Dementia Prevention and Treatment

JAMA Internal Medicine, Journal Year: 2024, Volume and Issue: 184(5), P. 563 - 563

Published: March 4, 2024

Importance Dementia affects 10% of those 65 years or older and 35% 90 older, often with profound cognitive, behavioral, functional consequences. As the baby boomers subsequent generations age, effective preventive treatment strategies will assume increasing importance. Observations Preventive measures are aimed at modifiable risk factors, many which have been identified. To date, no randomized clinical trial data conclusively confirm that interventions any kind can prevent dementia. Nevertheless, addressing factors may other health benefits should be considered. Alzheimer disease treated cholinesterase inhibitors, memantine, antiamyloid immunomodulators, last modestly slowing cognitive decline in people mild impairment dementia due to disease. Cholinesterase inhibitors memantine benefit persons types dementia, including Lewy bodies, Parkinson vascular traumatic brain injury. Behavioral psychological symptoms best nonpharmacologic management, identifying mitigating underlying causes individually tailored behavioral approaches. Psychotropic medications minimal evidence efficacy for treating these associated increased mortality clinically meaningful risks falls decline. Several emerging prevention hold promise improve care future. Conclusions Relevance Although current approaches less than optimally successful, substantial investments research undoubtedly provide new answers reducing burden worldwide.

Language: Английский

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Use of lecanemab and donanemab in the Canadian healthcare system: Evidence, challenges, and areas for future research

The Journal of Prevention of Alzheimer s Disease, Journal Year: 2025, Volume and Issue: unknown, P. 100068 - 100068

Published: Jan. 1, 2025

Language: Английский

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Age, sex and Alzheimer’s disease: a longitudinal study of 3xTg-AD mice reveals sex-specific disease trajectories and inflammatory responses mirrored in postmortem brains from Alzheimer’s patients

Alzheimer s Research & Therapy, Journal Year: 2024, Volume and Issue: 16(1)

Published: June 22, 2024

Abstract Background Aging and sex are major risk factors for developing late-onset Alzheimer’s disease. Compared to men, women experience worse neuropathological burden cognitive decline despite living longer with the Similarly, male 3xTg-AD mice, developed model disease, no consistently exhibit standard neuropathology yet higher rates of mortality - providing a unique opportunity further elucidate this dichotomy. We hypothesized that differences in biological aging process yield distinct pathological molecular disease signatures males females, which could be harnessed therapeutic biomarker development. Methods aged female, B6129 control mice across their respective lifespans ( n = 3–8 per sex, strain, age group) longitudinally assessed hallmarks markers hepatic inflammation, splenic mass morphology, as well plasma cytokine levels. conducted RNA sequencing analysis on bulk brain tissue examined differentially expressed genes (DEGs) between samples ages each sex. also DEGs clinical parahippocampal gyrus from Mount Sinai Brain Bank study Results females significantly outlived exhibited progressive neuropathology, while demonstrated splenomegaly, circulating inflammatory proteins, minimal hallmarks. Instead, experienced an accelerated upregulation immune-related gene expression relative females. Our investigations revealed individuals develop similar sex-specific alterations neuronal immune function. In diseased both species, we observed greater complement-related expression, lipopolysaccharide was predicted top upstream regulator DEGs. Conclusions data demonstrate chronic inflammation complement activation associated increased mortality, indicating age-related changes response contribute trajectories. provide evidence transgene-driven progression trigger widespread males, mimics impact stimulation absence infection.

Language: Английский

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Public perceptions related to healthcare preparedness to anti-amyloid therapies for Alzheimer’s Disease in Japan

Alzheimer s Research & Therapy, Journal Year: 2024, Volume and Issue: 16(1)

Published: Oct. 3, 2024

Language: Английский

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Lecanemab: A Second in Class Therapy for the Management of Early Alzheimer’s Disease

INNOVATIONS in pharmacy, Journal Year: 2024, Volume and Issue: 15(1)

Published: March 18, 2024

The Food and Drug Administration granted traditional approval of lecanemab for the treatment Alzheimer’s disease (AD). Lecanemab is a humanized anti-amyloid monoclonal antibody directed towards Aβ protofibrils. only drug that targets soluble protofils has shown statistical differences in mild AD or cognitive impairment. In its landmark phase III trial, was to slow progression clinical decline, reduction amyloid protein accumulation. difference mean CDR-SOB score improvement between placebo groups -0.45, which significance could be argued. Amyloid burden also considerably reduced as well, but true consequence this remains seen. This beneficial impact on daily living offset by rare serious side effects including amyloid-related imaging abnormalities (ARIA) causing cerebral edema (ARIA-E) microhemorrhages hemosiderin deposits (ARIA-H). Benefits therapy must considered against risk edema. Affordability taken into consideration. current estimated yearly cost twice monthly infusion $26,500. addition significant challenges, frequent infusions may pose concerns related access. Additional agents within class are pipelines with possibly increased efficacy decreased adverse events.

Language: Английский

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The efficacy and safety of lecanemab 10 mg/kg biweekly compared to a placebo in patients with Alzheimer’s disease: a systematic review and meta-analysis of randomized controlled trials

Neurological Sciences, Journal Year: 2024, Volume and Issue: 45(8), P. 3583 - 3597

Published: April 3, 2024

Language: Английский

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Progression analysis versus traditional methods to quantify slowing of disease progression in Alzheimer’s disease

Alzheimer s Research & Therapy, Journal Year: 2024, Volume and Issue: 16(1)

Published: Feb. 29, 2024

Abstract Background The clinical meaningfulness of the effects recently approved disease-modifying treatments (DMT) in Alzheimer’s disease is under debate. Available evidence limited to short-term on rating scales which may be difficult interpret and have intrinsic meaning patients. main value DMTs accrues over long term as they are expected cause a delay or slowing progression. While awaiting such evidence, translation time delays progression could offer powerful readily interpretable representation outcomes. Methods We simulated trajectories representing two arms, active placebo, hypothetical trial DMT. placebo arm was based estimated mean dementia scale–sum boxes (CDR-SB) recordings from amyloid-positive subjects with mild cognitive impairment (MCI) Disease Neuroimaging Initiative (ADNI). show an average versus 20% at each visit. treatment trials were model for repeated measures (PMRM) mixed (MMRM) comparison. For PMRM, effect expressed units (e.g., days) MMRM outcome CDR-SB points). PMRM results implemented health economics Markov extrapolating death 15 years. Results 19% 18 months (~ 7 delay) 36 months, while 25% reduction 0.5 points) months. had slightly greater power compared MMRM. economic suggested increase life expectancy (10 months) without extending severe stages disease. Conclusion methods can used estimate terms translates metrics that interpreted appreciated meaningful outcomes patients, care partners, practitioners.

Language: Английский

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Another Use for a Proven Drug: Experimental Evidence for the Potential of Artemisinin and Its Derivatives to Treat Alzheimer’s Disease

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(8), P. 4165 - 4165

Published: April 9, 2024

Plant-derived multitarget compounds may represent a promising therapeutic strategy for multifactorial diseases, such as Alzheimer’s disease (AD). Artemisinin and its derivatives were indicated to beneficially modulate various aspects of AD pathology in different animal models through the regulation wide range cellular processes, energy homeostasis, apoptosis, proliferation inflammatory pathways. In this review, we aimed provide an up-to-date overview experimental evidence documenting neuroprotective activities artemi-sinins underscore potential these already-approved drugs treating also humans propose their consideration carefully designed clinical trials. particular, benefits main pathological hallmarks events cascade throughout development are summarized. Moreover, dose- context-dependent effects artemisinins noted.

Language: Английский

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Exploring the efficacy and safety of lecanemab in the management of early Alzheimer’s disease: A systematic review of clinical evidence

Journal of Alzheimer s Disease, Journal Year: 2025, Volume and Issue: unknown

Published: April 15, 2025

Background Alzheimer's disease (AD) is a growing neurodegenerative disorder causing cognitive decline, memory loss, and functional impairment. Lecanemab has shown safety efficacy in clinical trials. Objective This review aims to understand the evidence of lecanemab's effectiveness managing early AD. Methods A systematic search was conducted using Scopus database ClinicalTrials.gov. Studies from 2014 2024 on safety, efficacy, outcomes for AD were included. Data extraction involved two independent reviewers, with synthesis qualitative methodology. Results Findings 13 studies ongoing trials reported, showing that lecanemab substantially reduces amyloid plaque load brains patients. The therapeutic regimens vary across reported trials, ranging 2.5 mg/kg biweekly, 5 monthly, 10 intravenously biweekly. Clarity phase 3 trial, AHEAD study, DIAN-TU-001 have positive study robust minimal side effects. Completed report onset amyloid-related imaging abnormalities (ARIA) continuation care status following ARIA these common infusion-related reactions observed 26.4% group compared 7% placebo group. Conclusions management evolved over years introduction novel agents like lecanemab. While its profile generally favorable, careful monitoring essential.

Language: Английский

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Use of dietary supplements by individuals with dementia - the caregivers’ perspective

Scandinavian Journal of Primary Health Care, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 12

Published: April 25, 2025

Due to their cognitive challenges, individuals with dementia, often rely on caregivers for support activities of daily living. Many them use dietary supplements (DS) but are at risk overdosing DS due forgetfulness. Moreover, may cause adverse events or interactions prescription drugs (PD). This study aimed explore the role in managing and identify potential risks associated its administration. A cross-sectional survey among dementia recruited from organisations North-Norway. Out 163 invited participate, 104 (64%) participated. Of those, 59 reported that individual under care used DS. Twenty-seven had assisted Eleven expressed concerns around use, 17 previously made mistakes Several did not know whether nor difficulties taking correctly. Additionally, only 45 were aware could potentially be harmful. Regarding securing safe this patient group, respondents ranked general practitioners most responsible. Nearly 50% those who sought advice health professionals regarding satisfied response. small sample size heterogeneous group must taken into account when interpreting results. Caregivers involved dementia's a willingness assume responsibility ensuring safer use. However, several unaware safety related Furthermore, communication failed met needs these patients caregiver. Collectively, conditions impose dementia.

Language: Английский

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