Sixteen years ago, we published an analytical model that projected the impact of a
breakthrough drug for Alzheimer's disease.
1
At that time, the enzyme that cleaves amyloid precursor protein had recently been
identified,
2
and it seemed reasonable to assume that a more effective treatment was on the near
horizon.
3
,
4
,
5
We modeled 2 scenarios: one in which the breakthrough drug delayed disease onset
and the other in which the new drug slowed disease progression.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the American Medical Directors AssociationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The public health impact of Alzheimer's disease, 2000–2050: Potential implication of treatment advances.Annu Rev Public Health. 2002; 23: 213-231
- Beta-secretase cleavage of Alzheimer's amyloid precursor protein by the transmembrane aspartic protease BACE.Science. 1999; 286: 735-741
- The beta-secretase, BACE: A prime drug target for Alzheimer's disease.J Mol Neurosci. 2001; 17: 157-170
- Amyloid forming proteases: Therapeutic targets for Alzheimer's disease.Curr Pharm Des. 2002; 8: 2521-2531
- Secretases as targets for drug design in Alzheimer's disease.Eur J Clin Invest. 2002; 321: 60-68
- Why do so many drugs for Alzheimer's disease fail in development? Time for new methods and new practices?.J Alzheimers Dis. 2008; 15: 303-325
- Recent progress in the pharmacotherapy of Alzheimer's disease.Drugs Aging. 2017; 34: 811-820
- Classifying neurocognitive disorders: The DSM-5 approach.Nat Rev Neurol. 2014; 10: 634-642
- Preventing Alzheimer's disease is difficult.Lancet Neurol. 2015; 14: 872-874
- Neuropathological correlates of cerebral multimorbidity.Curr Alzheimer Res. 2013; 10: 569-577
- Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade.Lancet Neurol. 2010; 9: 119-128
- Forecasting the prevalence of preclinical and clinical Alzheimer's disease in the United States.Alzheimers Dement. 2018; 14: 121-129
- Modifiable risk factors and prevention of dementia: What is the latest evidence?.JAMA Intern Med. 2018; 178: 281-282
- Interventions To prevent age-related cognitive decline, mild cognitive impairment, and clinical Alzheimer's-type dementia. Comparative Effectiveness Review No. 188. AHRQ Publication No. 17-EHC008-EF.Agency for Healthcare Research and Quality, Rockville, MD2017 (Available at:)https://www.ncbi.nlm.nih.gov/books/NBK442425/Date accessed: May 5, 2018
- Editorial: Prevention strategies targeting different preclinical stages of Alzheimer's disease.Curr Alzheimer Res. 2015; 12: 504-506
- A comparison of the prevalence of dementia in the United States in 2000 and 2012.JAMA Intern Med. 2017; 177: 51-58
- Agile implementation: A blueprint for implementing evidence-based healthcare solutions.J Am Geriatr Soc. 2018 Mar 7; ([Epub ahead of print])
- Healthy aging brain center improved care coordination and produced net saving.Health Aff (Millwood). 2014; 33: 613-618
- The interface between delirium and dementia in elderly adults.Lancet Neurol. 2015; 14: 823-832
- Anticholinergic medication and risk of dementia: A nested case-control study.BMJ. 2018; 361: k1315
- Association between anticholinergic medication use and cognition, brain metabolism, and brain atrophy in cognitively normal older adults.JAMA Neurol. 2016; 73: 721-732
- Antihypertensive medication regimen intensity and incident dementia in an older population.J Am Med Dir Assoc. 2018; 19: 577-583
- Cognitive screening at the population level. The Italian Health Examination Survey 2008–2012.J Am Med Dir Assoc. 2018; 19: 459-461
- Effects of combined physical and cognitive exercises on cognition and mobility in patients with mild cognitive impairment: A randomized clinical trial.J Am Med Dir Assoc. 2018; 19: 584-591
- Diabetes care and dementia among older adults: A nationwide 3-year longitudinal study.J Am Med Dir Assoc. 2018; 19: 601-606
- Predictors of falls and fractures leading to hospitalization in people with dementia: A representative cohort study.J Am Med Dir Assoc. 2018; 19: 607-612
- Antipsychotic deprescription for older adults in long-term care: The HALT study.J Am Med Dir Assoc. 2018; 19: 592-600
- Reliability and validity of the care plan checklist for evidence of person-centered approaches for BPSD.J Am Med Dir Assoc. 2018; 19: 613-618
- The cost-effectiveness of using PARO, a therapeutic robotic seal, to reduce agitation and medication use in dementia: Findings from a cluster randomised-controlled trial.J Am Med Dir Assoc. 2018; 19: 619-622
- Receptive music therapy is more effective than interactive music therapy to relieve behavioral and psychological symptoms of dementia: A systematic review and meta-analysis.J Am Med Dir Assoc. 2018; 19: 568-576
- Does cognitive impairment and agitation in dementia influence intervention effectiveness? Findings from a cluster-RCT with the therapeutic robot, PARO.J Am Med Dir Assoc. 2018; 19: 623-626
- Identifying and supporting nonpharmacological dementia interventions ready for pragmatic trials: Results from an expert workshop.J Am Med Dir Assoc. 2018; 19: 560-562
- Nursing staff distress associated with neuropsychiatric symptoms in young-onset dementia and late-onset dementia.J Am Med Dir Assoc. 2018; 19: 627-632
- Hospice care for patients with dementia in the U.S.: A longitudinal cohort study.J Am Med Dir Assoc. 2018; 19: 633-638
- Who is responsible? A man with dementia wanders from home, is hit by a train, and dies.J Am Med Dir Assoc. 2018; 19: 563-567
- Structural characteristics of specialised living units for people with dementia: A cross-sectional study in German nursing homes.Int J Ment Health Syst. 2014; 8: 39
- Associations of special care units and outcomes of residents with dementia: 2004 national nursing home survey.Gerontologist. 2010; 50: 509-518
- Special care units for dementia individuals with behavioural problems.Cochrane Database Syst Rev. 2009; : CD006470
- Specialized dementia programs in residential care settings.Gerontologist. 2000; 40: 32-42
- The Dutch village where everyone has dementia.(Available at:)https://www.theatlantic.com/health/archive/2014/11/the-dutch-village-where-everyone-has-dementia/382195/Date accessed: May 4, 2018
- People with dementia living alone: What are their needs and what kind of support are they receiving?.Int Psychogeriatr. 2010; 22: 607-617
- From dementia fearful to dementia friendly: Be a champion in your community.J Gerontol Nurs. 2014; 40: 3-5
- Dementia care and quality of life in assisted living and nursing homes.Gerontologist. 2005; 45: 133-146
- End-of-life issues in advanced dementia: Part 1: Goals of care, decision-making process, and family education.Can Fam Physician. 2015; 61: 330-334
- End-of-life care for patients with dementia in the United States: Institutional realities.Health Econ Policy Law. 2012; 7: 485-498
Article info
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
