A Brief History in Mind
How far have we come?
People have always had dementia over the past hundred years, ever since the time that Alois Alzheimer first described the first case, now 110 years ago. We used to call dementia “hardening of the arteries” or “senile dementia.” It was not until the mid 1980s that we were able to make distinctions about defining a diagnosis of Alzheimer’s. At that point, we were able to make a distinction that abnormal proteins called amyloid and tau were the hallmarks of the changes in the brain in Alzheimer’s. Since that time, most of the current investigative therapies have been directed at trying to stop the toxic amyloid from building up or dissolving pre-existing plaques. Similarly, new treatments are also directed at stopping tau proteins from forming or dissolving pre-existing proteins. The current medications that are now available, Aricept, Exelon pills and patch, galanthamine and Namenda, are all, unfortunately, symptomatic, short-lived band-aids. You get a little bang for your buck early, and then as time goes on, they are better than nothing, but they become like spitting in the wind. People do get some positive effect for 6 to 12 months, but only in 50% of the people. None of these drugs are designed to disrupt amyloid or tau, which are the primary causes of the disease.
Over the past 15 years, there have been numerous attempts to study and get approval of drugs that will dissolve amyloid, or stop it from forming, or alternatively, stop tau from forming or try to dissolve it.
The first disease modifying treatment, Aduhelm, was approved in June 2021.