Alzheimer's researchers shift their focus from treatment to prevention - Gainesville Sun

<p>Analucia Cadavid vividly recalls her time helping Alzheimer's patients, even if those she assisted can't remember her.</p><p>The 21-year-old psychology and biology major at the University of Florida volunteered in 2011 and 2012 at Al'z Place, a Gainesville facility that provides care for people with Alzheimer's disease and other forms of severe memory impairment.</p><p>“It's just to provide a safe place for them where they are watched and to create a support system for their families that maybe don't have the luxury of either hiring somebody full time or have to work,” she said. “It's an adult day care.”</p><p>Watching the visitors struggle with even simple things such as a game of charades took a severe toll on her emotionally, she said.</p><p>“You're just not completely there. It's not as easy to grasp basic things that used to be part of your normal life,” she said. “After they get dropped off, they get worried someone is not going to come back to pick them up. It was hard sometimes to see them so distraught.”</p><p>Those seeking to combat the debilitating disease that affects an estimated 5 million Americans recently have begun shifting their focus.</p><p>“More recently we've begun to think a lot more about prevention in addition to, or sometimes instead of, treatment,” said David Borchelt of the McKnight Brain Institute and the Center for Translational Research in Neurodegenerative Disease.</p><p>Treatment-based drug trials — the primary way that scientists test their research — have not translated into medications that could effectively combat the disease, he said.</p><p>Ethical concerns are part of the reason for the shift. Research ethics prevent scientists from using animals whose brains more accurately replicate the disease features in humans. Scientists are limited to using mice.</p><p>“The general problem with (Alzheimer's patients) is they can't remember, they can't reason well and they make poor decisions because they're not thinking clearly,” Borchelt said. “Those things are really hard to assay in a mouse.”</p><p>This has convinced researchers that they need to find a new approach.</p><p>“We want to use our tools the best way we can, which means if they're really good at finding things that prevent (the disease), then we'll use them for that,” he said.</p><p>“The mice that we have are excellent at reproducing the pathology,” he said, “so we can easily screen the mice for things that prevent the pathology of having it in the first place, and we will be in a position to test rigorously whether that works in people.”</p><p>Borchelt said the main obstacle will be finding a practice that works in mice so that human trials can begin, and he warned that whatever it is might take an unexpected form.</p><p>“Our history of expectation in drug development is that we will be able to take a pill that will make us better,” he said. But he explained that researchers will have to look outside medications for things that could be more successful in prevention, such as occupational therapy, or memory-enhancing exercises.</p><p>“Maybe there are things in the diet, in natural products that could have beneficial effects in prevention,” he added.</p><p>Community-based trials, in which people try following a prescribed regimen like eating more of certain foods and recording the results, could be fruitful, he said.</p><p>But even that might have limited success.</p><p>“We have to have a long-term plan that requires a rethinking of how we're going to fund this type of research because up to now most drug trials with Alzheimer's disease generally last less than two years … a preventative trial could be as long as 10,” he said. “We have to start from scratch … it's going to be difficult.”</p><p>Brenda Moore spends her days in the lab at the Neurodegenerative Disease center studying how the disease affects the brain. With the number of Alzheimer's sufferers increasing, Moore said the research is more important than ever.</p><p>“When I was starting out it was 4 million Americans and now it's something like 5.2 million. Everybody knows somebody (with the disease),” she said.</p><p>Cadavid said her experience with the program makes her thankful for the studies being done by researchers like Borchelt and Moore.</p><p>“It's sad to see the decline in somebody and really be unable to help them,” she said. “It's one of those things that we just can't ignore.”</p><p>The experts are making sure that it's not.</p><p>“We have every confidence that our animal models will allow us to test whether an intervention will prevent the pathology that's related to disease. Once we have something that works, we can then test whether preventing that pathology will prevent the disease in people,” Borchelt said.</p><p>“We think it probably will.”</p>