As reported in the New York Times, three drugs being prescribed for Alzheimer’s disease — donepezil (Aricept), galantamine (Reminyl) and rivastigmine (Exelon) — have been shown to delay somewhat the loss of mental abilities in people with the illness. Now they are being called smart pills or brain boosters or, to use the preferred pharmaceutical term, cognitive enhancers, and drug companies are scrambling to exploit what they view as an enormous medical and economic opportunity – to sell the drugs as a preventative suppliment as well as a disease treatment. The current cost of Alzheimer’s alone runs $100 billion or more, said Dr. William Thies. If no new medications for memory disorders are found, Dr. Thies added, the number of Alzheimer’s patients could quadruple by midcentury. “That’s going to bankrupt our health care system,” he said. “So there’s a need to find a way to short-circuit that impending disaster.” But it will probably be at least five years before any of those drugs meet the standards for approval as an Alzheimer’s preventative as well as a treatment by the Food and Drug Administration, researchers said. Unfortunately, there is even less optimism that these drugs will boost the brain power of younger people hoping to master a foreign language or excel on a calculus examination.

As reported in CNN, families with several members afflicted with Alzheimer’s disease are being recruited for a new gene bank that may help speed new treatments or even prevention of the mind-robbing ailment. The goal is to create a gene bank with samples from more than 1,000 families affected by late-onset Alzheimer’s. “By getting large samples like this we should be able to start zeroing in on these genes,” said Creighton Phelps, director of the NIA’s Alzheimer’s Disease Centers network. Samples will be sent to an NIA repository at the Indiana University Medical Center in Indianapolis, where the research will be conducted. Interested families may contact the Indiana University repository at 1-800-526-2839.

As reported in New Scientist, researchers claim that a causal link between plaques and tangles, the two pathological hallmarks of brains ravaged by Alzheimer’s disease, has been shown for the first time. The scientists found that the protein found in plaques can initiate a process that damages other proteins inside cells and makes them vulnerable to tangling. “This is a new, direct linkage” between plaques and tangles, says researcher Vincent Cryns. Both symptoms have long been known but it has been difficult to find any biological relationship between the two, or to demonstrate conclusively whether either directly contributes to the devastating memory loss seen in Alzheimer’s. The current research is being published in Proceedings of the National Academy of Sciences.

Finally, USA Today ran an interesting story about continuing work on a promising Alzheimer’s vaccine. In January 2002, a Dublin-based drug company Elan Corp. pulled the plug on a study of an experimental Alzheimer’s vaccine called AN-1792 because the drug triggered life-threatening brain swelling in 15 out of 360 elderly volunteers. Now, more than a year later, researchers say follow-up examinations of the test subjects show the vaccine may work for others by melting away the abnormal brain deposits thought to cause Alzheimer’s disease. Of 28 people who had gotten the vaccine before Elan halted the trial, 19 had responded to the vaccine by making antibodies that targeted the Alzheimer’s plaque. Twelve out of the 19 people had memory and cognitive test scores that either stayed the same or improved during the year-long study. Most impresively, two of the recruits had test scores that shot into the near-normal range. “This is an extremely exciting result,” researcher Roger Nitsch says.

Even more exciting results were observed during the autopsy of one of the test subjects whose adverse reaction had halted the test. The autopsy found evidence of inflammation in the 72-year-old woman’s brain, a problem that probably had hastened her death. But it also found that the vaccine had all but eliminated the gummy deposits of Alzheimer’s plaque. No other treatment has ever cleared a human brain of plaque. If the brain swelling side-effect of the current vaccine can be controlled, a powerful new tool in the arsenal against Alzheimer’s may result. Further research to examine the entire test group of 360 people is underway.