Forum: Explore safer, cost-effective treatments for Alzheimer’s disease
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Two new monoclonal antibodies that recently completed Phase 3 clinical trials came into the limelight with promising claims about slowing the progression of Alzheimer’s disease ( What to know about 2 new Alzheimer’s disease drugs approved in Singapore
While hopes are raised, we should objectively assess the pros and cons, the short- and long-term efficacy of these drugs. Besides their hefty price tags, be also mindful of the potential side effects. One significant set of side effects highlighted in the published reports is the occurrence of amyloid-related imaging abnormalities (Aria). Aria may be associated with brain oedema (Aria-E) or haemorrhage (Aria-H) where patients develop central nervous system symptoms.
In view of these concerns, do we have more affordable and safer alternatives to prevent and slow the progress of dementia, including Alzheimer’s disease (AD)?
One such option that has largely fallen outside public attention is the use of intensive multi-domain lifestyle intervention (IMLI). It primarily makes use of structured lifestyle changes in diet, exercise, intake of supplements and stress management to prevent and slow the progression of dementia, including AD.
Such a multi-domain intervention strategy is logical because dementia is not entirely about AD and amyloid alone. Many elderly persons with dementia or AD have associated chronic medical conditions, like hypertension, coronary artery disease, Type 2 diabetes and obesity, that put them at high risk of dementia. IMLI is beneficial not only for dementia but also for many of these other chronic medical problems.
Several studies have reported the favourable outcomes of using lifestyle interventions to improve cognition, and prevent and slow the progression of dementia. A recent study using IMLI on patients with mild or early AD showed significant improvements in cognitive assessment scales and biomarkers – measures very similar to those used in the clinical trials of monoclonal antibodies.
The cost-effectiveness and well-documented benefits of lifestyle interventions in the management of dementia and AD are worth considering along with other drug therapies.
Ho Ting Fei (Dr)
