Alzheimer’s disease is a national crisis. While there is currently no cure for the fatal disease that affects over 6.7 million Americans, treatments are being discovered to change the disease progression and offer more time to families.

In June 2021, Lecanemab received accelerated approval as a treatment for Alzheimer’s disease from the U.S. Food and Drug Administration (FDA). This was the first therapy that actually targeted one of the disease hallmarks instead of simply treating the symptoms, demonstrating that removing beta-amyloid from the brain reduces cognitive and functional decline in people living with early-stage Alzheimer’s.

Since then, additional anti-amyloid treatments have shown positive results to slow down the disease progression. Lecanemab received accelerated FDA approval in January this year, and last month.

While these treatments have shown a glimmer of hope for the future of Alzheimer’s, that hope was severely diminished by an unfortunate reality: lack of access.

In April 2022, the Centers for Medicare & Medicaid Services (CMS) issued an unprecedented decision to block Medicare coverage of all FDA-approved treatments that target amyloid for Alzheimer’s disease, severely limiting access by forcing people to join a clinical trial or pay out-of-pocket at the high cost of over $26,000-$28,000 per year.

Fourteen months later, after continuous efforts from the Alzheimer’s Association and advocates nationwide to change this decision, CMS announced on June 1, 2023 that it will cover Alzheimer’s treatments that receive traditional FDA-approval if physicians register and enter data in a registry.
“While registries are important, posing this condition of coverage on people living with early-stage Alzheimer’s still creates an additional and unnecessary barrier,” said Meg Barron, Alzheimer’s Association Region 3 Leader and Executive Director of the California Southland Chapter. “These families don’t have time to wait for a registry or search for a doctor who participates in one.”

Setting this requirement for registries is yet another unprecedented decision made by CMS towards this class of FDA-approved drugs.

Each day, the Alzheimer’s Association estimates that 2,000 people living with early-stage Alzheimer’s progress beyond the point where current treatments can help them.
On June 20, Alzheimer’s advocates from Ventura County and Southern California met in Los Angeles to rally at the Wilshire Federal Building, urging CMS to change its policy and expand access to FDA-approved Alzheimer’s treatments.

To get involved as an advocate or learn more about Alzheimer’s treatments and free support services, visit the Alzheimer’s Association online at alz.org/cacentral. Their Ventura office is located at 2580 E Main Street #201, and their 24/7 Helpline is 800.272.3900 for around-the-clock support and information in English and Spanish.

To diagnose dementia, a doctor will complete a medical history, physical exam, and neurological tests that assess balance, sensory response, reflexes, and memory and thinking skills. In addition, a doctor may order brain scans, blood tests, genetic tests, a spinal tap, and a mental health evaluation to help determine a diagnosis.

Because different types of dementia can share similar symptoms, providing an accurate diagnosis can be difficult. In addition, dementia may be difficult to diagnose as a single disease given that a person could have more than one type.

Visiting a primary care doctor is often the first step for people who are experiencing symptoms of dementia. Your doctor may refer you to a neurologist, which is a specialist in disorders of the brain and nervous system. Neurologists generally have the expertise needed to diagnose dementia.

While there is currently no cure for Alzheimer’s or related dementias, medicines are emerging to treat disease progression. There are also medications that may temporarily improve or stabilize memory and thinking skills in some people and may help manage certain symptoms and behavioral problems. A team of specialists — doctors, nurses, and therapists — can help with maintaining mobility; addressing speech and swallowing problems; and learning new ways to handle loss of skills with everyday tasks, such as feeding oneself.

Through substantial investments from the U.S. federal government and others, researchers continue to advance scientific growth and discovery to improve the diagnosis, treatment, and care of those living with dementia.

If you are concerned about memory problems or other symptoms of dementia, call your doctor. If you or someone you know has recently been diagnosed, explore the resources on this website and referenced below to find out more about dementia care, support, and research. It is important to educate family, friends, and caregivers about a loved one’s diagnosis. In-person and online support groups offered by nonprofit organizations can provide families and caregivers with additional resources and opportunities to share experiences and express concerns. You may also consider participating in a clinical trial or study.

People whose brains have less myelin — the fatty tissue that insulates nerve cells — experience steeper declines in cognition over time, according to an NIA study published in Alzheimer’s & Dementia. The findings show the impact of myelin content as healthy people age and underscore myelin as a potential therapeutic target for neurodegenerative diseases, such as Alzheimer’s and mild cognitive impairment.

Myelin is an insulating layer that forms around nerves, including those in the brain. It helps neurons communicate more efficiently, maintain a healthy water balance, and respond to signals involved in memory formation and other cognitive functions. Previous studies have shown that myelin production slows as people age, but whether changes in myelin are linked to age-related changes in cognition remained unknown. However, some animal study evidence suggests changes in myelin may be responsible for cognitive deficits in neurodegenerative diseases.

For this study, the team of NIA scientists gathered data from 123 cognitively unimpaired adults enrolled in the Baltimore Longitudinal Study of Aging and from the Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing study. The researchers tested several different types of cognition and used magnetic resonance imaging (MRI) brain scans to measure myelin content in the brain. They looked at two different MRI-based measurements to estimate the amount of myelin: myelin water fraction (MWF) and longitudinal relaxation rate (R1).

For both measurements, lower myelin was linked to greater cognitive decline over time. Lower myelin, as measured with MWF, was associated with a steeper decline in executive function, which includes skills such as planning, problem-solving, organization, and multitasking. Lower myelin as measured with R1 was associated with a faster decline in verbal fluency, which measures the ability to retrieve information from memory. These findings contribute to a foundation for further studies that explore how age-related changes in myelin are different in people who develop neurodegenerative diseases.

While, overall, this study establishes a meaningful relationship between myelin content and cognition, the authors noted some limitations, mainly that the cohort size was relatively small and included a higher proportion of men and White participants. Future research should reexamine the link in a larger, more diverse study cohort; explore the link between myelin and cognition in people with neurodegenerative diseases; and test whether promoting myelin production could be an effective strategy to prevent disease.