Earlier Alzheimer's treatments could be aided by new clinical trial

A new clinical trial could help spot early signs of Alzheimer's disease in older patients even before they begin to exhibit signs of cognitive decline, it has been suggested, which could lead to treatments that can more effectively slow the progress of the disease.

The Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) study, which is being run with funding from the US' National Institute on Aging (NIA), appears to have found that high levels of the amyloid protein in the brain can be an early indicator of Alzheimer's disease in clinically normal adults, even if they are showing no symptoms of dementia.

Understanding the impact of amyloid

The idea of a connection between amyloid proteins and Alzheimer's has been suggested for many years, with the theory being that build up of toxic amyloid proteins in the brain, known as plaques, is a primary degenerative driver behind the disease.

However, New Atlas notes that previous clinical trials in this area that have aimed to slow the onset of Alzheimer's through anti-amyloid treatments have often come to nought, which has led to some researchers looking elsewhere for answers to slow the progress of Alzheimer's. But the A4 study suggests such solutions could still prove effective if they are administered early enough.

NIA director Richard J Hodes, MD, suggested that one reason previous trials have not been successful is because they were intervening too late in the process to be effective.

He added: "A4 is pioneering in the field because it targets amyloid accumulation in older adults at risk for developing dementia before the onset of symptoms."

The study is the first of its kind as it uses a relatively new tool called amyloid positron emission tomography (PET) imaging to identify buildups of amyloid proteins in people with no symptoms of cognitive decline.

Opening the door for new trials

The data gathered by the A4 study could be highly useful in identifying prospective Alzhiemer's patients who have not yet shown signs of the disease for future clinical trials into anti-amyloid treatments.

So far, such efforts have focused on patients who already exhibit mild or severe symptoms of Alzheimer's, by which time it may be too late for medication to have an impact, due to the degenerative nature of the disease.

Being able to identify and enrol patients who are at high risk of developing the disease before they start to show cognitive decline could therefore be critical in determining if early intervention with anti-amyloid treatments can prove effective.

However, Laurie Ryan, PhD, chief of the Dementias of Aging branch at NIA's Division of Neuroscience, cautioned that ultimately, precision medical approaches that tailor treatments to each individual patient will still be essential in the fight against the neurodegenerative condition.

"Alzheimer's disease is never going to have a one-size-fits-all treatment," she said. "We're likely to need different treatments, even combinations of therapies, for different individuals based on their risk factors."