BOSTON — Major medical strides are being made in the fight against Alzheimer’s disease, with new treatments and testing offering patients more options to slow cognitive decline and identify the disease earlier.
The FDA recently approved an at-home injection pen that helps reduce cognitive decline by as much as 30%. But experts say a key part of changing the course of the disease is recognizing signs and getting screened earlier.
Katie Brandt, director of Caregiver Support Services at Mass General’s FTD unit, knows firsthand how Alzheimer’s and dementia can affect families. Brandt’s grandparents lived with Alzheimer’s disease, but the disease became much more personal when Brandt’s husband was diagnosed with young-onset dementia in Brandt’s late 20s. Brandt’s father was also diagnosed with Alzheimer’s at age 59. Brandt’s husband has since died.
“I had grandparents who lived with Alzheimer disease, and I thought it was a disease of elderly people,” Brandt said.
Brandt said fear and stigma can make families hesitant to bring cognitive changes to a doctor’s attention.
“I think that there has always been a lot of shame and worry associated with my gosh, my mom. My husband is experiencing these changes and I am nervous to bring it up to the primary care physician or their doctor because I just know it will be this horrible journey and it’s only a downward hill, but that’s not necessarily true anymore,” Brandt said.
That is because of research being done by doctors including Dr. Daniel Seichepine, a clinical neuropsychologist who has been studying Alzheimer’s for two decades. Seichepine was involved in a trial that resulted in FDA-approved disease-modifying treatments.
“They’re the first time we’ve had a medication that directly addresses the underlying biology of Alzheimer’s disease. So this is a significant difference than what we had before where the medications were just working on symptoms,” Seichepine said.
Seichepine said one of the first things that happens with Alzheimer’s disease is the buildup of a harmful protein in the brain. New medications target that protein and help the body process and eliminate it.
“And these medications attach to that protein, they tell our immune system that this is something bad and it will help us process it and eliminate it through our body,” Seichepine said.
The medications are not a cure, but Seichepine said they can reduce the decline in cognitive function by about 30 percent.
“So if you think about that over a 10-year span, that’s two extra years of functioning or two extra year of being with your family and spending good time with them,” Seichepine said.
The FDA also approved a blood-based biomarker last year that tells patients how much of the harmful protein is in their brain. With new testing and medications available, experts say patients should talk to their doctors sooner about possible symptoms.
“The best evidence suggests that Alzheimer’s starts building up in the brain in somebody’s 40s or 50s. And we’re not treating them until their 60s or 70s,” Seichepine said. “We want to intervene before that happens because the medications aren’t going bring back the brain or bring back memories. We want to intervene early before it starts to, you know, slowly dissolve parts of the brain and you lose those memories.”
Brandt said caregiving can take a significant toll on families, with caregivers sometimes leaving the workforce, neglecting their own health and becoming isolated from friends and family.
“Caregivers leave the workforce. They ignore their own health and wellbeing. They isolate themselves from friends and family because it’s all consuming to take care of someone living with dementia. So accessing treatment for your loved one is also a way to protect yourself from the terrible side effects of dementia,” Brandt said.
The best advice for anyone worried about cognitive changes in themselves or a loved one is to talk with a primary care physician, who can determine whether an evaluation is needed. Seichepine said even better treatments for Alzheimer’s could become available within the next five years.
This is a developing story. Check back for updates as more information becomes available.
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