Alzheimer’s disease is a progressive neurological disorder that slowly chips away at our cognitive functions.
As Alzheimer’s disease progresses, patients often find that they have difficulties in completing simple tasks as the nerve cells are irrevocably damaged.
As such, patients with Alzheimer’s disease suffer through stages of behavioral changes that are caused by memory loss, confusion, and deterioration of fine motor skills.
Alzheimer’s Data and Research
In America, Alzheimer’s disease affects more than 5 million people over the age of 65 and the statistics are predicted to increase to 13.8 million people affected by 2050.
To date, there are no known treatments for Alzheimer’s or other forms of dementia.
However, the Alzheimer’s Association expressed that a significant amount of research funds is directed towards Alzheimer’s research and will likely reach $1 trillion by 2050.
Until then, patients affected by Alzheimer’s disease receive treatment through a variety of different drugs and therapies.
As a progressively deteriorating disease, the top priority in the treatment of Alzheimer’s disease is to beat the race of time.
Moreover, through each stage of the disease, one symptom inevitably contributes to the symptoms that occur in the next stage.
Therefore, drug intervention continuously needs to be changed to adapt.
Sometimes, drug interventions do not succeed as neurological damage to the nerve cell typically go unnoticed and by the time pharmaceutical treatments are introduced to the patient, the nerve cells are already irrevocably damaged.
For instance, brain changes may occur as early as 15 years back before neurological impairments begin to happen.
Autopsies that have been performed on Alzheimer’s patients show that the disorder eats away at the cerebral cortex on the region of the brain that is responsible for our memory and planning skills.
The cerebral cortex is not the only part of the brain affected by Alzheimer’s disease.
The hippocampus region of the brain is also damaged as abnormal clusters of amyloid plaques, which is a poisonous toxin, fill the spaces in the hippocampus that ultimately destroys the patient’s ability to remember new memories.
The chemical toxin that builds up in the brain also leads to a damaging protein called tau to develop inside the brain cells, which speeds up the progression of brain deterioration.
For years, new Alzheimer drugs continue to be tested to provide aid for early intervention.
Changes in the brain that may be linked to the continuum of Alzheimer’s disease begin to show as early as 25 years before outward signs of cognitive impairment.
Therefore, researchers believe that early intervention can help slow down the progress of Alzheimer’s in its later stages.
However, despite the severity of the disease and the millions of dollars invested into Alzheimer’s disease treatment, the National Institution of Health, which funds the clinical trials of experimental drugs, emphasizes that a new Food and Drug Administration treatment has not been successfully developed in over 12 years.
The most currently developed and accepted treatment for the protein accumulation of tau and amyloid toxins is to prescribe monotherapy with memantine or acetylcholinesterase inhibitors (AChEIs).
Monotherapy refers to the use of a single drug or therapy treatment alone to treat a specific disease.
Patients with complex diseases, such as Alzheimer’s, where the study of the pathogen is incomplete, benefits from monotherapy as an effective form of pathogen management.
Since signs of Alzheimer’s disease typically becomes outwardly noticeable among older patients, monotherapy serves as a less intensive and less toxic treatment than polytherapy treatments as the use of drugs and radiation is confined to one set of treatments.
For instance, memantine is an approved monotherapy treatment for Alzheimer’s disease that is effective in preventing excess glutamate from damaging the brain.
Glutamate is an amino acid neurotransmitter that takes up the spaces in between the hippocampus.
In combination with the amyloid toxins, when the brain is exposed to a high level of glutamate, the neurotransmitters cause significant deaths of the cell.
Therefore, memantine serves to reduce cell damage by decreasing the irregularities of an overactive glutamate receptor.
This monotherapy is effective in slowing down the deterioration of brain cell damage, which helps slow down the symptoms of brain damage.
Thus, memantine effectively helps patients with s-to-severe Alzheimer’s disease maintain normal daily activity while stabilizing mood and behavioral problems.
However, memantine monotherapy has limitations including the efficacy of the drug on a relatively small cohort. While memantine is well accepted as a monotherapy, its scope of benefit is marginalized.
The problem with monotherapy is that monoclonal antibodies are not necessarily effective on everyone since the range of neurological damage found in each Alzheimer’s patient is different.
Combination Therapy Treatment for Alzheimer’s Disease
Therefore, recent studies suggest that a customized, polytherapy treatment may be more appropriate in providing early intervention for early signs of Alzheimer’s disease.
The purpose of using a combined therapy treatment is to customize personally tailored treatment for patients depending on the point of their disease continuum.
The combination therapy includes a mix of anti-amyloid drugs and memantine treatments that are delivered through pharmaceutical drugs or intravenous infusion.
While combination therapy is more intensive than monotherapy, researchers believe that patients dealing with Alzheimer’s disease are willing to take the risk to see improvement, rather than allow the disease to progress further.
Currently, trials are conducted to test the success rate of combination therapy.
The purpose of combination therapy is to provide flexibility in targeting changes in the brain through the progressive stages of the disease.
Essentially, the drug tests seek to provide benefits from add-on therapies to the standard monotherapy treatment, such as memantine.
As far as early 2018, phase III of the add-on trials for combination therapy specifically targets the brain functions that are affected by Alzheimer’s disease.
In particular, monoclonal antibodies that decrease amyloid secretion showed positive results for mild Alzheimer’s disease patients.
In a phase III combination trial, plasma exchange was used in combination with intravenous immunoglobulin to block amyloids from entering the barrier to the brain.
The effects of the trial showed promising results for future use of amyloid-clearance therapy as add-on therapy in combination with memantine and other monotherapy options.
Moreover, combination therapy is also proving to be highly beneficial for moderate-to-severe forms of Alzheimer’s disease.
The evidence shows that patients who tested with a combination dosage of donepezil and memantine showed significant improvement on the Alzheimer’s Disease Assessment Scale-Cognitive subscale.
In patients with later stages of Alzheimer’s disease, the combination of memantine and donepezil helps to improve cognitive functions, behavioral issues, and the patient’s overall physical health.
While combination therapy is still in its clinical trial period, the results have shown auspicious results are proving to be more successful than the traditional monotherapy treatment.
The add-on treatments are focused on tailoring medical treatment to the patient’s needs, based on the progression of their disease.
Therefore, the objective of add-on therapies is to provide more support in decreasing the effects of Alzheimer’s disease and preventing the disease from progressing further in each stage.
