Dementia and Alzheimer’s disease treatment. The future directions. 6

Dementia and Alzheimer’s disease treatment. The future directions. 6

Dementia and Alzheimer’s disease treatment. The future directions. 6

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That’s what is important to discover effective Alzheimer’s disease treatment. We have to have an open mind. We have not only to focus on one particular target, but to focus on many targets. We must have an open mind about mechanisms of pathogenesis. We have to keep on working on what actually causes the disease. What actually kills the cerebral cells? Prof. Sir Mark Pepys, leading immunologist and amyloidosis expert. What do you think is the future in Alzheimer's disease treatment? Where hope in treatment of Alzheimer's disease might come from? Dr. Anton Titov, MD. What are the trends in Alzheimer's disease treatment, from your perspective? Dr. Anton Titov, MD. Professor Pepys, you have an enormous experience in research and clinical work. Many clinical trials have been unsuccessful. Billions of dollars have been spent. Dr. Anton Titov, MD. What the future might hold for Alzheimer's disease treatment? Professor Dr. Mark Pepys, MD. Well, it is very encouraging. There is much more focus and attention on this important field than there had been in the past. Compared to the cost to society of Alzheimer's disease, there had been significantly less money invested in studying it. There is less investment into attempts to clinically investigate Alzheimer's disease. Now there is a great focus on Alzheimer's disease, people have prioritized it very highly. That can only be good. As to where the advances are going to come from. Professor Dr. Mark Pepys, MD. My guess is not any better than anybody else's guess, I am afraid. There are a lot of very intelligent and industrious people, companies, organizations working on Alzheimer's disease. These are very challenging problems. I'm not sure that any of us can predict where any breakthrough in Alzheimer's disease is going to come. What's important is to have an open mind. We have to focus on more than one particular target of Alzheimer's disease. We must focus on many targets for Alzheimer's disease. Professor Dr. Mark Pepys, MD. We have to have an open mind about mechanisms of pathogenesis of Alzheimer's disease. We have to keep on working on what actually causes Alzheimer's disease. Dr. Anton Titov, MD. What actually kills the cerebral cells. I mean there are many many different avenues to pursue in Alzheimer's disease treatment. The only way to make progress, I believe, is to keep on with the earnest scientific inquiry to understand things better. Professor Dr. Mark Pepys, MD. Then once you understand Alzheimer's disease, you have an opportunity to challenge them. You can then treat patients with Alzheimer's disease. Dr. Anton Titov, MD. At the moment our understanding of Alzheimer's disease is incomplete. It doesn't enable us necessarily to research Alzheimer's disease in a rational way. Unfortunately, this is the way society is organized. It is inefficient how the drug development proceeds. People tend to get in a track. Then everybody does the same. All research and thinking is more or less the same thing. A herd mentality in science does exist! It certainly does! Professor Dr. Mark Pepys, MD. Herd mentality devalues the quality of the decision-making in Alzheimer's disease. But it is more than just that. But certainly the costs of medication development Alzheimer's disease are so vast. The companies have to be risk-averse. They can't take huge gambles with their shareholders resources. Dr. Anton Titov, MD. Drug companies spend vast amounts of money on something. Alzheimer's disease treatment candidates is less validated or less popular. Therefore, companies do tend to go in similar directions. That is a very difficult thing to overcome in Alzheimer's disease. But now that governments are very focused on Alzheimer's disease. They have made it a big priority. Different national governments have made dementia a great priority. That can only be a good thing. Professor Dr. Mark Pepys, MD. I hope that it will lead to progress on therapy for Alzheimer's disease. As to whether we will get cure of Alzheimer's disease, that is probably fanciful. Once the brain is badly damaged, its capacity to recover is probably limited. But who knows? We're seeing amazing things with stem cells in Alzheimer's disease. Maybe there are possibilities for improvement. But the most one could hope for in Alzheimer's disease is slowing it down. That would be a huge advance. We could possibly arrest progression of Alzheimer's disease. Professor Dr. Mark Pepys, MD. We could arrest the progression of Alzheimer's disease. Then patients with mild cognitive impairment or very early Alzheimer’s disease could continue to function. Then patients wouldn't need to be cared for so much. Dr. Anton Titov, MD. Patients with Alzheimer's disease would have better quality of life. They are mostly old. Patients would succumb to other illnesses before they ended up with end-stage dementia. That is what we have to hope for.

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