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Early diagnosis for Alzheimer's disease: the reasons to do so keep building

by Carol Bradley Bursack, Editor-in-Chief

The time when an informed doctor would say, "Yes, you have Alzheimer's disease. Sorry, but there's nothing to be done," is over. There is still no cure, and the causes of Alzheimer's are still widely debated and studied. However, unlike just a few years back, there are some treatments available.

Medications can slow Alzheimer's progression

The US Food and Drug Administration has approved donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) as drugs which may help maintain cognitive abilities and help control some behavioral symptoms for a few months to a few years. Another drug, memantine (Namenda), is often used in tandem with one of the other drugs. These drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons. They can help maintain thinking, memory, and speaking skills and may help with certain behavioral problems, as well.

Some people cannot tolerate the side effects of the drugs, which are different for everyone, but many times a doctor can experiment with dosages and/or combinations until the right treatment is found. I must emphasize that these treatments do not reverse the disease.

New research shows possible signs of Alzheimer's reversal

Research on medications that may reverse Alzheimer's is being done around the world. I was heartened to read about the results of research at the University of Texas Health Science Center at San Antonio. The researchers reported on Feb. 23, 2010 that Rapamycin, a drug that keeps the immune system from attacking transplanted organs, "rescued learning and memory deficits in a mouse model of Alzheimer's."

The really great news for people now diagnosed in the early stages of Alzheimer's is that if Rapamycin shows the same benefits in humans, it is already available and on the market. In other words, a drug that may actually reverse Alzheimer's is already approved for human use. That means doctors could prescribe Rapamycin by what they call "off label" prescribing, which means that if a doctor feels an approved medication may help a patient, even if it is not officially used for the disease they are treating, they may still be able prescribe it. It's not within the scope of this article to address rules that govern doctors when they prescribe off label, but it seems reasonable to think that if Rapamycin proved to be helpful to humans with Alzheimer's, the demand for this drug will be high.

The safety testing of new drugs can, and likely should, take years. However, people with Alzheimer's have a terminal illness that continues to take them sliding down the hill of increased dementia. Many, if not most, people with the disease would opt in for a trial if they could get a drug that could possibly reverse the disease. Speaking personally, I'd be first in line.

New Alzheimer's medications in development

As I mentioned above, laboratories worldwide are frantically researching causes and cures for Alzheimer's. Millions--likely billions--of dollars have been spent and will continue to be spent in the attempt to end this devastating disease. The search is humanitarian, of course, but just imagine the stock prices skyrocketing if a company actually discovers a drug that can stop or even reverse Alzheimer's disease? With the aging population worldwide clamoring for a cure, there is a lot of pressure to be the first to come up with the "miracle drug."

What to do about Alzheimer's? See your doctor

So, what of those of us who don't want to get diagnosed? What about our fear? Obviously it's easy for me to say, since I don't (yet) have symptoms, but I say just do it. If you get a physical to rule out other causes for your symptoms, such as low vitamin B-12 levels, an infection or side effects from medications, and your doctor suggests testing for dementia, get tested.

If these tests are positive, your doctor may be able to put you on medications to stave off the decline for a time. And then? If all goes well, Rapamycin, or some other drug, may be available offering the possibility of a reversal. If you do have an Alzheimer's diagnosis and you do nothing? You may go downhill and you may do so faster than if you had treatment. You may have missed you chance to tread water until a drug can save you from drowning. There is hope, no matter how far away the cure seems. Don't let fear trump hope. The stakes are too high.