CTAD 2024 Shows How We're Rethinking Alzheimer's Treatment

The Clinical Trials on Alzheimer's Disease (CTAD) conference in Madrid brought together over 2,200 experts to share advances in detecting and treating Alzheimer's disease. Dr. Sheona Scales provides an insightful overview of the most significant developments.

Here are the major takeaways from this year's conference:

Treating Alzheimer's: Moving Beyond Single Drugs While drugs like donanemab show promise in slowing cognitive decline, they come with limitations. The benefits are modest - patients see about a six-month delay in brain function loss. The treatment requires expensive PET scans or lumbar punctures for diagnosis, carries risks of brain swelling, and comes at a high cost. This explains why NICE hasn't approved it for NHS use.

But researchers aren't putting all their hopes in one approach. The Alzheimer's Drug Discovery Foundation emphasized that finding a cure means exploring multiple treatment types tailored to each patient. New drugs in development show promise:

• Trontinemab uses "Brainshuttle" technology to cross the blood-brain barrier more effectively
• Remternetug, given by injection, could offer a more practical treatment option
• Genetic therapies target the disease at its source
• New medicines focus on reducing inflammation

Blood Tests: A Game-Changing Diagnostic Tool A blood test measuring the p-tau217 protein emerged as a breakthrough in early detection. This could transform how we diagnose Alzheimer's, making it faster and more accessible than current methods. Swedish researchers have even developed tests using just a single drop of blood.

The AHEAD 3-45 study analyzed blood samples from 20,000 people to identify suitable candidates for clinical trials. This approach could speed up research and reduce costs compared to brain scans.

Looking Forward - Shifting to a more Holistic Approach

Progress in Alzheimer's research has brought us to a point where disease-modifying treatments are available in some countries, and blood tests can detect the earliest signs of the disease. However, finding a cure requires looking beyond single-drug solutions.

The path forward combines medical treatments with lifestyle changes. Diet, exercise, and brain training can slow disease progression and help people live independently longer. Early detection and intervention make a real difference - something I reflect on personally, thinking how different things might have been if my mother had been diagnosed sooner.

But we face significant challenges in implementation. Only 16% of adults over 65 receive routine dementia screening. Primary care doctors, who serve as the front line for identifying early signs, often lack adequate training and resources for dementia care. With the shortage of neurologists, we need to better equip consumers and family doctors to have these conversations early and make cognitive screening a standard part of elder care.

While recent advances in treatments and diagnostics mark important progress, transforming these developments into real-world impact requires:

• Better training for primary care physicians
• Regular cognitive screening for older adults
• Earlier conversations about brain health
• Support for lifestyle interventions alongside medical treatments

The journey to effective Alzheimer's treatment isn't just about finding new drugs - it's about building a healthcare system that can identify, support, and treat patients at every stage of the disease.

[Link to original article: https://www.alzheimersresearchuk.org/news/ctad-highlights-2024/]