Possible Future Solutions for Slowing, Stopping, or Eradicating Alzheimer’s Disease

Alzheimer’s disease is, understandably, one of the most feared diseases of old age. It robs people of their memories, places a tremendous strain on caregivers, and imposes a huge economic burden on both individuals and society. Tens of millions of people have already been diagnosed with Alzheimer’s, and if predictions are correct, that number will more than double by 2050.

Until recently, it seemed there was no hope of averting this catastrophe, but rapid advances in medical science have made it realistic prospects that Alzheimer’s may be treatable and eventually eradicated (see “A new kind of vaccine could lead to Alzheimer’s eradication”).

The first of a new class of drugs is already creating buzz, but not necessarily for the right reasons. Last week, the UK’s Medicines and Healthcare products Regulatory Agency approved the drug, called lecanemab. But NICE, the body that advises on whether new treatments are cost-effective, has made a provisional decision that taxpayers will not fund the drug in England. No decision has yet been made in the rest of the UK.

This is obviously a tough pill to swallow for Alzheimer’s patients and their families. But in the grand scheme of things, this is good news. Lecanemab is not a particularly effective drug. Its effects are modest, it has serious side effects, and it is expensive. But it does show that the causes of Alzheimer’s are now understood and treatable. This is further reinforced by the fact that the drug is also approved in the United States and Japan, but the European Medicines Agency has refused to approve it.

So the way is almost paved for the next wave of drugs to target the causes of Alzheimer’s, which could be ready around 2030. These are vaccines, not in the traditional sense of conferring immunity against an infection, but they work in essentially the same way, by stimulating an immune response against the misfolded proteins that cause the symptoms of Alzheimer’s. The first vaccines will be therapeutic, slowing or stopping the progression of Alzheimer’s, but the next generation will be preventative, preventing the onset of Alzheimer’s. Eventually, the only memory that will fade will be Alzheimer’s itself.