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Attacking Alzheimer's

Researchers have a bold new strategy for beating the dreaded disease: stop it before it starts

THE ANNOUNCEMENT came the day before Thanksgiving, but there was nothing in it to be thankful for: An experimental Alzheimer’s drug many thought would slow the disease’s steady cognitive decline had failed to make a signii cant dif erence in a massive trial of people with early signs of the illness.

Marty Reiswig took the news hard. “I was just sad,” he says. “I was really hopeful that it would be life-changing for us.” Reiswig doesn’t have Alzheimer’s disease—he’s a 38-year-old real estate agent in good health. But he is part of a large extended family that’s been al icted by Alzheimer’s for generations. His Uncle Roy died of the disease. So did Grandpa Ralph. Eleven great-aunts and great-uncles. Dozens of cousins. And now, Reiswig says, “I’ve got a 64-yearold father who’s almost dead of Alzheimer’s.”

His family is one of around 500 in the world with a genetic mutation that means its carriers will develop Alzheimer’s at a much younger age than those without the mutation, for whom the age of onset is typically about 80. For the Reiswigs, those with the gene become sick around their 50th birthday. Other high-risk families can start showing symptoms as early as their mid-30s or, in some cases, their late 20s.

Reiswig decided not to learn his own gene status— there’s a 50-50 chance he inherited his father’s faulty DNA, and he prefers living with the uncertainty. However, he isn’t just idly waiting to meet his fate. Three years ago, he signed up for an innovative drug study that could alter his family’s genetic destiny. Once a month, a nurse comes to his home, inserts a needle in his arm and watches as a bag full of liquid slowly drips into his bloodstream.

As with most trials designed to test whether an experimental drug works—even for diseases that are akin to death sentences—Reiswig might be getting a placebo. But there’s also a chance his monthly infusions include a drug that could stop him, his family members and others like them from losing loved ones to Alzheimer’s. Or, at the very least, delay the disease long enough to give them many more good years, genetics be damned.

The key is early intervention, before symptoms are evident and brain damage is too extensive. “That’s how you stop the disease,” says Rudy Tanzi, director of the Genetics and Aging Research Unit at Massachusetts General Hospital. “You don’t wait.”

PUSH BACK THE ONSLAUGHT

THIS AGGRESSIVE attempt to prevent Alzheimer’s rather than treating it is the most exciting new development in decades, as well as a radical departure for researchers and the pharmaceutical industry. Traditionally, drug companies have tested their therapies on patients who already have memory loss, trouble thinking and other signs of dementia. It’s been a losing tactic: More than 99 percent of all Alzheimer’s drugs have failed tests in the clinic, and the few that have made it to the market only ameliorate some symptoms. Not a single medicine has been shown to slow the relentless progression of the disease.

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THE WAR ON ALZHEIMER'S This aggressive attempt to prevent Alzheimer’s rather than treating it is the most exciting new development in decades, as well as a radical departure for researchers and the pharmaceutical industry. Traditionally, drug companies have tested their therapies on patients who already have memory loss, trouble thinking and other signs of dementia. It’s been a losing tactic: More than ninety nine percent of all Alzheimer’s drugs have failed tests in the clinic, and the few that have made it to the market only ameliorate some symptoms. No single medicine has been shown to slow the relentless progression of the disease. However this new approach, even partial success an appreciable slowing of brain degeneration could have a big impact, says Dr. Reisa Sperling, a neurologist who directs the Center for Alzheimer’s Researc.
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