Alzheimer's disease is the most common cause of dementia among older adults and involves the loss of neurons and brain tissue. There is no cure currently, only treatments to temporarily slow symptoms. The disease burden will double by 2050 due to the aging population, potentially costing over $1 trillion annually. Research is focused on developing disease-modifying drugs, improving early diagnosis methods, and investigating prevention strategies to delay disease progression and long-term care costs.

1. 
Alzheimer’s Proposal
BACKGROUND
Presented by Stefan Marcus

2. Alzheimer’s Disease
Dementia – Impairment in cognitive function which is significant enough to interfere with
daily activities
 Most common dementia
 Loss of neuron function and
degeneration of the brain
 Deficiencies in neurotransmitters
 Exact causes unknown
 Changes in the brain: beta-amyloid
build up and tau tangles
 Known cause: Genetic mutation (<1%
cases)

3. Progression and Diagnosis
Progression Diagnosis - primary caregiver
 New guidelines as of 2011
 Variety of symptoms such as
memory loss, personality  New stages
changes, and physical  Biomarkers (protein levels in
impairments blood, for example)
1984
1. Beta-amyloid in the
brain
2. Extent of neuron
damage
2011
 Timely diagnosis is crucial
 Preventative approach (active
care)

4. Treatment
Pharmacological
NMDA Ligand – Binds to glutamate
receptors to prevent overstimulation
Acetylcholinesterase Inhibitors – Maintain
acetylcholine levels by preventing enzyme
hydrolysis
FDA APPROVED  No cure, only palliative
treatments currently available
Total Sales: 7 billion USD (2009)

5. Future Developments
 Potential: Disease modifying drugs (Anti-beta-amyloid antibodies)
 Acetylcholine esterase inhibitors and memantine facing patent loss and
generic competition
Indication Preclinical Phase I Phase II Phase III Pending
approval
Alzheimer’s 92 59 57 3 11
Global Alzheimer’s Development Pipeline (2009)
 Validating and quantifying biomarkers (gold standard)
 Prodromal standardization and asymptomatic characterization
 Studies on the effect of diet, exercise, previous ailments

6. Alzheimer’s in the US (2012 and beyond)
Prevalence Incidence
 Increases with age
 5.4 million affected in (2012)
 BUT under diagnosed  Number of cases projected to
double by 2050
 2/3 are women
Economic Burden
Aggregate Cost of Care by Payers for Alzheimer’s
Patients over 65
 Forecast: $1.1 trillion in 2050
Percentage of People With  Delaying long-term care could save
Alzheimer's by Age Group
millions of dollars

7. Summary
 Debilitating disease with no cure
 Major cause of death for elderly Americans
 Socioeconomic drain
 What is needed?
 Understanding pathology of disease to develop new
classes of drugs
 Clinically integrated early diagnosis methods
 Evidence on prevention measures

8. References
Alzheimer’s Association, 2012. 2012 Alzheimer’s Disease Facts and Figures.
Business Insights, 2011. Advances in Alzheimer’s Disease Drug Discovery. , (May).
Business Insights, 2010. The Market Outlook for Neurodegenerative Diseases. , (September).
Forsyth, E. & Ritzline, P.D., 1998. An overview of the etiology, diagnosis, and treatment of Alzheimer disease.
Physical therapy, 78(12), pp.1325–31. Available at: http://www.ncbi.nlm.nih.gov/pubmed/9859951.
Hampel, H. et al., 2011. The future of Alzheimer’s disease: the next 10 years. Progress in neurobiology, 95(4),
pp.718–28. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22137045 [Accessed July 18, 2012].
Herrmann, N. et al., 2011. Current and Emerging Drug Treatment Options for Alzheimer’s Disease: A Systematic
Review. Drugs. Available at:
http://www.ingentaconnect.com/content/adis/dgs/2011/00000071/00000015/art00006 [Accessed
September 23, 2012].