Interpreting the Flurry of Alzheimer's Disease News

It has been an interesting couple of weeks in the field of Alzheimer's disease.  On one hand, there are some dire predictions about the number of people in coming decades that will have this disorder.  On the other hand, there is some exciting news about potential treatments. 

These are important topics. However, it has occurred to me that there are not only many aspects about these topics that are important, but how the topics are discussed is equally important. I would like to take this SharePost to give some perspectives on that issue.

In thinking or writing about this disease we can take one of many different perspectives.  Individuals commonly are interested in knowing how the information translates to them or their family members personally.  For example, as an individual, one might ask if the increased number of people with Alzheimer's disease (It is expected that the total number will quadruple over the next 50 years.) reflects an increased risk for the disease.   If this is the case, then each of us might be more concerned about getting Alzheimer's disease.  On the other hand, the increased number of people with Alzheimer's disease may also be due to an increase in the number of older people.  If this is the case, each of us will only have an increased risk because we grow older.

Health professionals and other researchers are commonly interested in how the information translates to people as a group.  For them the potential increase in the number of people with Alzheimer's disease appears to be an overwhelming medical problem, whether or not a specific individual is affected.

These perspectives are important in understanding how new research findings are perceived, interpreted and reacted to.  There are a couple of potential new medications, that are not yet approved for use in Alzheimer's disease, that appear to improve the functional capacity of many patients with Alzheimer's disease to a small but significant extent.  For many of us as individuals, such findings are encouraging, but we would like to hear about medications that significantly delay or reverse the disease.  In contrast, as a public health problem, even a small improvement in many patients can be appreciated as a major advance in healthcare. 

There is an alternative group of medications that also has potential as new medications, and are also not yet approved, that may help only a small percentage of people, but may help them to a marked extent.  For many of us as individuals, such findings are quite exciting because we can imagine this marked improvement occurring in ourselves or our family member.  The public health impact of such treatment might potentially be less then the potential benefit described in the previous paragraph.

Dimebon is a new drug that falls into the first category.  It was studied in Russia and was shown to have benefits better than those of placebo (sugar pill) for activities of daily living and performance on memory tests.  Based on what I can find out about this drug, the benefit seems to be similar to those drugs that we currently have (Aricept, Excelon, Razidyne and Namenda).  In the second category are a series of drugs being evaluated for decreasing the amyloid deposits in the brain.  These drugs appear to have the potential for significant impact on some individuals.