Amber Walker

Professor Malcom Campbell

English 1103
April 5th, 2016
Drugs to Treat Alzheimers. Helping or Hurting?
My body erupted with cold chills as I walked down the hallway of Hickory Village
Memory Care on a warm day in July of 2011. Surrounded by many elderly people walking idly
down the hallway or in wheel chairs taking medicine. I was walking directly behind my mother;
we soon entered room 114. My great grandmother, Mary, sat on the end of her bed with a
confused but excited smile on her face. We both proceeded to hug her and as I pulled away she
asked Now whose daughter are you? as she would continue to do multiple times throughout
her visit. Although she was unsure of all of her surroundings, she seemed happy. As she recalled
old memories such as playing softball as a kid and an old boyfriend, she seemed to have joy in
her voice. The visit ended with a couple laughs, smiles, and hugs.
Fast forward almost five years later, I enter the same building with my mother. The visits
had continued but became less frequent. This time as we entered Marys room a different vibe
was received. She , she looked at us with confusion but a less joyful face. As we tried to
converse with her she wanted barely anything to do with us and responded to almost nothing.
Her doctor explained to us she had been irritable and had no desire to see or talk to even her
friends at Hickory Village. This visit was short and left us with a troubled feeling. I was told of
her disease long before but seeing the toll Alzheimers took on her mind and how it changed her
made me extremely curious.

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This made me want to know more. I wanted understand why it happens, how it happens, and ,
who it happens to.
Alzheimers is the most common form of dementia. Other forms of dementia include:
Huntingtons and Parkinsons disease, mixed dementia, vascular dementia, frontotemporal
dementia, and more. The Alzheimers This disease is believed to be caused by changes in the
brain, usually beginning in late middle age, characterized by memory lapses, confusion,
emotional instability, and progressive loss of mental ability.
To understand the effects of Alzheimers you must understand first the functions in a
healthy brain. Understanding a brain without Alzheimers will allow you to more easily identify
and understand why things are happening in an infected brain being damaged by the disease. In a
healthy brain the cortex helps interpret sensations from your body, sights, and sounds for the
outside world. The functions of the cortex include generating thoughts, solving problems,
forming and storing memories, and controlling voluntary movement. This can be important to
understand because the Alzheimers disease affects memories and problem solving. The
individual cells are where most activity and work is happening. With 100 billion nerve cells and
branches connecting to 100 trillion points, the cells play a major role in proving signals that form
the basis of memory, thoughts, and feelings. In a brain affected by Alzheimers the nerve cells
decrease and plaques build on these cells. Dead and dying nerve cells contain tangles. Tangles
consist of twisted strands of other proteins. Plaques and tangles are key suspects to the cause of
cell death which contributes to the spread of the Alzheimers disease in the brain.

Overall Alzheimers and other forms of dementia affect 44 million world-wide. The
mMajority, one out of three, is seen in those 85 and older, although one in nine have it at the age
of 65 or greater. Only one fourth have been diagnosed but 5.3 million just in the U.S. alone are
expected to be affected with it. This number is expected to exponentially increase by 2050 due to
the baby boom and the increase in the elderly population. By this time if there is no cure or
strong advances in drugs to slow down the process, over 16 million could be affected. This is
equivalent to fifty-one percent of those 65 and older. As the number of patients increase, the cost
of treatments, research, and products also increases. As of 2015, $226 million has been spent in
the United States. $605 million has been spent world-wide, equaling out to as much money as
one percent of the entire worlds gross domestic product (Alzheimers Statistics).
With this growing cost questions are being raised:; Where is the money going to? Is
there any progress in the research? How are the drugs contributing to the process of the disease?
Are the drugs effective if the numbers are still increasing at the fast rate they are nowso greatly?
The majority of questions being raised standing out for too many people, including myself, are
focused to involve the drugs and treatments and the accuracy of them. If we find a cure or an
advancement toward them then the numbers of those infected can begin to decrease. With the
decrease in those numbers eventually we can start to use the money spent on research, facilities,
and medicine in other useful places. and money The Alzheimers Association has invested over
$350 million in more than 2,300 scientific investigations over the years (Our
Commitment).involved in research and care can decrease as well. The question of the
efficiency and accuracy of the drug is important to all those suffer fromwith Alzheimers,
including family and friends, those who may suffer, and those who are contributing their time
and money to researching itthe disease.

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The Alzheimers Association has been involved in every major advancement towards
Alzheimers since the 1980s. y were established on April 10th, 1980. The association works on a
global, national and local level to enhance care and support for all those affected by Alzheimers

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and other dementias. They host support groups and education sessions, and provide a 24/7
helpline. They have contributed by developing drugs that slow down the spread of the disease
and improve quality of life for those affected (About Us).. These FDA approved drugs include
two different types; Cholinesterase inhibitors and Memantine. Cholinesterase inhibitors work by
slowing down the process that breaks down key neurotransmitters in the brain. , tThese include
three individual drugs; Donepezil, Galantamine, and Rivastigmine. Donepezil and Rivastigmine
can be used in all stages of Alzheimers while Galantamine is used to treat milnd to moderate
cases. Memantine works by regulating the activity of glutamate in the brain, an important
neurotransmitter in the brain which is involved in learning and memory. This drug is used to
treat moderate to severe cases of Alzheimers. In 2014 an advancement was made involving the
combination of Donepezil and Memantine but no additional drugs have been proven to be
effective since this time. These approved drugs help with symptoms and temporarily help with
memory and thinking problems but do not treat the underlying causes of the disease.
(Alzheimer's: Drugs Help Manage Symptoms, What We Know Today About Alzheimers
Disease).
Over the last thirty years, the understanding of the functions of a normal brain and the
differences in an infected brain have greatly increased. A damaged brain shrinks dramatically
due to nerve cell death and tissue loss. Inside the brain the cortex shrivels up and the ventricles
grow larger (Wegerer, Jennifer). ed. Now researchers can more easily identify and find thesefind
specific problems, causes of the problems, and ways in which the disease it is able to spread

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throughout the brain. This understanding allows drugs to be more specific and affective. The
association has helped contribute to the continuing research for drugs such as Solanezumab, MK8931, CSP-1103, Intranasal Insulin, and others (What We Know Today About Alzheimers
Disease). The Association contributes significantly to the conversation but seems to contribute
mostly to the positive side of the argument.
Recent studies have had seemed to have less positive outcomes and many dead ends.
Scott Hensley, a National Public Radio reporter, addresses the failure of the newer drugs for
patients in 2012. Eli Lily & Company recently agreed to drop the drug Solanezumab as it
received no positive response from either of two double-blind, placebo-controlled trials. (Phase
3 Solanezumab Trials). Also earlier in 2012 Janssen Alzheimer Immunotherapy discontinued
the studies of intravenous bapineuzumab for those that suffer with mild to moderate Alzheimers
disease. Since the results from the second phase of trails was not up to par with the expected
development they decided to end the trials before phase three began. Bapineuzumab failed to
have any effect on those with the ApoE4 allele, the strongest genetic risk factor for Alzheimers.
Since the results from the second phase of trails did not have any effect and couldnt compare to
thewas not up to par with the expected development they decided to end the trials before phase
three began (Intravenous Bapineuzumab). (Phase 3 Solanezumab Trial Fails). Gammagard,
also known as IViG, adds to the list of failures. The drug seemed to provide promising data to
the cause but the results ended the same as most. Phases one and two showed a benefit for
patients but the final two phase three trials showed no difference in outcome between the groups
tested. Baxter company terminated the second trials which began in 2013 (Gammagard). Adding
to this conversation, Greg Miller, a scientific journalist, addresses the latest study in
Alzheimers. The drug Dimebon, which took the world by storm in 2008. Dimebon originated in

Chernogolovka, Russia where Dr. Sergery Bachurin observed its positive effects on the
performance of memory-impaired rats. The drug traveled to the United States in hopes to have
further researcher done. At first the trials were a major success and gave hope for a breakthrough
to many researchers. Sadly, in March of 2016, Pfizer Inc. announced the heartbreaking results of
yet another failed Alzheimers drug in the late stage of the studies. After six months the results
showed no difference in the control or drug groups.
The most recent research and findings have all led to the same conclusion and sadness for
all involved with the disease. Although some research continues there has been only one
breakthrough for Alzheimers since 2003 which included combining Donepezil and Memantine,
two two of the drugs already proven to be successful. With all the failures it leads me to
question the approach we have taken. Most drugs have been similar in what they target so would
a change in perspective be effective? For example, Memantine targets the regulation of
glutamate in the brain so would taking on a different approach, such as targeting a different
function of the brain, help lead to better results?
Genetics is another factor I believe would be beneficial to study more about. According
to the Alzheimers Association there are two categories of genes that are known to play a role in
genetics; Risk genes and deterministic genes. Risk genes increase the likelihood of developing
the disease. APOE-e4, mentioned previously, is one of the main genes influencing Alzheimers.
There is no evidence of why this gene increases risks but it is known to do so. Advancement in
the study of the APOE-e4 gene would be beneficial to understanding more about heredity in the
Alzheimers disease. Deterministic genes directly cause the disease. Genes containing the three
proteins: amyloid precursor protein (APP), presenilin-1 (PS1), and presenilin-2 (PS-2) is known
as familial Alzheimers disease. Family members with variations of these three genes have

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been linked to Alzheimers in multiple generations (Genetics). Finding the direct cause and
elements of these proteins could lead us closer to finding why they directly cause Alzheimers.
Genetics, age, and family history cannot be changed but there are factors available to help
influence the chances of being affected with Alzheimers. Factors such as general lifestyle
choices and wellness choices could help prevent the disease. There has been some research to
link Alzheimers with head trauma as well as a connection between the head and heart.
Protecting your brain from head trauma could be beneficial because trauma can affect the
cognitive abilities such as learning and thinking skills. Damaging these parts of the brain may
only make it easier to Alzheimers to start to take place. Also, more evidence is starting to show
the link between your head and your heart. Damaging the heart or blood vessels could lead to a
greater risk in developing Alzheimers. The brain is dependent on the heart and every heartbeat
pumps about 20 to 25 percent of your blood to your head. High blood pressure, heart disease,
stroke, and diabetes can contribute to health risks for your heart which in return can contribute to
damages in the brain. Becoming aware of these factors could help reduce the numbers of those
affected with Alzheimers and maybe even allow you to stay Alzheimers or dementia free.
Although the Alzheimers Associationorganization gives us hope that the treatments are
moving in the right direction the most recent evidence shows this to be incorrect. It is hard to
understand the success of the first trials and research when the final phases show the complete
opposite. As a supporter, you want to believe in all the good but the evidence supports the sad
reality that what is being studied now just isnt working. Although knowledge of the brain has
strongly increased, I believe researchers should continue more to understand the brain and the
disease. If they can pin point the changes then they can start to form a drug specific to a certain
location or a certain part such as the neurotransmitters or the ventricles.

By researching this topic and the drugs I have d to understand more about the brain itself.
I found how Alzheimers works inside the brain after learning key concepts of brain function and
parts of the brain. Although the outcome of this paper provides negative answers towards a sad
cause, I now know the actual reality of the progress being made on this disease. The dissatisfying
results pushed me to become more involved and want to help in any way possible to find the cure
for this disease. Im still curious as to what other drugs are being studied and how each one
aeffects the brain. If I wasere to continue with the research, I believe it would switch to a more
scientific and understanding approach. I want to know more about the chemical make-up of the
drugs, and how they are supposed to affect the brain and how they actually affect the brain of
those with Alzheimers. Also, as Alzheimers seems to be is hereditary, finding additionaly I
would find beneficial ways in every day life to help postpone Alzheimers and strengthen my
brain would be beneficial andto allow myself to live a healthy life as long as possible.

Works Cited
"About Us." Alzheimer's Association. N.p., n.d. Web. 26 Apr. 2016.
"Alzheimer's Statistics." Alzheimers.net. N.p., n.d. Web. 5 Apr. 2016.
"Alzheimer's: Drugs Help Manage Symptoms." - Mayo Clinic. N.p., 11 July 2014. Web. 5 Apr.
2016.
"Gammagard" Gammagard. N.p., n.d. Web. 9 Apr. 2016.
"Genetics." Alzheimer's & Dementia. N.p., n.d. Web. 27 Apr. 2016.

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"Help End Alzheimer's." Alzheimer's Association. Publisher. 14 Mar. 2016.

Hensley, Scott. "Failure Of Lilly Drug Is Latest Alzheimer's Setback." NPR. NPR, 24 Aug. 2012.
Web. 14 Mar. 2016.
"Intravenous Bapineuzumab." AlzForum. N.p., 8 Aug. 2012. Web. 23 Apr. 2016.

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Miller, G. "The Puzzling Rise and Fall of a Dark-Horse Alzheimer's Drug." Science 327.5971
(2010): 1309. Jstor. Web. 14 Mar. 2016.
"Our Commitment." Alzheimer's Association. N.p., n.d. Web. 26 Apr. 2016.

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"Phase 3 Solanezumab Trials." AlzForum. N.p., 24 Aug. 2012. Web. 24 Apr. 2016.

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Wegerer, Jennifer. "What Does Alzheimer's Do to the Brain?" Alzheimers.net. N.p., 13 Mar.

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2014. Web. 26 Apr. 2016.

"Phase 3 Solanezumab Trials "Fail"" Phase 3 Solanezumab Trials "Fail"N.p., 24 Aug. 2012.
Web. 08 Apr. 2016.

"What Is Alzheimer's?" Alzheimer's Disease & Dementia | Alzheimer's Association. Alzheimer's

Assocation, n.d. Web. 10 Apr. 2016.
"What We Know Today About Alzheimer's Disease." Alzheimer's Association. N.p., n.d. Web.
11 Apr. 2016.

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