The 2016 Alzheimer’s Association International Conference has just ended, with few encouraging developments. Here are the highlights:

• A decline in one’s sense of smell may herald the onset of Alzheimer’s
• A thinning of the retina may be an early indicator of Alzheimer’s
• A change in personality or behavior may accompany the onset of Alzheimer’s
• The first clinical trial of a drug targeting tau proteins failed
• A brain game commercially available may protect against cognitive decline. The first three developments are all part of efforts to find biomarkers for Alzheimer’s that are inexpensive and easy. Currently, Alzheimer’s is diagnosed through PET scans or spinal taps, both of which are expensive, invasive and time-consuming. The question about these possible biomarkers is whether they can reliably identify early Alzheimer’s since there are many other reasons why older people experience changes to their eyes and sense of smell.

 

The results of the clinical trial involving a drug targeting tau are disappointing, and will be the focus of another blog.

 

News of the success of the brain game met with immediate skepticism.  The study participants received 10, one-hour sessions designed to increase their ability to quickly identify objects that only briefly appear on a computer screen. The researchers reported that the people who received this training had a 33% reduced risk of developing dementia ten years later. Further, if the subjects undertook four booster sessions, the risk was reduced by 48%. The objections to this study are many:

• It was an analysis of another study that ended in 2014 and which had concluded there was no impact on the incidence of dementia;

• The findings have not been peer reviewed, nor published in a scientific journal;

• It contradicts the assertion of many scientists in the field who went on record earlier this year protesting the overstatement of the benefit of brain games; and

• The author gave no explanation for how 10 hours of brain training conveys 10 years of protection.

The conference findings reflect the challenges of finding effective treatments without understanding the basic science of Alzheimer’s disease.  It gives rise to the question of why the government is not supporting basic research in this field.