Alzheimers Disease Future Perspectives

1
Alzheimers DiseaseFuture Perspectives

• Richard J. Hodes, M.D.
• Director
• National Institute on Aging
• NIA/NIH/DHHS

2
Estimated Percentage of People over Age 65 with
Probable Alzheimers Disease
Percent
Age Group
Source Evans D , et al. JAMA , Vol. 262, No.
18, 1989.
3
Older Population by Age 1910 to 2030
(In millions)
69.4
65-84
85
53.2
39.4
35.0
31.1
25.5
20.1
16.6
12.3
9.0
6.6
4.9
4.0
1910
1920
1930
1940
1950
1960
1970
1980
1990
2000
2010
2020
2030
Projected
4
Alzheimers Disease and Estrogen
AD risk with postmenopausal estrogen use
Less estrogen
1.0
0.8
0.6
More estrogen
46
Relative Risk
0.4
0.2
0
Estrogen
No Estrogen
5
Estrogen Replacement as Treatment for AD

• Hysterectomized women with AD received estrogen
  or placebo for 15 months
• Estrogen did not improve cognitive function or
  delay the progression of disease
• Estrogen may still be effective earlier in the
  disease process

Mulnard, R., JAMA Vol. 283 No. 8, 2000.
6
(No Transcript)
7
AD Prevention Trials Estimation of Risks

• WHI study - adverse effects of estrogen/progestin
  additional cases per 10,000 women per year
• 8 breast cancer
• 7 coronary heart disease
• 8 stroke
• 8 blood clots in the lungs or legs

• Risk of AD in women with MCI
• 1,200 new cases per 10,000 women per year
• Risk of AD in women 65 with a first degree
  relative with AD
• 500 new cases per 10,000 women per year

8
Funded AD Prevention and Selected Treatment
Trials
April 2002