Should Alzheimer’s Be Treated Before It Becomes Symptomatic? Experts Weigh In

Experts Debate the Treatment of Alzheimer’s Before Symptoms Appear

July 1, 2024 TruthUSA

The FDA has issued guidance to drug companies developing medication to treat Alzheimer’s before symptoms begin to show. The concern is whether this will lead to overdiagnosis.

In March, the U.S. Food and Drug Administration (FDA) issued a revised draft guidance to help drug companies develop medication to treat cases of early Alzheimer’s disease that “occur before the onset of overt dementia.”

One theory about Alzheimer’s is that amyloid pathology can occur decades before symptoms appear and to stop the disease, doctors may need to address this underlying pathology well before that happens. Some say that will label people as having a disease they may never develop; others say it’s the only way to stop it in those who will come to have it.

Treat Dementia Like Heart Disease

Rudolph E. Tanzi, a professor of neurology at Harvard Medical School, emphasized the need to treat dementia and Alzheimer’s in a preventive manner, similar to how heart disease is managed.

“Just like we keep track of cholesterol and alter lifestyle and take safe drugs to lower cholesterol levels in order to avoid heart disease, we will need to do the same for Alzheimer’s disease,” Mr. Tanzi told The Epoch Times. “The FDA guidance is a step in that direction.”

The American Heart Association reports a significant decline in deaths due to heart disease since the 1950s, attributing it to proactive treatment measures.

As a geneticist involved in Alzheimer’s research, Mr. Tanzi stressed the importance of intervening with safe drugs as early as possible to address amyloid deposition and prevent the disease’s progression.

Mr. Tanzi also highlighted the necessity of developing blood tests and imaging techniques to detect and prevent amyloid deposition in the brain before it leads to irreversible damage.

“This would be most important for those with early-onset familial Alzheimer’s disease gene mutations, those with Down syndrome, and carriers of the APOE epsilon variant that increases risk for Alzheimer’s disease, where you know amyloid deposition is guaranteed or highly likely beginning early in life,” Mr. Tanzi added.

Is Amyloid Positivity Enough to Redefine Alzheimer’s Disease?

Dr. Eric Widera, a professor of clinical medicine, raised concerns about overdiagnosis and the effectiveness of drugs targeting amyloid reduction in preventing dementia.

While acknowledging the potential of amyloid-focused drugs to remove amyloid, Dr. Widera cautioned that their impact on cognitive decline remains subtle, suggesting that multiple factors contribute to Alzheimer’s progression.

He expressed skepticism about redefining Alzheimer’s solely based on amyloid positivity, emphasizing the need for comprehensive understanding and treatment strategies beyond targeting amyloid.

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