I am often asked about potential treatments for Alzheimer’s disease.  The intention behind the question is to solicit my assessment of whether there are any medications that show promise for the future.  Anyone who has talked to me or followed my columns knows that I am frustrated by the rigid commitment and inflexibility of many clinical trials that focus on treating brain proteins called amyloids that cause the build up of plaques in the brain.  This strategy has channeled so many intellectual and financial resources into a collective tunnel vision despite many failures of the concept.

There are two recent studies that merit attention in that they each add intriguing findings that are not directly connected to amyloid pathology.  They focus on slowing progressive diseases as well as suggest new strategies in the search for disease modifying treatments of Alzheimer’s and related diseases.

Diabetes is a slowly progressive disease that has been linked to Alzheimer’s disease.  Indeed, the reasoning is that brain insulin resistance and deficiency is associated with Alzheimer’s disease as well as with Type II diabetics.  Rates of Mild Cognitive Impairment and diabetes are higher among Type II diabetics than non-diabetics and intranasal administration of insulin may preserve cognitive functioning in those with Mild Cognitive Impairment.

A small study (The Journal of Clinical Intervention, May 20, 2013) reports that Byetta, a glucagon related diabetes medication, used as a supplement to Parkinson’s drugs improved function in Parkinson’s patient after a year.  Control patients on Parkinson’s drugs only showed decline.  Hence, there is emerging theory that at least some forms of progressive neurological disease may be a “brain form of diabetes.”

An interesting article was published last year suggesting that survivors of malignant cancers have a lower risk of developing Alzheimer’s disease and those with Alzheimer’s disease have a lower risk of cancer. Cancer survivors had 33% less risk of developing Alzheimer’s disease than comparison subjects who never had cancer.  Interestingly, survivors of smoking related cancers were less likely to develop Alzheimer’s disease than survivors of nonsmoking related cancers however; they had a substantially higher risk for having a stroke.

An article published in Neurology (May, 2013) reports that patients with a history of squamous or basal cell skin cancer had a reduced risk of developing Alzheimer’s disease over several years of follow up and had better performance on cognitive testing when entering the study.  Melanoma may not offer the same protection.

We need to put more research money and intellectual assets into pursuing findings such as these.  I am hopeful that we can find ways to slow the progression Alzheimer’s and related brain disorders.  But we need to overcome the inertia of pet theories that have not produced clinically useful results.