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Alzheimer's disease: science and treatments, where do we stand?

On December 17, 2018

September 21, 2019, marked World Alzheimer's Day—An opportunity for researchers, physicians and journalists to take stock of the latest scientific advances on the disease.


The ageing population reveals an ever increasing number of diagnoses: 1 in 10 people by age 65, and 1 in 3 by age 85.  All eyes are on the research teams, and every positive result is considered a victory. In this race against time, Dr. Andréa LeBlanc, James McGill Professor of Neurology and Neurosurgery at McGill University, and Mallar Chakravarty, neuroscientist and Lab Leader of the CoBrA Lab, recently provided an update on the significant progress they have made. Each agreed to explain to us a little bit about their research and the current issues related to the disease. Treatment, prevention, screening, medication? Alzheimer’s disease: where do we stand? 

Prevention is still the best bet

The debate between medication and prevention currently divides research groups, and some countries have decided to stop covering medications for symptoms of Alzheimer’s disease due to lack of conclusive results. Both specialists interviewed believe prevention is important. “At this time, pharmaceutical solutions do not allow us to control the disease, so the brain's resistance must be maintained through a balanced diet, exercise, less stress, intellectual stimulation, etc.,” notes Chakravarty.

LeBlanc shares this observation: “Once damaged, the brain cannot repair itself and for the time being, it is impossible to say whether a person is predisposed to cognitive decline; we cannot systematically treat everyone who is 60 years old, so prevention is our best bet right now.”

Artificial intelligence: innovation to help diagnosis

The work of Mallar Chakravarty has garnered a great deal of interest within the scientific community: “Montréal has a very enviable position on the world stage of artificial intelligence: the conjecture is ideal.”

From MRI analyses, genetic data and cognitive test results, Mallar Chakravarty and his team have designed an algorithm capable of predicting the decline of a person’s cognitive abilities within the next three, four or five years. It has taken two years to achieve these results: “The algorithm was difficult to create, because at the start, when it detected Alzheimer’s disease, it was already too late,” explains Chakravarty. Neurological assessment, clinical assessment, lumbar puncture, MRI or the PET scan already provide a diagnosis that is 95% accurate; how can artificial intelligence perform better? “There are many sub-types of Alzheimer’s disease, hence the need to use several sources to adjust our algorithm.”

The next important step is to continue the tests using new data, to improve the accuracy of the algorithm. At this pace, Chakravarty is confident that collaboration with physicians will be available in the near future. “The basic diagnosis will be made by our algorithm, but it is not meant to replace a physician’s judgment, merely to accelerate the process.”

Do not give up on medications

Dr. Andréa LeBlanc is very interested in the different techniques being tested: “The important thing is to progress, but in research, you need evidence, you have to test.” She and her team have discovered a new medication that reverses memory problems and stops the progression of the disease in mice. She is currently waiting to run clinical trials on humans, and she thinks two or three years would be needed to validate the effects of this medication.

There are two types of Alzheimer’s disease: a hereditary form, which is explained by the mutation of a gene and can affect people between 40 and 50 years old, and a sporadic form, the most widespread, attributable to a set of factors involving ageing, genetics, our environment and our lifestyle:  “If the tests are conclusive, our medication could be used for both forms,” LeBlanc pointed out.

What are the prospects for caregivers?

For the time being, these advances do not yet have a direct impact on caregivers or the people receiving care: “This disease is very much in the media, so a lot of funding is available and there is also a great deal of philanthropic support. Research is ramping up, hypotheses are put forward, quickly verified and refuted, LeBlanc notes. An effective treatment soon? “It needs to happen, because this is a social, financial and political issue: caregivers are suffering as much as the people with the disease,” she confides.

Good to know:
If you or a loved one has Alzheimer's disease, know that resources are available for you. For more information: https://www.lappui.org/en/Practical-tips/Alzheimer-s-disease-and-other-neurocognitive-disorders


Sources

  • Interview with Dr. Andréa LeBlanc, James McGill Professor in the Department of Neurology and Neurosurgery at McGill University
  • Interview with Mallar Chakravarty, neuroscientist and director of the CoBrA Lab;
  • Sender, Elena. (2018, septembre). « Alzheimer : Prévenir, ralentir – Le point sur la recherche ». Science et Avenir, no 859, p. 24-35.