Emerging Drug Therapies for Dementia

Edward Zamrini, MD

Disclosures

Geriatrics and Aging. 2006;9(2):107,110-113. 

In This Article

Abstract and Introduction

Emerging drug therapies for dementia are increasingly chosen to tackle molecular targets important in Alzheimer's disease (AD) pathobiology. Amyloid oligomers, amyloid deposits, and neurofibrillary tangles (NFTs) are characteristic findings in AD. Hence, drugs that interfere with these proteinaceous aggregates are receiving the most attention: a) alpha, beta, and gamma secretase modulators, b) inhibitors of amyloid beta (Aβ) aggregation, and c) anti-Ab immunologic strategies. Oxidative stress and inflammatory reactions appear part of a loop of neurotoxicity with the proteinacous aggregates. Antioxidants and anti-inflammatory compounds have thus received much attention. Finally, other compounds may work by a variety of other mechanisms.

Alzheimer's disease (AD) is the most common cause of dementia in the older adult. Hence, it has received the greatest attention in drug development. Fortunately, some of the advances in AD therapy may translate into benefits for other dementias as well. Therapies for AD currently approved by the Food and Drug Administration in the United States are symptomatic--that is, they help allay some of the symptoms of AD such as memory loss, other cognitive and behavioural changes, and impairment in activities of daily living. They have not been shown to alter the course of the illness. Numerous compounds with potential disease modifying effects are being investigated. Many of these compounds interfere with disease pathogenesis or progression. Some may have a neuroprotective effect that may delay onset of symptoms.

Current studies involve extension of uses of currently approved compounds, natural compounds, compounds approved for other medical conditions that may produce a benefit in AD, and novel compounds (Figure 1). To best understand emerging therapies for AD, it is easiest to subdivide them according to principal presumed target in AD: 1) amyloid beta (Aβ), 2) oxidative stress, 3) inflammation, and 4) other. Many have multiple modes of action.

Emerging Drug Therapies for Dementia

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