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Treatments and Research - Research
The National Institute on Aging (NIA) is part of the National Institutes of Health, and it is the lead federal agency for research on Alzheimer's disease. NIA coordinates the National Institutes of Health's Alzheimer's Disease Prevention Initiative.

The Alzheimer's Disease Prevention Initiative is designed to

• * understand why Alzheimer's disease occurs and who is at greatest risk for developing it.
• * improve the accuracy of diagnosis and the ability to identify those at risk.
• * discover, develop, and test new treatments and ways to prevent Alzheimer's.
• * discover treatments for behavioral problems in patients with Alzheimer's disease.

People with Alzheimer's disease and those with mild cognitive impairment, or even healthy people who want to help scientists test new treatments may be able to take part in Clinical trials. Clinical trials are studies done with people to find out if a new drug or treatment is both safe and effective.

New therapies are tested on people only after laboratory and animal studies show that the therapy is safe and has promising results. The Food and Drug Administration sets strict rules to make sure that people who agree to be in the studies are treated as safely as possible.

People who take part in clinical trials say that the biggest benefit is having regular contact with experts who have lots of practical experience and a broad understanding about the disease. They also feel they are making a valuable contribution to knowledge that will help people who develop Alzheimer's in the future.

Scientists funded by NIA are testing a number of drugs in clinical trials to see if they prevent Alzheimer's disease, slow the disease, or help reduce behavioral symptoms. Many drugs and therapies are tested in clinical trials. Some ideas that seem promising turn out to have little or no benefit when they are carefully studied in a clinical trial.

There is evidence that Inflammation in the brain may contribute to the damage caused by Alzheimer's disease. Some studies have suggested that drugs such as nonsteroidal anti-inflammatory drugs, or NSAIDs, might help slow the progression of Alzheimer's. So far, however, clinical trials have not shown a benefit from these drugs.

A clinical trial studying two of these drugs, Vioxx and Aleve, showed that they did not delay the progression of Alzheimer's in people who already had the disease. In another trial, testing whether the NSAIDs Celebrex and Aleve could prevent Alzheimer's in healthy older people at risk for the disease, the drugs were stopped, although subjects continue to be followed for safety. New reports showed that Celebrex was linked to an increased risk for heart disease and a preliminary review of the data on Aleve from the trial suggested a possible increased risk for heart disease and Stroke.

Researchers are continuing to look for ways to test how other anti-inflammatory drugs might affect the development or progression of Alzheimers.

Recent research has suggested a link between Alzheimer's disease and factors that increase the risk for heart disease. Medicines already used to help reduce the risk of heart disease may help lower the chances of developing Alzheimer's disease or may slow its progression. Clinical trials of drugs known as statins, commonly used to lower Cholesterol, have begun to see if they might help slow down the progression of Alzheimer's disease.

Studies have shown that people with Alzheimer's often have higher levels of an amino acid called homocysteine in their blood. High levels of homocysteine are known to increase the risk of heart disease. Folic acid and vitamins B6 and B12 can reduce levels of homocysteine in the blood, and scientists are conducting clinical trials to see whether these substances can also slow rates of mental decline.

Recently, scientists have focused on a type of memory change called mild cognitive impairment, or MCI. MCI is different from both Alzheimer's disease and age-related memory change. People with MCI have ongoing memory problems but do not have noticeable problems in other areas like confusion, attention problems, and difficulty with language.

Scientists funded by the National Institute on Aging recently completed a clinical trial -- the Memory Impairment Study -- to learn whether treatment of MCI might prevent or slow further memory loss, including the development of Alzheimer's.

This 3-year trial compared the drug donepezil or vitamin E to a Placebo in people with MCI to see if the drug or vitamin might delay or prevent the development of Alzheimer's. The study found that taking vitamin E did not prevent or delay Alzheimer's in a person with MCI. It is possible that vitamin E may not help after memory loss has already started. However, donepezil, also known as Aricept®, did seem to delay the onset of Alzheimer's, but only during the first year of treatment, providing no clear guidance to doctors about prescribing donepezil for people with MCI.