase 2.

    Indeed, aging is the leading risk factor for Alzheimer’s disease. Our strategy has long been to translate aging biology into new drugs for Alzheimer’s. ADDF funds a diverse pipeline of drugs aimed at neuroinflammation, genetics and epigenetics, neuroprotection, among others. Like other diseases of aging, including cancer, diabetes and heart disease, it is likely a combination of drugs addressing multiple target pathways will be needed to effectively treat Alzheimer’s vs. a “one size fits all” approach.

    I see progress in all fronts, including prevention and delaying of the onset of Alzheimer’s disease, progress toward diagnostics, such as blood tests, retinal scans, and even digital tools for early detection, as well as increasing scientific evidence to the benefit of practicing good brain health.

    Now is the time to accelerate research efforts to develop new drugs and renew hope for the millions of patients suffering from this disease. It will take the continued collaborative efforts of philanthropists, investors, government, and the biopharma industry – each playing their unique role – to get there. We have developed safe and effective therapeutics for other chronic diseases of aging and old age, like cancer and heart disease, and we can do it for Alzheimer’s.

    Howard Fillit, MD
    Founding Executive Director and Chief Science Officer
    Alzheimer’s Drug Discovery Foundation

    • Real patients need real solutions sooner rather than later.
      This is what really needs to be first and foremost
      Well said.
      My wife has advanced Early Onset AD. disease.
      We recently visited a national ADRC center.
      There was no hope given in regards to current available treatments
      for advanced AD. Why don’t the powers that be get a protocol
      of options that might offer some hope to AD. patients. Donepezil
      and Namenda is the best you can offer? Really sad.

  • Expect the unexpected. If Alzheimer’s is found to be triggered by microbes, a simple fast treatment would soon follow. Patients whose cognitive declines are halted early will enjoy life and easily remain at home. The main casualty will be the nursing home industry, which I predict will be destroyed. (https://doi.org/10.1016/j.mehy.2019.109398).

  • Giving an anti-amyloid mab to All 55+ yr olds would dramatically reduce these numbers. Unfortunately no one can do a 10yf anti amyloid study in early enough pts. Treating someone for 18mos whose brain is half full of amyloid is what’s been studied and will never work. Removing beta-amyloid is clearly good, but would take $10B+ to show it in a 5000pt 10yr trial with sophisticated imaging. I’m afraid because of faulty trials and lack of funding, we will abandon this obviously useful approach

    • bapineuzumab was the best designed antibody with better properties than even add animal but it came too early before our understanding that we need to treat 15yrs before demention. It’s off patent. If would be wonderful if nih could support its long term use in younger people who are just developing amyloid

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