Can Alzheimer’s Be Treated Before Symptoms Occur?

reisa sperlingWhile considering whether to go to medical school, Dana Alliance member Reisa Sperling, M.D., noticed her grandfather had started to act strangely. She only later realized that he had symptoms of Alzheimer’s disease. His death when she was a neurology resident, along with her father’s diagnosis, influenced her decision to focus her research on the early detection of Alzheimer’s. She is now the director of clinical research at the Center for Alzheimer’s Research and Treatment at Brigham and Women’s Hospital in Boston. Sperling discussed her personal experience with the disease, and her ongoing research, in a fall interview for the Harvard Medical Labcast.

In her studies, Sperling made the major discovery that amyloid beta plaque builds in the brain approximately 20 years before symptoms appear. While some people with plaque buildup do not develop Alzheimer’s, it is a strong indicator that a person is at risk for the disease. She calls this “a glass half full,” as it gives time to administer preventative treatment. She told Harvard:

I really do feel like now is a special time in Alzheimer’s disease–the ability to detect disease before symptoms is really the way we’ve made progress in almost every other disease where there’s really been medical breakthroughs, particularly in HIV/AIDS, cancer, diabetes, osteoporosis. So, I’m really hopeful this will allow us to make progress in Alzheimer’s disease.

Sperling is now working on the Anti-Amyloid in Asymptomatic Alzheimer’s study, or A4 for short, which aims to see if preventing amyloid beta plaque buildup in the brain will delay or prevent the onset of Alzheimer’s. Over 1,000 people in the United States, Canada, and Australia will be separated into three groups: a group that has amyloid beta plaque buildup and receives antibodies against it, a group that has amyloid beta plaque buildup and receives placebos and salt water infusions, and a Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) study group without amyloid beta plaque buildup that is monitored as a control group.

Since one out of every nine individuals over 65 has Alzheimer’s, most people experience the disease at some point as a caretaker, friend, or family member. With a quickly aging population, Sperling feels it’s urgent that Alzheimer’s becomes a “public health conversation.” The A4 study gives hope that we will be able to slow or stop the progression of Alzheimer’s and make it manageable. It is currently in a phase three trial, meaning, if the results are positive, the treatment may soon be available around the world. Sperling hopes her work, “will allow people to die out ballroom dancing healthy, instead of in nursing homes.”

– Ali Chunovic

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