Student Spotlight: Are lifestyle changes more effective than potential new Alzheimer’s drugs?

Expensive expectations and copious controversies

March 8, 2023

Stock photo by Kyle Wagner via

Contributed by Maria-Elizabeth Baeva, University of Calgary medical student.

Alzheimer’s disease (AD) is the most common form of dementia; it affects 10% of people over the age of 65. Despite having been discovered over 100 years ago, there has yet to be an effective cure. Instead, between 2000 and 2012, 99.6% of drugs tested in clinical trials for AD failed, which is a higher fail rate than cancer trials. 

There are several reasons for the difficulty in finding a cure: 

  • Etiology of AD is still unknown.
  • Most of our animal models are based on the familial variant of AD, which accounts for only 10% of total cases. 
  • While we think that amyloid and tau may play a role in the pathology of the disease, it is unclear if targeting these biomarkers can slow or reverse AD. 
  • The relationship of amyloid and tau to cognitive decline has always been in question (see the famous nun study). 
  • High interpatient heterogeneity.
  • The fundamental inaccessibility of the brain for routine testing. 

With the global population getting older, AD will become more prevalent, and a treatment is desperately needed. This creates a temptation to take shortcuts and accept even the smallest glimmer of hope. Aducanumab and lecanemab are two new AD monoclonal antibody therapies from Biogen which have received accelerated approval – but not without controversy. Biogen withdrew its application for aducanumab from Health Canada in June 2022 after approval by the FDA one year prior, but it is worth revisiting the issues surrounding this drug and seeing whether the process of Alzheimer’s drug approval has improved.

Continue reading this Student Spotlight profile (Alberta Doctors’ Digest, March-April 2023)

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