So it’s been several months since the new Alzheimer’s drug Aduhelm was introduced, in a hopeful sign that a treatment for Alzheimer’s might finally be available. As you may recall, in June we reported on the FDA approval of Aduhelm, a medication that targets the build-up of amyloid plaques in the brain, which are thought to contribute to the development of Alzheimer’s. While the drug is not a cure for Alzheimer’s, the goal was to get it into the hands of those in the early stages of dementia (i.e., those experiencing mild cognitive impairment) so that the process of cognitive decline could be halted or at least slowed. However, as we reported back in June, the drug is not without its controversies, including its price, regulatory approval, supporting data, and significant side effects. So where do things stand now?

As was extensively outlined in a recent episode of the NPR podcast Shortwave, very few patients- perhaps only a few hundred- have been given this drug, in contrast to the hundreds of thousands that were expected to have received it by now. The reasons for this dismal showing to date? Everything from the cost (too expensive) to the side effects (too risky) to the deflated expectations of how it can help (not much). As NPR journalist Jon Hamilton makes clear in this podcast, given the limitations of the drug usage and the insufficient evidence to support its claims- not to mention the lack of Medicare coverage to date for the drug- few physicians are anxious to encourage their patients to take Aduhelm, and even those that discuss the drug do so with many caveats and concerns. As will be further debated this week at the 14TH CLINICAL TRIALS ON ALZHEIMER’S DISEASE (CTAD) Conference, many physicians are simply sitting on the sidelines waiting for further proof that removing amyloid plaque can slow the progression of Alzheimer’s. While there is hope that this drug may just be the first in a long line of new therapies to treat Alzheimer’s, the consensus seems to be that Adulhem is not the miracle drug some were hoping for, and we still have a ways to go before an effective treatment can be administered to the millions of Alzheimer’s patients desperate for viable therapies. To find out more on the state of play in Alzheimer’s research, click here.

So is there any good news to report? There is a new study out of MIT and published in the journal Science Translational Medicine that focuses on older adults whose brains appear to be afflicted with Alzheimer’s yet who actually have no symptoms and have not experienced cognitive decline (estimates are that up to 30% of older adults fall into this category). It’s long been thought that such environmental/lifestyle factors as education and intellectually stimulating activities (and possibly diet and exercise) can all contribute to a kind of cognitive resilience to help protect the brain against neurodegeneration. The MIT researchers discovered that a family of proteins in the brain can instigate this type of neuroprotective resilience, and that brain enriching activity can activate this family of proteins. The hope is that understanding these brain processes could lead to the development of new drugs that can mimic this process and protect the brain from cognitive decline. As a reminder of how to build up some cognitive resilience, take out the crossword puzzle and click here and here.