International Conference on Prevention of Dementia
More than 1,000 dementia experts from around the world converged June 9-12 in Washington, D.C., for the Alzheimer's Association International Conference on Prevention of Dementia.
"It's been an extremely exciting meeting, especially in the area of new medicines," said Sam Gandy, M.D., Ph.D., of the Farber Institute for Neurosciences at Thomas Jefferson University in Philadelphia, chairman of the association's National Medical and Scientific Advisory Council. "Several of these are moving on to phase III trials before FDA approval."
At the annual meeting, the U.S. Centers for Disease Control and Prevention and the Alzheimer's Association released the first-ever national "roadmap" for maintaining cognitive health. Stressing physical activity and lowering cardiovascular risk as key contributors to cognitive health, this map takes aim at high blood pressure, cholesterol, diabetes, obesity, smoking and other factors.
"Public health has a key role to play in ensuring that added years for older Americans are quality years," CDC director Julie Gerberding, M.D., M.P.H., said at the conference. "The Road Map provides critical action steps that organizations and agencies can take to move cognitive health into the public health arena in a strategic, coordinated manner."
Other research presented at the meeting included new 4.5-year follow-up research data on participants in the first big Alzheimer disease "vaccine" trial.
This immunotherapy trial, which used a synthetic form of the amyloid β protein, was halted because some participants developed brain inflammation. However, Michael Grundman, M.D., of Elan Pharmaceuticals, Inc., and colleagues reported that 4.5 years after immunization with AN1792, follow-up data showed that participants who developed amyloid antibodies maintained them, halting their mental declines.
"Those who maintained high antibody levels in the blood were able to stabilize their cognitive decline," Gandy said. "It's very exciting. It's the best evidence yet that amyloid, the substance used for the vaccine, will be a useful target for Alzheimer disease."
Researchers at the meeting also reported promising results of a phase II study of Dimebon (Medivation), an oral drug with an innovative mechanism of action. Rachelle Doody, M.D., Ph.D., of Baylor College of Medicine in Houston, Texas, reported the findings of a half-year extension of a six-month Russian trial of 183 Alzheimer disease patients given 20 daily milligrams of Dimebon. The results showed patients significantly improved compared to those on placebo, Gandy said.
"It seems to increase cognitive function initially and to maintain cognitive function at a substantially higher level than placebo," Gandy added. "So that looks encouraging."
Also causing excitement at the meeting was data on a new class of "plaque buster" medicines, Gandy said. Paul Aisen, M.D., of the Georgetown University Medical Center in Washington, D.C., reported promising results of a phase III study involving Alzhemed.
In addition, one study found that patients who were treated for risk factors for heart disease and stroke were less likely to develop Alzheimer disease, said Bill Thies, Ph.D., vice president for medical and scientific relations for the Alzheimer's Association. "That tells us what we've been saying to people: be sure you know what your numbers are around cholesterol, blood pressure, blood sugar, and get them treated if you need it."
Another key to cognitive health is keeping fit, said Thies. "A steady stream of data says physical activity is really important for maintaining your brain. Your brain is a biological organ, and you have to take care of it the way you take care of other biological organs. Staying connected to society, not being isolated, also appears to be protective. There are things you can do at any age. And if you're worried about your memory, you ought to see a physician."
New strategies for earlier detection of Alzheimer disease, discussed at the meeting, may eventually lead patients to more effective therapy, Gandy said.
"There are new leads in developing a blood test and using imaging to detect Alzheimer's earlier and earlier," said Gandy. "The medicines against amyloid will be most effective at the very beginning, and we don't want to miss that window."
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