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Alzheimers disease
Vascular dementia
Dementia with Lewy bodies
Time
The Alzheimers disease burden in the US
2009 Alzheimers Disease Facts and Figures report, March 24, 2009 2
Percentage changes in selected causes of death
between 2000 and 2006 in the US
2009 Alzheimers Disease Facts and Figures report, March 24, 2009 3
According to a recent European meta-
analysis, the annual costs for caregiving and
nursing demented patients in Austria are
around 1.1 billion Euro (Jnssn and Berr,
2005), 85% of which are paid by the patients
families; 75% are non-medical costs, while
only 6% are medical treatment costs.
History of Alzheimer s disease
6
Inflammatory
response
Mutations in
APOE4
APP/PS-1
Age
Nistic et al, Mol Neurobiol 2012
Available treatments
At present, no treatment
can prevent or cure
Alzheimer s disease
Available treatments
The fact that Alzheimer s disease affects a
geriatric population complicates its
treatment. Older patients metabolize drugs
more slowly and are more vulnerable to
adverse effects; they are also likely to be
taking multiple medications, heightening the
risk of drug-drug interactions.
Available treatments
Figure 1. Approaches to treatment during different stages of
Alzheimer s Disease
4 3
Muscarinic receptor
Nicotinic receptor
1 Choline ACh
ACh metabolites
Lecithin Acetyl
CoA AChE
AChEIs 2
Current treatments for Alzheimer s Disease:
Cholinesterase Inhibitors
? Might be disease-modifying
Time
Disease-modifying drugs
(anti-A compounds?)
Symptomatic drugs
(cholinesterase inhibitors,
memantine)
No treatment
Design to prove disease-modification
in Alzheimers disease
+ anti-Ab drug ?
Performance
stable dose of
donepezil
and/or
memantine
+ placebo
Amyloidogenic Non-amyloidogenic
cleavage cleavage
cleavage
Disease Protection
Fibrillogenesis
Enhancing -secretase
Secretase
Amyloidogenic Non-amyloidogenic
cleavage cleavage
cleavage
Disease Protection
Fibrillogenesis
Attacking amyloid
Secretase
Amyloidogenic Non-amyloidogenic
cleavage cleavage
cleavage
Disease Protection
Fibrillogenesis
Targeting tau
GSK-3
Mutations
Microtubules
Function Dementia
Drug development in Alzheimer's disease