Research against Alzheimer’s disease, which is the day of the world this Sunday, September 21, continues to advance, especially in terms of diagnosis. But we remain far from knowing how to treat the disease, and contrasting lives remain.
What are the new treatments? It is the great debate about Alzheimer’s disease, the most common dementia with dozens of millions of patients in the world. I just commercialized, do new treatments have real interest?
Eli Lilly Kisunla (Donenémab) and Eisai (Lecanémab), are, after several decades of failed research, the first to demonstrate such a marked effect on the slowdown in symptoms.
But these benefits, only written down in patients at the beginning of the disease, are still very modest and, according to some experts, they hardly make any difference. However, these medications can also cause serious cerebral bleeding.
Throughout the world, health authorities have made contrasting decisions about these treatments. The last to speak, France considered it at the beginning of September in early September to reimburse them immediately.
While certain associations to combat the disease, especially in the United Kingdom, grow strongly for authorization, others have a more balanced position.
Leqembi is a “therapeutic innovation”, but it is necessary to “take into account intrinsic limitations” to this treatment, France Alzheimer, the main French organization in the field warned in spring.
A simple blood analysis
How to diagnose the disease? More discreet, another debate agitates specialists, with a growing split between Europe and the United States: how to diagnose Alzheimer’s disease?
Great advances have been made to allow a very simple diagnosis, through a blood test, which allows identifying the “organic markers” of the brain mechanisms involved in the disease.
It is a revolution in relation to valid tests, for example, lumbar punctures, whose heavy and expensive character in fact excludes many patients.
A first blood analysis has been authorized since May in the United States. This is not the case in Europe, but a great program is underway in the United Kingdom to assess whether these tests change the situation: a clinical trial has just been launched.
An still necessary in -depth exam?
But these tests will one day be enough for themselves? Positions differ. At the end of 2024, the Alzheimer’s Association, the reference organization in the United States, changed its criteria to consider that only biomarkers are enough to make a diagnosis.
In Europe, specialists continue to consider that an in -depth clinical examination will continue to be necessary to confirm the loss of cognitive and functional abilities.
“Many patients have abnormal biomarkers but never develop dementia,” Dutch neurologist Edo Richard, who is also skeptical about new treatments, told AFP.
The two questions come together because the defenders of Leqembi and Kisunla believe that an early diagnosis, before marked clinical symptoms, could multiply the effect of these treatments.
Sports activity and support
Can prevention be effective? There is consensus on multiple risk factors for Alzheimer’s disease and more widely dementia. According to an expert evaluation published in 2024 in Lancet, almost half of the cases are linked to identifiable factors: bad audition, smoking, obesity …
But divergent experts in the degree to which this observation can lead to concrete and effective actions. More and more studies are testing the effectiveness of support programs that encourage patients to regular physical activity and better diet. But these essays “had few or no effect on cognitive deterioration or the appearance of dementia,” says Edo Richard.
Last, a study, published this summer in JAMA magazine this summer, measured in the United States the cognitive abilities of patients who had undergone intensive support for two years. Its degradation slowed down a little, but the effect remains modest.
For some observers, “it is not much,” admitted the French epidemiologist Cécilia Samieri in mid -September during a conference organized by the French Foundation defeated Alzheimer’s.
But, for her, “it’s already huge.” The researcher considers that only ten or fifteen rehearsals could do justice to the effectiveness of interventions against such prolonged development disorders.
Source: BFM TV
