Latest Alzheimer's Drugs Can Add Years of Independence to Patient Lives
While researchers continue to work on a full cure for Alzheimer's disease, they're finding treatments that can help manage symptoms and delay their onset, including the recently approved next-gen therapies lecanemab and donanemab.
Both treatments have been approved by US regulators in the last couple of years, and they work by clearing out some of the amyloid protein plaques in the brain that are linked to Alzheimer's. However, there's some debate over how effective they are.
To quantify the effectiveness of lecanemab and donanemab in more meaningful terms, researchers from the Washington University School of Medicine (WashU Medicine) recruited 282 volunteers with Alzheimer's, analyzing the impacts of taking these drugs over an average of nearly three years.
"What we were trying to do was figure out how to give people a piece of information that would be meaningful to them and help them make decisions about their care," says Sarah Hartz, a professor of psychiatry at WashU Medicine.
"What people want to know is how long they will be able to live independently, not something abstract like the percent change in decline."
The researchers measured two different types of independence: being able to live with day-to-day responsibilities (so dealing with appointments and bills, for example), and being able to care for yourself alone (for instance, the basics of washing and dressing).
Those with very mild Alzheimer's symptoms, who may have difficulty remembering dates and medications, would live independently for another 29 months without treatment on average, the estimates showed.
A person with this same level of dementia could expect around 10 additional months of independence on lecanemab and 13 months of independence on donanemab, the estimates suggest.
However, it's important to note that these figures are averages, and different patients have different responses to these drugs.
"My patients want to know, how long can I drive? How long will I be able to take care of my own personal hygiene? How much time would this treatment give me?" says Suzanne Schindler, a physician and a professor of neurology at WashU Medicine.
"The question of whether or not these drugs would be helpful for any particular person is complicated and has to do with not only medical factors, but the patient's priorities, preferences and risk tolerance."
It's important to mention that these therapies come with downsides too: they're expensive, require regular infusions, and can lead to potentially dangerous side effects such as brain swelling and brain bleeds.
Those with Alzheimer's and their families therefore need to weigh up the potential pros and cons – and the possible implications later in life.
"The purpose of this study is not to advocate for or against these medications," says Hartz. "The purpose of the paper is to put the impact of these medications into context in ways that can help people make the decisions that are best for themselves and their family members."
The research has been published in Alzheimer's & Dementia: Translational Research & Clinical Interventions.
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Miami Herald
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- Miami Herald
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Yahoo
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He explains that in one recent study, the maker of digital games designed to challenge the brain and boost memory pitted their product against the old-fashioned crossword puzzle. 'Their prediction was that people who played their battery of games would end up doing better cognitively and show less brain shrinkage on MRI results,' he shares. 'But they found that doing crossword puzzles was better for the brain than playing their games.' That's because these puzzles are one of the few cognitive activities that force you to stretch your brain again and again. 'The clues are always different and the words link together in new ways,' he continues, explaining that the brain feeds on novelty and variety. Digital games, on the other hand, are more static and predictable. If you prefer apps, just try to switch them up every few weeks. Once you master them, it's time to introduce your noodle to a new challenge to maximize the dementia prevention benefits. Fostering deeper relationships doesn't just feel great, it literally boosts brain power and wards off dementia. 'One study that came out of Japan showed that people who were more socially isolated actually saw a shrinkage of their brain,' reveals Dr. Budson. 'Social interaction is one of the most important kinds of brain stimulation there is.' His simple prescription: Call, or even better, hang out with a friend and engage in a meaningful conversation. Everything from making a joke to showing empathy to simply listening is the cognitive equivalent of lifting a megaton weight, strengthening neural pathways and reducing this risk factor for dementia. 'When we use our brain, we're helping it stay metabolically active and robust,' Dr. Budson says, revealing that there is an increased risk of dementia in people with hearing loss, likely because 'they're not getting as much information into their brain if they can't hear it.' This can lead to a different kind of loss that accelerates cognitive decline: the loss of connection. People essentially become isolated when they can't hear and participate in the conversation, he observes. The good news: 'It's estimated that seven percent of dementia cases could be prevented if people address their hearing loss with hearing aids—that's an enormous percentage.' It's also important to take preventative measures to protect your hearing by wearing earplugs when you're, say, mowing the lawn or attending a loud concert. Going for a stroll is like winning the lottery for your brain. 'When you take a walk, you're doing all sorts of things that improve cognitive health, from navigating a new environment to spurring the release of growth hormone,' says Dr. Budson. Plus, aerobic exercise increases the oxygen-carrying capacity of your blood, helping your brain work more efficiently. While walking 30 minutes a day, five times a week, is still the study-proven gold standard for brain health, that doesn't mean you have to carve out a large block of time for regular physical activity. 'There's lots of evidence that shows breaking up a 30-minute workout into three 10-minute intervals gives you just as many benefits,' he confirms. Study after study confirms the best brain food comes from the Mediterranean. 'A menu which includes fish, olive oil, fruits, vegetables, nuts, beans and whole grains has been shown to decrease the risk of Alzheimer's,' Dr. Budson assures. 'And its sister plan, the MIND diet, which pulls in poultry like chicken and turkey, is very good as well.' In fact, new research finds that the MIND diet—a hybrid of the Mediterranean and blood pressure-slashing DASH diet—lowers the risk of dementia by nine percent. What's more, the age of study participants ranged from 45 to 75 years old, showing it's never too late to adopt healthy, brain-building habits. Everything from conjuring characters in your mind's eye to setting the scene makes reading incredibly stimulating for your brain, notes Dr. Budson. In fact, a study in International Psychogeriatrics showed reading helps stave off cognitive decline in older adults. To reap even more dementia prevention benefits, consider reading aloud to the kids in your life. Not only does this stimulate more of your senses—keeping your neurons on their toes, so to speak—but it also incorporates that all-important social component that your brain craves. Sadly, the same can't be said for watching TV. 'There are actually two studies involving hundreds of thousands of people, and in one of them, researchers found that people who watch more than an hour of television a day were more likely to develop dementia later on.' No need to cancel Netflix, though: Just try to balance binge time with a little more book time. Ditch the map, turn off the GPS and let yourself discover a new route. Challenging yourself to navigate the unknown creates neural superhighways in your brain. Dr. Budson points to a famous study in the Proceedings of the National Academy of Sciences (PNAS), which showed that when novice London cab drivers learned new streets to pass their exam, the size of their hippocampus—the seat of memory in the brain—increased substantially. The common denominator among Dr. Budson's tips is that they all tap into a growth mindset for dementia prevention. Whenever you learn something new, not only does your brain light up, but so does your world, making your gray matter healthier and your life more colorful. More strategies to boost brain health: Want to Keep Your Brain Sharp? Experts Reveal Simple Habits to Prevent Cognitive Decline 6 Brain Foods That Can Help Reduce Your Risk of Dementia—And Keep Your Memory Sharp Surprising Tricks That Boost Brainpower, Improve Memory and Keep Your Mind SharpThis content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
