The Future
The biggest bang of LY450139 and similar compounds will probably be in their ability to forestall cognitive decline, Dr. Siemers said. He and other researchers envision a time when advances in imaging and biomarkers will foster the advent of a regular dementia screen as people approach old age–something akin to today's colorectal-screening process.
Those who screen positive–perhaps by a brain imaging study showing amyloid plaque deposition–will immediately receive a disease-modifying drug, or perhaps a cocktail of remedies including Aβ-modulators and immunotherapy. “These things could be used presymptomatically to catch people before they experience significant decline,” Dr. Siemers said.
Drug research will combine in a very powerful way with advances in markers and imaging technology to improve social acceptance of early diagnosis, predicted Dr. Paul Aisen, of Georgetown University Medical Center in Washington. “Today at diagnosis, you are basically giving them a death sentence, so right now there is a great deal of reluctance to diagnose someone early,” said Dr. Aisen, Neurochem's principal U.S. investigator of tramiprosate. “But if you have a way to detect early changes and drugs that will prevent progression, that will change our entire outlook on early diagnosis.”