Three other anti-amyloid drugs – lecanemab, donanemab and gantenerumab – are in late-stage clinical trials with results expected this year and next year. The Centers for Medicare and Medicaid Services limited coverage to people enrolled in clinical trials, and the drug has been prescribed sparingly. The FDA’s outside expert advisers recommended against approval of the drug, which was based on two studies that were ended early and yielded mixed results. We're going to be adding those to the cocktail."įederal agencies and pharmaceutical companies have invested hundreds of millions in amyloid drugs. Only one amyloid-targeting drug, Biogen's Aduhelm, has gained Food and Drug Administration approval for people with mild forms of the disease. "And then we'll be looking at other types of drugs, which, for example, go for tau or go for the microglia and inflammation. "I'm optimistic an amyloid drug will be the first out of the box," Hardy said. But he's also interested in the role of microglia, which may play a role in clearing amyloid. John Hardy, a London geneticist who first described the amyloid cascade hypothesis three decades ago, said he still believes an amyloid-targeting drug will show a clear clinical benefit. Other potential targets focus on inflammation, vascular and microglia, immune cells of the central nervous system that might perform a protective role.ĭr. Researchers at Washington University are studying a combination of drugs targeting both tau and amyloid. In an article published this week in the medical journal JAMA, a National Institute on Aging official said only 13 of 61 early- or midstage clinical trials funded by the agency involve therapies that target amyloid.Īnother target is the protein tau, which forms tangles in the brains of Alzheimer's patients. More: Investigation into pivotal Alzheimer's study raises questions on suspected disease culprit While high-profile studies of drugs targeting amyloid beta protein that builds up in the brains of Alzheimer’s patients have commanded most of the headlines, experts are studying other targets for the neurodegenerative disease. How does it aid other Alzheimer’s treatments? Nor did it evaluate whether regular movement can help those diagnosed with dementia. It did not answer whether regular exercise helps all older adults prevent or delay cognitive decline expected with normal aging. “If that exercise does not include regular support, I have no confidence that they're going to see (cognitive) protection,” Baker said. Having someone to help older adults exercise – or just providing social interaction – is critically important, Baker said. The comparison group, which included people of similar age, education and genetic risk, showed a significant cognitive decline over 12 months, Baker said.īaker’s conclusion: Sedentary adults at risk of dementia can prevent or slow cognitive decline if they exercise regularly with supervised support. Instead, researchers found a comparable group from another study called the Alzheimer's Disease Neuroimaging Initiative. The study did not include a placebo group because researchers thought it would be unethical to withhold something potentially beneficial, Baker said. “We really did expect the high-intensity group to have more protection,” she said. Baker expected the more rigorous aerobic group would perform better, but the test scores showed both groups maintained similar levels over the year.
Participants' memory and thinking scores, as measured by a cognitive test, did not slip over the 12 months. They were evaluated using a cognitive test store at the beginning of the study, at six months and at 12 months.
Participants exercised four days each week for 30 minutes or more. Study participants were paired with YMCA trainers.Īll participants had mild cognitive impairment, which is when memory and thinking worsen beyond normal aging but not enough to be diagnosed with dementia.
A second group completed less rigorous stretching, balance and range-of-motion exercises. One group regularly exercised with moderate to high-intensity aerobics. The Wake Forest team recruited 296 people with memory problems who lived sedentary lifestyles and randomly assigned them to two groups. It’s just too hard.” What did the study results show? “If it was only the high-intensity exercise that was protective it would be very difficult to roll out and make it sustainable. “The results are exciting to me,” Baker said.