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Reversal Strategies Destroy the current plaques/amyloid Vaccination Strategy: AN-1792 vaccine is in testing. This is an amyloid B protein fragment which can induce antibodies that bind to plaques and activate microglial destruction processes. Trial halted b/o menigoencephalopathies ‘Plaque busters’ Alzhemed prevents Amyloid B fragments from forming fibrils Clioquinol - A metal-protein-attenuating compound (MPAC) that inhibits zinc and copper ions from binding to beta-amyloid, thereby helping to dissolve it and prevent it from accumulating. Transthyretin shows promise at interfering with toxic effects Generate new tissue - Neuroregeneration strategies (STEM cells) Neurotransplantation strategies Other Drugs in the Pipeline Tau protein modulators (to prevent abnormal phosphorylated ‘tau’ protein Beta and gamma-secretase inhibitors Alpha secretase stimulators Bryostatin – CA drug that stimulates brain protein production. Reduces B-amyloid levels in mice, enhances memory and learning. New generation NSAIDS (flubiprofen) – testing in humans looks promising Immune enhancers (immunoglobulin) New vaccines and new anticholinesterases (huperzine) Caregiver Burden Alzheimer’s caregivers spend an average of 69 to 100 hours per week providing care Caregivers of patients suffering from dementia(compared to control subjects) reported: 46% more physician visits Over 70% more prescribed drugs More likely to be hospitalized More than 50% of caregivers are at risk for clinical depression Staging of Dementias MILD: difficulties with checkbook maintenance, complex meal preparations, complicated medication schedules MODERATE: difficulties with simple food preparation, household or yard work. May need some assistance with self-care SEVERE: Need considerable assistance with feeding, grooming and toileting PROFOUND: Largely oblivious to surroundings, totally dependent TERMINAL: Bed bound; require constant care Common Associated Problems depression (occurs in 20-40% - esp. AD and VaD)