Medications to Prevent Alzheimer’s

By ⁠Dr. Brandon Colby MD, a physician-expert in the fields of Genomics and Personalized Preventive Medicine.

Alzheimer’s disease is the leading cause of dementia and neurodegenerative disease in the world, and as life expectancy increases around the world, so does the prevalence of this condition.

Alzheimer’s disease and dementia are estimated to affect more than 50 million people across the globe, and that number could rise to more than 152 million by 2050.¹ That’s more than the entire population of Russia, potentially living with Alzheimer’s disease less than 30 years from now. This condition places a significant burden on healthcare systems, patients, and caregivers around the world.

Currently, there’s no cure for Alzheimer’s disease, but the best way we can combat these increasing statistics is by aiming to prevent the condition. Clinical trials are constantly researching new treatments and strategies that could potentially treat or successfully prevent Alzheimer’s disease and many other conditions.

But in the meantime, it’s important to do everything we can to prevent it. Many different lifestyles and wellness choices can lower your risk of Alzheimer’s, but in this article, we’ll discuss the medications that could also help us prevent this disease.

Read on to learn more about medications to prevent Alzheimer’s disease.

Is There Medication to Prevent Alzheimer’s Disease?

To date, no medications have been approved specifically for Alzheimer’s prevention. However, there is strong evidence that certain drugs that are commonly used to treat other conditions can also help prevent Alzheimer’s disease.

Medications that are used to treat Alzheimer’s disease, on the other hand, may be unable to prevent the onset of the disease, but they can slow the worsening of its symptoms. Additionally, studies have found that it’s possible that certain medications that have been approved to treat the disease could also prevent it.

And last — but certainly not least —, researchers are spearheading clinical trials with the aim of developing new medications for Alzheimer’s even as you read this.

What Medications Prevent Alzheimer’s

Let’s discuss some of the medications that could be useful in the prevention of Alzheimer’s disease, and the ones that can be used in the early stages of this condition to prevent its progression.

Please remember that you should always consult with your physician before starting or discontinuing any medication.

NSAIDs

NSAIDs (non-steroidal anti-inflammatory drugs) are already a part of our everyday lives. Many of the drugs that belong to this category are sold as over-the-counter pain relievers and fever reducers. It’s very likely that you have taken NSAIDs many times over the course of your life.

Some of the most commonly used NSAIDs include:

• Aspirin
• Ibuprofen
• Naproxen
• Ketoprofen
• Diclofenac
• Celecoxib

But despite the fact that these medications are most often used to treat simple illnesses, such as colds, research has discovered that they could also help prevent Alzheimer’s disease.²

These medications may have a protective effect against Alzheimer’s in people who have one or two ⁠APOE4 alleles of the APOE gene. This gene contains the coding information for a protein called apolipoprotein E, which works by clearing up beta-amyloid deposits in the brain. When beta-amyloid builds up, it creates amyloid plaques that lead to Alzheimer’s disease.

There are different variants of this gene: APOE2, APOE3, and APOE4. APOE2 and APOE3 don’t increase your risk of Alzheimer’s — although research shows that APOE3 could lead to a slight increase when combined with other genetic mutations. But APOE4, on the other hand, is the main genetic ⁠risk factor of Alzheimer’s disease. We all inherit two copies of the APOE gene, one from each of our parents. Inheriting even a single APOE4 copy increases our risk of the disease, but inheriting two makes this risk even greater.

That’s where NSAIDs could be helpful. Studies have theorized that the protective effect of NSAIDs could be due to their anti-inflammatory properties. Additionally, NSAIDs could also disrupt the process that leads to amyloid plaques building up between our brain cells.³

Long-term daily use of NSAIDs could potentially delay or prevent the onset of Alzheimer’s disease or dementia in patients with mild cognitive impairment (MCI), which is defined as a measurable decline — such as memory loss — in a person’s cognition. However, NSAIDs seem to become less effective once Alzheimer’s disease has already set in.

Please consider that NSAIDs can ⁠cause side effects, just like any other medication. These drugs can cause stomach ulcers and blood clotting abnormalities, so it’s important to seek medical advice before you start taking a new medication. NSAIDs appear to be primarily effective for people with one or two copies of APOE4 — you can determine whether you have this variant ⁠through genetic testing.

Statins

Just like NSAIDs, statins are already a part of everyday life for many people. These medications are commonly used to manage high cholesterol and triglycerides, but they have also shown potential as a preventive therapy for Alzheimer’s disease. Statins include:

• Pravastatin
• Atorvastatin
• Simvastatin
• Lovastatin

High cholesterol levels can accelerate the accumulation of beta-amyloid plaques in the space between our neurons. Statins help prevent Alzheimer’s and cognitive decline by reducing cholesterol levels to slow down this process. Statins also appear to be able to independently reduce the production of beta-amyloid, while also reducing vascular inflammation and brain ischemia.⁴

Statins can also ⁠help prevent Alzheimer’s by managing one of its biggest risk factors, which is heart disease itself. Conditions like dyslipidemia and high blood pressure can both increase your risk of developing Alzheimer’s.

Evidence also suggests that statins can reduce the formation of tau protein tangles inside our brain cells, which is another pathophysiologic mechanism of Alzheimer’s disease.

However, other studies have found that statins could actually cause reversible cognitive decline in some patients. That’s because “good” HDL cholesterol is actually an important component of brain function — so reducing cholesterol levels too severely could lead to cognition problems.

Memantine

This medication belongs to the class of N-methyl D-aspartate (NMDA) receptor antagonists. Other medications in this class are used to treat Parkinson’s disease, traumatic brain injury, and stroke, among others.

Memantine is the only drug currently approved by the Food and Drug Administration (FDA) to treat severe Alzheimer’s disease, and its commercial name is Namenda®.

Memantine works by regulating glutamate, which is a neurotransmitter.⁵ A dysfunction in the metabolism of glutamate is involved in Alzheimer’s disease, and it can lead to brain cell death. Memantine targets and regulates the glutamatergic system to inhibit this dysfunction.

Recent research suggests that in addition to slowing the progression of Alzheimer’s disease, memantine could actually help prevent it.⁶ However, this effect only seems to occur if a patient starts taking memantine before the symptoms of Alzheimer’s set in. This is another instance in which ⁠genetic testing for Alzheimer’s could be very useful since it can determine who is at a higher risk of developing the disease long before symptoms appear.

Cholinesterase inhibitors

Cholinesterase inhibitors are the medications that are most often used to treat mild to moderate Alzheimer’s disease. These drugs can’t prevent Alzheimer’s disease itself, but they’re used to slow down its progression and manage behavioral symptoms.

• Donepezil (Aricept®)
• Galantamine (Razadyne®)
• Rivastigmine (Exelon®)

These medications work by preventing the breakdown of acetylcholine, a neurotransmitter that is essential to many cognitive functions. The FDA has also approved a drug called Namzaric®, which contains a combination of donepezil and memantine.

Other medications may be prescribed to patients with Alzheimer’s to manage cognitive and psychiatric problems, even if they don’t have an effect on the disease itself, such as antidepressants and antipsychotic drugs.

Alzheimer’s Cure Breakthrough 2020

As we previously mentioned, numerous researchers constantly work on clinical trials in the hopes of discovering new treatments for Alzheimer’s that are safe and effective.

Update: New Alzheimer’s Drug - Aducanumab

One of the most promising new drugs for Alzheimer’s disease is called aducanumab, and it’s currently being developed and tested by a biotech company called Biogen. It initially received mixed results during clinical trials. However, a new trial used an increased dose and was able to achieve a significant reduction in patients’ symptoms when compared to a placebo group.

The medication is a monoclonal anti-amyloid antibody, and it’s currently awaiting an FDA decision on its approval; if it’s approved, it would be the first disease-modifying agent to become available for Alzheimer’s disease. Aducanumab targets beta-amyloid in an attempt to clear up amyloid plaques and studies have reported that it can also decrease tau burden to reduce neurofibrillary tangles.⁷

Another promising therapy involves the use of somatostatin, a peptide that can help our bodies break down amyloid plaques.⁸ Although this study is still in its pre-clinical stage, it could also become a breakthrough treatment for Alzheimer’s disease in the future.

Visit our ⁠Education Center to learn more about Alzheimer’s disease, its risk factors, and what you can do to prevent it.

About The Author

Dr. Brandon Colby MD is a US physician specializing in the personalized prevention of disease through the use of genomic technologies. He’s an expert in genetic testing, genetic analysis, and precision medicine. Dr. Colby is also the Founder of Sequencing.com and the author of Outsmart Your Genes.

Dr. Colby holds an MD from the Mount Sinai School of Medicine, an MBA from Stanford University’s Graduate School of Business, and a degree in Genetics with Honors from the University of Michigan. He is an Affiliate Specialist of the American College of Medical Genetics and Genomics (⁠ACMG), an Associate of the American College of Preventive Medicine (⁠ACPM), and a member of the National Society of Genetic Counselors (⁠NSGC).