[en] The current therapy of Alzheimer's disease is primarily symptomatic. Drugs which aim to modify the course of the disease are currently being developed and tested in clinical trials. Given the complex and partly unknown pathogenesis of the disease, failure of such forms of therapy has to be taken into account. Clinical epidemiology suggests a possible neuroprotective effect of statins and non-steroidal anti-inflammatory drugs, however, the molecular basis of these effects has to be further unraveled. Therapies that modify the course of Alzheimer's disease are only likely to be effective years if not decades before the disease becomes clinically apparent. Thus, the therapy of risk factors including arterial hypertension and obesity in midlife as well as a Mediterranean diet currently provides the highest chance of modifying the course of the disease.
Disciplines :
Neurologie
Auteur, co-auteur :
HENEKA, Michael ; Klinische Neurowissenschaften, Klinik und Poliklinik für Neurologie, Universität Bonn, Bonn, Deutschland. michael.heneka@ukb.uni-bonn.de
Co-auteurs externes :
yes
Langue du document :
Allemand
Titre :
Verlaufsmodifizierende Therapien der Alzheimer-Demenz.
Titre traduit :
[en] Course modifying therapy of Alzheimer's dementia.
Date de publication/diffusion :
juillet 2010
Titre du périodique :
Nervenarzt
ISSN :
0028-2804
eISSN :
1433-0407
Maison d'édition :
Springer Science and Business Media LLC, Allemagne
IQWiG (2008) Nutzenbewertung von Cholinesterasehemmern, ginkgohaltigen Präparaten und Memantin bei Patienten mit Demenz, auch im Vergleich untereinander, Vorbericht A05-A19
Pirtillä T et al (2004) Long-term efficacy and safety of galantamine in patients with mild to moderate Alzheimer's disease: A multicenter trial. Eur J Neurol 11:734-741
Hardy J, Selkoe DJ (2002) The amyloid hypothesis of Alzheimer's disease: Progress and problems on the road to therapeutics. Science 297:353-356
Wolfe MS (2008) Gamma-secretase inhibition and modulation for disease. Curr Alzheimer Res 5:158-164
Green RC et al (2001) Safety and efficacy of tarenflurbil in subjects with mild Alzheimer's desease: results from an 18-month multi-center phase 3 trial. Alzheimers Demen 4(Suppl 1):165
Aisen PS (2005) The development of anti-amyloid therapy for Alzheimer's disease: From secretase modulators to polymerisation inhibitors. CNS Drugs 19:989-996
Gauthier S et al (2009) Effect of tramiprosate in patients with mild-to moderate Alzheimer's disease: Exploratory analyses of the MRI subgroup of the Alphase study. J Nutr Health Aging 13:550-557
Saumier D et al (2009) Domain-specific cognitive effects of tramiprosate in patients with mild to moderate Alzheimer's disease: ADAS-cog subscale results from the Alphase study. J Nutr Health Aging 13:808-812
Schenk D (2002) Amyloid-beta immunotherapy for Alzheimer's disease: the end of the beginning. Nat Rev Neurosci 3:824-828
Brody DL, Holtzman DM (2008) Active and passive immunotherapy for neurodegenerative disorders. Annu Rev Neurosci 31:175-193
Holmes C et al (2008) Long-term effects of Abeta42 immunisation in Alzheimer's disease: follow-up of a randomised, placebo-controlled phase I trial. Lancet 372:216-223
Boche D et al (2008) Consequence of Abeta immunization on the vasculature of human Alzheimer's disease brain. Brain 131:3299-3310
Szabo P et al (2008) Natural human antibodies to amyloid beta peptide. Autoimmun Rev 7:415-420
Salloway S et al (2009) A phase 2 multiple ascending dose trial of bapineuzumab in mild to moderate Alzheimer's disease. Neurology 73:2061-2070
Ballatore C et al (2007) Tau-mediated neurodegeneration in Alzheimer's disease and related disorders. Nat Rev Neurosci 8:663-672
Sigurdsson EM (2008) Immunotherapy targeting pathological tau protein in Alzheimer's disease and related tauopathies. J Alzheimers Dis 15:157-168
Heneka MT et al (2007) Drug insight: Effects mediated by peroxisome proliferator-activated receptor-gamma in CNS disorders. Nat Clin Pract Neurol 3:496-504
Risner ME et al (2006) Rosiglitazone in Alzheimer's Disease Study Group. Efficacy of rosiglitazone in a genetically defined population with mild-to-moderate Alzheimer's disease. Pharmacogenomics J 6:246-254
Höglund K, Blennow K (2007) Effect of HMG-CoA reductase inhibitors on beta amyloid peptide levels: Implications for Alzheimer's disease. CNS Drugs 21:449-462
Haag MD et al (2009) Statins are associated with a reduced risk of Alzheimer's disease regardless of lipophilicity. The Rotterdam Study. J Neurol Neurosurg Psychiatry 80:13-17
Luchsinger JA et al (2005) Aggregation of vascular risk factors and risk of incident Alzheimer's disease. Neurology 65:545-551
Kivipelto M et al (2005) Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer's disease. Arch Neurol 62:1556-1560 (Pubitemid 41434560)
Whitmer RA et al (2008) Central obesity and increased risk of dementia more than three decades later. Neurology 71:1057-1064
Stranahan AM et al (2008) Diet induced insulin resistance impairs hippocampal synaptic plasticity and cognition in middle-aged rats. Hippocampus 18:1085-1088
Cao D et al (2007) Intake of sucrose sweetened water induces insulin resistance and exacerbates memory deficits and amyloidosis in a transgenic mouse model of Alzheimer's disease. J Biol Chem 282:36275-36282
Schröder 2004 Adherence to the traditional mediterranean diet is inversively associated with body mass index and obesity in a spanish population. J Nutr 134:3355-3361
Scarmeas N et al (2009) Mediterranean diet and mild cognitive impairment. Arch Neurol 66:216-225
Rozzini L et al (2005) Effects of cholinesterase inhibitors appear greater in patients on established antihypertensive therapy. Int J Geriatr Psychiatry 20:547-551
Doody RS et al (2008) Effect of dimebon on cognition, activities of daily living, behaviour, and globalfunction in patients with mild-to-moderate Alzheimer's disease: A randomised, double-blind, placebo-controlled study. Lancet 372:207-215
Moreira PI et al (2008) Alzheimer's disease and the role of free radicals in the pathogenesis of the disease. CNS Neurol Disord Drug Targets 7:3-10
IQWiG (2008) Nichtmedikamentöse Behandlung der Alzheimer Demenz, Vorbericht A05-19D
Karsten SL, Geschwind DH (2005) Exercise your amyloid. Cell 120:572-574
