Conference second day and the latest research update

I attended the second day of the conference, Collaborating for a Dementia-Friendly Washington, on Wednesday.  My part was to participate on a panel  of ten thought leaders, focusing on the major takeaways from the conference.  My takeaway was the utility of the toolkit that the Dementia-Friendly America organization has created for communities to use in understanding their situation with respect to livability of their communities for people with dementia.  It is a very rich and valuable resource.

The week before, I attended a webinar with Maria C. Carrillo, Chief Science Officer of the Alzheimer's Association in which she reviewed the current state of affairs in Alzheimer's research.  Here are a few highlights and interesting statements that I noted:   

• We don't know when the FDA will act on Biogen's request for approval of aducanumab, but there is some thought this may happen in March 2021.
• Aducanumab doesn't cure Alzheimer's disease, but it does appear to slow its progress.  What is significant about it is that it is the first medication that actually addresses the disease process.  Earlier medications, such as donepezil, may temporarily improve cognitive function, but they only treat symptoms.
• If aducanumab lives up to it's potential and even somewhat slows the progress of Alzheimer's disease, it could still significantly reduce the load of dementia patients on the healthcare system. 
  
• Thirty percent of dementia cases are mixed dementia, meaning that more than one cause is at work.
• Knowing what mix of causes is at work in a case of dementia will influence the treatment plan.  Therefore, there has been important work on several new types of PET scans that can more clearly distinguish which mechanisms are at work.  For this reason, the Alzheimer's Association is promoting the idea that Medicare should begin covering PET scans.
• As we've discussed previously, very sensitive blood tests for Alzheimer's disease are nearing approval.  This is very significant, because they will make it easier to identify per-clinical cases and thereby accelerate drug trials.  They are currently looking to recruit about 3,000 test subjects.
  
• There are currently 121 drug candidates involved in 136 trials in progress.  43% of these involve re-purposing previously approved drugs.
• As we noted before, there is a correlation between flu shots and reduced incidence of Alzheimer's disease.  No one knows why.  It may simply be that people who get flu shots tend to be people who live a healthier lifestyle.
  
• More work is needed to investigate Alzheimer's disease in non-white populations.  In the U.S., the disease incidence and progression is different among African American and Hispanic populations.  Much of the research to date has focused on Europeans and Americans of European ancestry.
• The current goal is the have a cure for Alzheimer's disease by 2025.