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February 14, 2003
Based on recent findings of 12 new potential sites for Alzheimer's genes, a leading researcher estimates that within 50 years, patients will be routinely screened for Alzheimer's disease and receive prescription drugs tailored to their genetic risk.
Speaking at the American Association for the Advancement of Science (AAAS) Annual Meeting in Denver today, Rudolph E. Tanzi, director of the Genetics and Aging Research Unit at the Massachusetts General Hospital, said that his research and that of other geneticists offers hope that physicians eventually will be able to predict and prevent the disease that poses a serious threat to the minds of millions of aging baby boomers.
"The genetic underpinnings for up to 70 percent of Alzheimer's cases remain unsolved," Tanzi said. "This research lays the ground work for identifying genes that will allow us to reliably predict the disease before it strikes, giving us new clues about biological causes of disease so that we can help prevent it. The ultimate goal is to custom-make drugs to address our own genetic properties."
During a topical lecture at the AAAS Annual Meeting, Tanzi, who is also professor of neurology and neuroscience at Harvard Medical School, will describe his work on a decade-long analysis of 500 families with Alzheimer's disease, carried out as part of a multi-institutional effort with funding from the National Institute for Mental Health. The findings lead inevitably to a new vision of medical care, not only in the treatment of Alzheimer's, but of any disease with genetic causes, Tanzi said.
"Our laboratory's goal of early prediction-early prevention of this insidious neurological disorder will likely emerge in the future as the preferred means for treating cancers, diabetes, heart disease, and other common yet complex genetic disorders that challenge the health of our elderly population," Tanzi said. "Like Alzheimer's, all of these disorders involve, on one hand, rare gene mutations that cause early onset forms of the disease and, on the other hand, common gene variants that increase susceptibility to these diseases as we age."
Tanzi and other researchers have already identified four different genes that play a role in Alzheimer's disease. Three of these genes have been shown to cause the disease known as "early-onset" Alzheimer's (5 to 10 percent of all cases). The fourth gene, involved in cholesterol metabolism, places people at risk (but does not directly cause) the Alzheimer's that strikes people as they age.
"Genetic findings over the years indicate that in virtually every case of Alzheimer's, inheritance and genetics plays at least some role," Tanzi said. "As Alzheimer's genes have been uncovered, the biological pathways that become impaired in the disease have gradually been elucidated, paving the way for the development of effective therapies for prevention and treatment of the disease."
Alzheimer's disease, which leads to loss of memory, judgment and reasoning ability, affects four to six million Americans, but its future impact will be much greater, as the advancing age of 76 million baby boomers places them more at risk for the disease. By the year 2040, Tanzi said, the United States will have more than 14 million people diagnosed with Alzheimer's, and suggested that, "if it is not cured, the national cost of managing this dreadful disease will likely consume the entire federal budget by 2025."
Tanzi, co-author of Decoding Darkness: The Search for the Genetic Causes of Alzheimer's Disease, noted that treatment of Alzheimer's could begin to change as early as five years from now, given a strong link between high cholesterol and risk, and recent research regarding preventive factors such as consumption of Vitamin E to combat anti-oxidants, and Folic Acid, which lowers the amount of the amino acid homocysteine, in the blood.
Currently, medical practitioners diagnose Alzheimer's after eliminating other possible causes for symptoms such as short-term memory loss. An autopsy provides the only sure diagnosis of the condition that robs people of their ability to reason and think and affects more than 4 million people in the United States alone.
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