Dementia | Progress in Treatments for Severe Neurological Disease

Dennis Selkoe MD and Rudy Tanzi PhD moderated a discussion with John Sims, Reisa Sperling MD and Donna Masterman on how Alzheimer's disease is beginning to move from late diagnosis and disease management toward earlier detection, prevention and more effective treatment.

Sims compared current Alzheimer's care to waiting for someone to have a heart attack before checking blood pressure or cholesterol. The biology can be developing for years before symptoms become visible, which makes the growing availability of blood-based biomarkers especially important. Sperling pointed to prevention trials aimed at treating patients before cognitive symptoms develop and discussed the possibility of identifying people at meaningful risk much earlier.

The conversation also looked beyond today's first generation of anti-amyloid therapies. Selkoe and Tanzi framed the broader scientific challenge. At the same time, Masterman and Sperling discussed the potential of new delivery approaches, including brain-shuttle technologies designed to move drugs across the blood-brain barrier more efficiently. Future treatment will likely involve multiple targets, including amyloid, tau, inflammation, and other mechanisms.

Even with that progress, one major gap remains. Removing disease-associated proteins is not the same as restoring brain function. The field still needs therapies that protect neurons and help synapses work better.