Controversies Surrounding Alzheimer's Disease

Alzheimer's disease results in dementia--the loss of a person's social and intellectual abilities. More than half of all people older than the age of 85 have Alzheimer's. It is no wonder that scientists, doctors, pharmaceutical manufacturers and caretakers relentlessly pursue the quest for treatment and cures. With these pursuits come controversies; over the mechanisms of Alzheimer's disease, the cause, the treatment, ethics for recruitment of research participants and even whether it is responsible to tag the patient with Alzheimer's.

Controversy over the Mechanism of Alzheimer's

• Over the years there has been an ongoing controversy over the mechanisms that cause brain cell death and memory loss in Alzheimer's. But in 2009, scientists at the University of Michigan and the University of California, San Diego have resolved this controversy.

  Michael Mayer, an assistant professor in the U-M departments of Biomedical Engineering and Chemical Engineering, and Jerry Yang, an assistant professor in the Department of Chemistry and Biochemistry at UCSD, and their colleagues have proven that small proteins called amyloid-beta peptides damage brain cells allowing extra calcium ions to enter the neurons, killing the brain cell.

  Because the disease is not well understood it is thought that in addition to amyloid-beta peptides causing cell death in the brain, other mechanisms could also play a part. But this is a beginning. "It is our hope that putting this disagreement to rest by showing that amyloid beta peptides do not thin membranes but instead form discrete pores in membrane can help the field move forward at a more rapid pace." Mayer said. He does caution, however, that more research is needed.

Controversy over the Cause of Alzheimer's

• The cause of Alzheimer's is not known. However there are conflicting theories. Some believe that Alzheimer's is caused by aging, genetic makeup, damage to neurons from toxic free radicals, serious head injuries, inflammation of the brain, and even environmental factors such as aluminum toxicity. It is thought that exposure to aluminum in our drinking water might cause cognitive impairment and results in the increased incidence of Alzheimer's disease, according to the National Institutes of Health.

Controversy over Medical Therapies

• One of the most controversial discussions about the treatment of Alzheimer's disease is a drug that, according to Edward Tobinick, M.D. director of the Institute for Neurological Research in Los Angeles, Calif., is injections of etanercept (ENBREL) an arthritis drug made by AMGEN. He claims he can produce drastic results within minutes when it is injected through the neck into the spine. "Their verbal ability improves, they find words easier, they seem happier, and we often also see an improvement in gait in those patients whose gait is affected," said Tobinick.

  The controversy is that Amgen, the maker of ENBREL, does not back the drug as a treatment for Alzheimer's. They state: "While Amgen and others have long recognized the potential role of inflammation in neurological conditions, we have carefully examined these reports and believe that there is insufficient and unsubstantiated scientific data to support the use of ENBREL as a means of treating Alzheimer's disease."

Conflict over Recruitment of Participants for Research

• There is controversy over the conflicts of interest in research companies paying a finders' fee to researchers and doctors to find participants for their studies. According to Leslie E. Wolf, associate professor of law at Georgia State University College of Law, federal and state laws prohibit payments for patient referrals or for other health care business, and clinical investigators may not realize that these laws might also apply to clinical research. Others debate whether Alzheimer disease patients should even be included in clinical trials because they are so vulnerable.

Controversy over Tagging Alzheimer's Patients

• In an effort to monitor Alzheimer's patients, they are being offered a medical microchip that is surgically implanted into their flesh. The microchip creator VeriChip Corp. is encouraging this surgical procedure for Alzheimer sufferers.
  Patients and their families wonder why they should abandon noninvasive tags such as MedicAlert. The relative permanence is a big reason why some are suspicious; along with the fact that the company charges annual fees for this service. Another drawback to microchip implants is the suspicion that they are linked to cancer even though they are approved by the Food and Drug Administration.