Alzheimer’s disease is feared by most people as they age. Finding a cure would probably be considered the single-biggest medical breakthrough of the 21st century. Blaine Roberts, PhD is a research fellow at the Florey Institute of Neuroscience and Mental Health and he shares his thoughts on how the war must be fought.
For want of a nail the shoe was lost.
For want of a shoe the horse was lost.
For want of a horse the rider was lost.
For want of a rider the battle was lost.
For want of a battle the kingdom was lost.
And all for the want of a horseshoe nail.
– Nursery rhyme
The old nursery rhyme is an appropriate analogy for the war on Alzheimer’s disease. Our ability to find a cure for the disease relies on the accurate diagnosis of the condition, much in the same way the kingdom depends on a horseshoe nail.
From pathological studies we know the battle against Alzheimer’s disease begins at the molecular level in the brain 15 – 20 years before symptoms begin. This provides a great opportunity to detect the disease before symptoms even occur. If we can diagnosis the disease in this preclinical window, then it also provides the opportunity to develop effective treatments for Alzheimer’s which prevent the symptoms of dementia from ever presenting. However, to find a cure we must first be able to diagnose the disease early so we can test potential therapies.
Unfortunately, definitive diagnosis occurs post mortem. Thus, an accurate diagnostic test for Alzheimer’s is the ‘nail’ missing which will allow us to win the war. Without an accurate way to assemble cohorts of people with the preclinical phase of Alzheimer’s disease we will experience, and in fact are experiencing, a difficult and expensive battle in discovering a treatment. The key to being able to do this is an effective test to diagnose Alzheimer’s before symptoms occur. This is essential for providing the foundation on which a cure can be discovered.
I am often asked the question, “what good is an early diagnosis if there are no effective treatments?” This is a legitimate question, particularly from the individual’s point of view. However, the truth is that without the ability to test potential treatments for Alzheimer’s disease early, there may never be a treatment. Those developing drugs are often calling for a better understanding of the disease, which is critical, however, a complete understanding of the disease is not necessary to find a therapy.
This is particularly true in the field of mental health where many treatments have been discovered without a known mechanism of how the disease works or the drug. In Alzheimer’s disease the need to test drugs in the preclinical stage before symptoms are obvious is critical. By the time symptoms become severe, a large percentage of the neurons are lost (–50 per cent). Thus, treating the disease early gives us the best chance of finding a cure before the massive loss of neurons has occurred.
Our best chance to win the war against Alzheimer’s disease is to win the battle against neuronal loss. This requires an accurate diagnostic test to detect the molecular changes which occur in the brain before the disease begins. A diagnostic test will allow us to accurately test therapies before the clinical signs of the disease present.
Alzheimer’s disease is treatable and once we have an ability to test treatments in people in the pre-symptomatic phase of Alzheimer’s, we will have the horseshoe nail which will allow us to win the war.
This year Albert Park Rotary Club are running to raise money to help the Florey Institute for Neuroscience and Mental Health to find a cure for Alzheimer’s Disease. They are running in the City2Sea run on the 16th November 2015! Why not run or walk with us to help find a cure for this terrible illness?
You can register at www.thecity2sea.com.au Run or walk five kilometres or run 14 kilometres or sponsor a runner for Alzheimer’s the Cure.