More than six million Americans are living with Alzheimer’s dementia. This figure is expected to double by 2050. Alzheimer’s patients can often be cared for in the home by family in the initial stages of the disease. However, at some point they require more care than most family members can provide. The average monthly cost of memory care is $6,935. As Alzheimer’s patients become more disabled, they will require a nursing home bed (about $9,034 for a private room). Estimates vary but Alzheimer’s patients live 6, 8 or even 10 years or more with the condition.
In 2021 the U.S. Food and Drug Administration (FDA) approved the Alzheimer’s drug, Aduhelm against the FDA advisory committee’s recommendation. It was initially priced at $57,000 a year, with another $30,000 required for physician services and monitoring. Every Alzheimer’s patient was potentially a candidate for Aduhelm, even if they are unlikely to benefit. Back-of-the-envelope math suggests an annual cost of up to $600,000,000,000 (6 million X $100,000). Bad press ultimately discouraged many physicians from prescribing it. Aduhelm did not work well and came with all kinds of nasty side effects. It has since been withdrawn from the market. Other Alzheimer’s drugs that came before Aduhelm also do not work well and there are some in the pipeline that may also not work very well. Alzheimer’s has so far defied attempts to significantly slow its progression.
A landmark study published in 2006 implied amyloid beta in the brains of Alzheimer’s patients could be the cause of their disease. However, a recent investigation is casting doubt on data used in the 2006 study. The study and others published by the same authors were responsible for a shift in Alzheimer’s research towards drugs and therapies to reduce amyloid beta. Researchers are hopeful that the controversy has not resulted in years of wasted research efforts. Indeed, drugs focused on reducing amyloid plaques have not shown to reduce Alzheimer’s symptoms. Rather than the cause of Alzheimer’s, plaques could be the symptom of the disease.
There are some alternative voices that are finally being heard. One research team questions whether Alzheimer’s is even a brain disease. They argue it is more likely to be an autoimmune disorder, saying:
Based on our past 30 years of research, we no longer think of Alzheimer’s as primarily a disease of the brain. Rather, we believe that Alzheimer’s is principally a disorder of the immune system within the brain.
The immune system, found in every organ in the body, is a collection of cells and molecules that work in harmony to help repair injuries and protect from foreign invaders.When a person trips and falls, the immune system helps to mend the damaged tissues. When someone experiences a viral or bacterial infection, the immune system helps in the fight against these microbial invaders.The exact same processes are present in the brain. When there is head trauma, the brain’s immune system kicks into gear to help repair. When bacteria are present in the brain, the immune system is there to fight back.
How might the brain’s immune system trigger Alzheimer’s?
When brain trauma occurs or when bacteria are present in the brain, beta-amyloid is a key contributor to the brain’s comprehensive immune response. And this is where the problem begins.Because of striking similarities between the fat molecules that make up both the membranes of bacteria and the membranes of brain cells, beta-amyloid cannot tell the difference between invading bacteria and host brain cells, and mistakenly attacks the very brain cells it is supposed to be protecting.This leads to a chronic, progressive loss of brain cell function, which ultimately culminates in dementia – all because our body’s immune system cannot differentiate between bacteria and brain cells.When regarded as a misdirected attack by the brain’s immune system on the very organ it is supposed to be defending, Alzheimer’s disease emerges as an autoimmune disease.
Alzheimer’s disease is a costly condition due to years of long-term care, while the disease progresses. Alzheimer’s patients can live for 6, 8 or even 10 years or more. The current approach to Alzheimer’s drugs has not proven to be beneficial and may be based on faulty research. New research may increase our understanding of Alzheimer’s and leave to better treatments.
The entire article is worth reading: Alzheimer’s May Not Actually Be a Brain Disease, Expert Reveals : ScienceAlert
The article’s title may be a little misleading, because the types of immune responses being investigated are mostly specific to the brain.
I like the agnostic approach used by Cure Alzheimer’s Fund, which seems to use a shotgun approach funding everything that could potentially shed light on the disease.
Some of their reports suggest that microglia-modulated inflammation is an important link in the chain leading to symptomatic disease. This inflammation is likely an example of a brain-specific immune response. The question is, a response to what?