For generations, cognitive decline and dementia were thought to be simply a part of getting older. Today we understand that these are just symptoms of physical changes in the brain. Diseases such as Alzheimer’s disease have penetrated the public consciousness; according to the Alzheimer’s Association, 5.5 million people are currently living with the affliction (a number predicted to be as high as 16 million in a few decades). In fact, the disease is the sixth leading cause of death in the United States today.

Despite its prevalence, old stigmas about “senility” and impairment persist. Coupled with a perceived lack of progress towards prevention and treatment, these stigmas both lead many to conclude that a diagnosis of Alzheimer’s is akin to a death sentence. But modern clinical trials may lead the way to a brighter future for those afflicted with Alzheimer’s as well as the loved ones who care for them.

Trials are the key

“Without clinical trials, we just cannot advance the care, especially in a disease like Alzheimer’s which has such high unmet need for patients and their families.”

“Clinical trials can give us answers and new ideas,” says Rachelle Doody, M.D., Ph.D., global head of neurodegeneration at Roche. “Without clinical trials, we just cannot advance the care, especially in a disease like Alzheimer’s which has such high unmet need for patients and their families.”

Doody knows firsthand the stigma patients perceive in a diagnosis of Alzheimer’s disease, as well as the vital importance of clinical trials. “Before coming to Roche, I ran an Alzheimer’s disease research center and took care of patients. The stigma comes because of placing a label — patients think that others will say ‛oh this means senility’ or ‛this means a total loss of ability.’ But I’ve seen people with prodromal Alzheimer’s disease (the earliest clinical manifestation) who are still doing their work and living their life. They don't have to tell people that they're in a clinical trial.”

Doody has seen a lot of progress in recent years. “We have learned that people differ in their risk, what some of the risk factors are, and what some of the resistance factors are. That means that we've learned some promising treatment targets, such as abnormally folded proteins like amyloid and the proteins that form neurofibrillary tangles in the brain. We've also learned that the immune system is involved — all of these things have come about from our research.”

Dignity and hope

Although clinical trials have historically had a high failure rate in Alzheimer’s research, they are the best tool science has against the disease; Roche has two phase III trials in testing at the moment.

“There are more leads than we have resources to pursue,” Doody says. “There're just so many different reasons why things might not make it through to the end. But perceptions are starting to change; people who are educated about Alzheimer’s disease are starting to think in terms of prevention. Over time we’ll develop better approaches to risk reduction, but we’ll also develop very good tools toward detection. The process of Alzheimer’s disease starts more than 20 years before you can make a diagnosis. During that big window of time, we already have several trials underway to try to intervene, prevent progression or slow down progression.”

Doody is optimistic about what those clinical trials might mean to patients. “The potential of early diagnosis and treatment means, to the patient, living with dignity and hope, not inevitable progressive disability. I would love to see a move in that direction.”

To learn more about what Roche and its partners are doing to fight Alzheimer’s click here.