Clarifying the AARP's Claims About Alzheimer's Treatment Advances
This past week has brought attention to as well as some hope for future scientific advances related to Alzheimer’s disease. It is a hope that all of us desperately want to come to fruition in the very near future. But from where I sit as the leader of a national Alzheimer's disease care organization, this past week has been one of the most distressing as a result.
The scientific conference that reviewed recent therapeutic developments has spurred countless stories in the media. It is only right to bring these potential advances to the public’s eye, but what is wrong is creating unreasonable expectations about treatment for Alzheimer’s disease.
I point your attention, in particular, to headlines in the June 2007 issue of the AARP Bulletin: “Exclusive Report-Alzheimer’s: Finally, New Drugs Offer Real Hope For Reversing the Disease” coupled with “I Got My Brother Back.”
The AARP Bulletin resulted in numerous phone calls to the Alzheimer’s Foundation of America’s hot line from hopeful family members who believed that a cure for Alzheimer’s disease had been discovered—and is available. Many readers don’t go beyond the headlines, to learn further that although there is enormous optimism about the multitude of drugs in the pipeline, we are not there yet.
In response to this article and in the hope of clarifying the issues, I include comments from Richard Powers, M.D., who serves as chairman of the Alzheimer's Foundation of America's Medical Advisory Board as well as chief of the Bureau of Geriatric Psychiatry for the Alabama Department of Mental Health and Mental Retardation, and associate professor of the University of Alabama School of Medicine:
“The AARP Bulletin from June 2007 published a front-page story on present and future treatments for Alzheimer’s disease. The story includes interviews from several national experts and may leave the reader with the misunderstanding that a treatment may be available that will arrest or reverse dementia. Although we do not question the good intentions of AARP for encouraging family caregivers, we have serious concerns about the conclusion that may be inferred from this news story.
“Many medications are presently under trial for Alzheimer’s disease that show great promise for future efficacy. There is no medication currently available or in trial that reverses brain damage caused by dementia in humans. Available and evolving treatments will work in some, but not all individuals. Many medications that show promise in the treatment of Alzheimer’s disease work by reducing the production or deposition of amyloid. The efficacy of these medications in the general population remains unclear as does the toxicity.
“Dementia is often produced by a complex mixture of neurodegeneration, vascular injury and other neurological disease processes. Most persons with Alzheimer’s disease have a minimum of two molecules such as amyloid and tau that are disordered in the brain. A simple cure for dementia or Alzheimer’s disease remains elusive and unlikely.
“The most thoughtful opinion in the AARP series of articles was expressed by Dr. Huntington Potter, director of the Johnnie B. Byrd Sr. Alzheimer’s Center and Research Institute, Tampa, FL, who points to the complexity of this illness and the likelihood that multiple treatments—a ‘cocktail of drugs’—may be necessary to assure success.
“It is important for consumers to look beneath the headlines of announcements about drug trial results—to differentiate conclusions from non-human rodent studies and those involving humans, to note which phase the trial is in, and to question the source of the findings. What constitutes evidence of a drug having a meaningful efficacy? Only data published in a peer-reviewed journal. Release of human trial data in press releases generated by pharmaceutical companies or in a poster format alone, without the next step of a peer-reviewed journal, means that the results have not yet been published in a manner that allows for scholarly criticism. The latter is the marker that consumers should look for. They must be able to distinguish between science and hype.”
Buzzwords used in the media recently, such as “promising drugs in the pipeline” and “incremental progress,” are encouraging. There is no doubt that a glimmer of hope keeps caregivers and keeps all of us involved with Alzheimer’s disease going day after day. We just need to make sure it is kept in perspective.