An NHS trust is giving medications to people without Alzheimer’s to see if it can be prevented. A “trust” is an organizational unit within the NHS. Typically, Alzheimer’s is treated once symptoms, such as memory loss, occur. This trial wants to see if there’s a way to prevent Alzheimer’s in high-risk individuals using a medication called Trontinemab which attacks toxic amyloid plaques that build up and kill cells in the brain. Early research has found that it eliminates amyloid plaques in 9 out of 10 people with early-stage Alzheimer’s. The phase III trial is called the PrevenTRON study. People with an elevated level of the biomarker p-tau217 have a 78% chance of developing cognitive impairments within 10 years according to research. 

What is an international clinical trial?

As an international clinical trial, the PrevenTRON study conducts research with participants from different parts of the world in order to see how a treatment works on a diverse population of people. This diversity is in terms of genetics, culture, and geography. The PrevenTRON study follows the Good Clinical Practice (GCP) guidelines. These guidelines were developed by the International Council for Harmonisation (ICP). There are 5 phases in a clinical trial ranging from Phase 0 to Phase IV. During each phase, the number of people the drug is tested on increases. Drug development goes through five main phases: Discovery and Development, Preclinical Research, Clinical Research (Human Trials), Regulatory Review, and Post-Market Surveillance.

What is Alzheimer’s?

Alzheimer’s is a progressive brain disorder. It’s considered “progressive” because the damage it causes to the brain gets worse over time. Symptoms include memory loss, reduction in thinking skills, and the inability to carry out daily tasks. Alzheimer’s disease is the most common cause of dementia, an umbrella term for a decline in an individual’s mental abilities and their ability to execute the tasks of daily life. The exact cause of Alzheimer’s is not yet known, but the leading theory is that it’s due to a combination of lifestyle, environmental, and genetic factors. It’s also due to abnormal protein build-up such as amyloid plaques, tau tangles, and cell death. 

What is cognitive reserve?

There are instances in which people with amyloid plaques can never develop the life-changing symptoms of Alzheimer’s. This is because they have high cognitive reserve. Cognitive reserve is the brain’s ability to find alternative neural pathways when neural pathways are compromised by disease or injury. There are different ways that people can build cognitive reserve. This includes learning new things, working, having hobbies, and having an active social life. The concept of cognitive preserve was developed by Dr. Yaakov Stern, a neurophysiologist at Columbia University. In the nineties, he came up with this concept to explain why some people tolerate brain damage and Alzheimer’s better than others. 

How can you prevent Alzheimer’s without the use of drugs?

Reading books helps people build greater cognitive reserve. Other activities include tackling complex puzzles or learning a musical instrument. It’s also helpful to choose challenging tasks over passive entertainment such as scrolling on TikTok or binge-watching TV shows. You can also build cognitive reserve through developing social and physical habits as well. This includes participating in group classes, volunteering, or participating in community events. Exercising regularly also helps by increasing blood flow and promoting the development of new nerve cells. It’s also important to get enough sleep and manage stress levels. Learning Arabic in particular helps build cognitive reserve through its non-concatenative morphology and its use of cross-hemispheric brain processing. 

Both medication and lifestyle changes have a role to play

That said, there are instances in which people need medication to help them with symptoms that are overwhelming or to help them with genetic factors that have made them more susceptible to this disease. This current trial is still experimental and the trial is expected to last four to six years.