The curse of longevity

Albert Wettstein says a vaccine for Alzheimer's is at least ten years away Keystone Archive

A third of people over 85 suffer from Alzheimer’s in Switzerland, and cases of dementia among the elderly are rising steadily.

Efforts to treat the disease have accelerated, spurred on by an ageing population. But Alzheimer’s expert Albert Wettstein told swissinfo that a cure remains a long way off.

Hundreds of medical experts were meeting in Philadelphia this weekend to discuss the disease at the international Alzheimer’s conference.

Alzheimer’s destroys nerve cells in the brain, leading to memory loss and dementia. Sufferers generally live for a decade or more after the onset of the disease.

The emotional toll on families is huge: those afflicted forget their closest relatives, and gradually become more and more helpless, and requiring 24-hour care.

Wettstein, who is in charge of Zurich’s medical service, says that despite years of research and massive investment, no effective treatment has yet been developed for the disease.

swissinfo: Why is the incidence of Alzheimer’s increasing so rapidly?

Albert Wettstein: It’s because – fortunately – we are living longer, so more people are reaching ages when the disease starts to become a problem.

swissinfo: So it is not actually spreading?

A.W.: Absolutely not; quite the contrary. The disease may actually be declining because better awareness and control of blood pressure and cholesterol reduces damage to the brain, which in turn reduces cases of dementia.

swissinfo: Better diagnosis may also have led to more cases of the disease coming to light?

A.W.: The name we give the disease has changed over the time, but it is still the same illness that Homer was writing about 800 years before Christ.

swissinfo: Some of the best brains in research are meeting at the Alzheimer’s conference in Philadelphia. Can we expect anything significant?

A.W.: There are two burning issues, so to speak. A study in England revealed that advances in the treatment of Alzheimer’s patients were not nearly as promising as was thought. This gave the entire research community pause for thought.

The treatments currently available were thought to delay the development of the disease significantly. However, the study – which was conducted by the [British] National Health Service, and had nothing to do with the pharmaceutical industry – showed that over a period of two years, the delay was effective for only three months. This is not a significant improvement.

swissinfo: That must have been a grave disappointment?

A.W.: The experts knew that already. It was a step forward – previously there was no effective treatment at all – but we always knew that the improvement was fairly modest. It hardly helps in making life better for sufferers and their families, who must care for them at home.

swissinfo: You mentioned a second “burning issue” at the Philadelphia conference?

A.W.: It is possible that we will see some progress in strategies to significantly slow the development of Alzheimer’s. There are two studies being presented at the conference which examine how dementia can be retarded by medication.

We should not be too hopeful of a breakthrough, though.

swissinfo: There are high hopes for an Alzheimer’s “vaccine” being developed at the University of Zurich. Are these justified?

A.W.: A vaccine would undoubtedly be an ideal and elegant solution. A few inoculations, and one’s immune system would – like that of a mouse in a laboratory – produce the appropriate antibodies to destroy the unwanted Alzheimer’s proteins.

This procedure worked in tests where the development of the tests was arrested, so the results are encouraging. The severe side effects were a problem: these affected eight per cent of those involved in the tests, but 92 per cent were unaffected.

More work is needed on a potential vaccine to reduce these complications.

swissinfo: How long is this likely to take?

A.W.: It will still be at least ten years before real progress is achieved with a vaccine. At the moment, there are no medications, which have a significant effect on treating the disease.

But there is an enormous amount of research and money being invested into this disease, and that will continue. So one is always optimistic that an effective treatment will be found.

swissinfo: What challenge does Alzheimer’s pose for our ageing society?

A.W.: It is the primary reason why elderly people become dependent on care in their later years. It is also the most feared disease facing the elderly. And as a consequence is one reason why growing old is seen in a negative way.

Alzheimer’s has an extremely powerful influence on our society: it has implications for the state pension system, and the funding of care for the elderly.

It is also very important that the relatives of people with Alzheimer’s receive advice and support to help them cope with the burden of caring. A key issue at the Philadelphia conference is also to explore non-medical ways of making life easier for sufferers and their families.

Research shows that special training for patients and their relatives – explaining what the disease is and how to properly react to the symptoms – helps both to cope.

swissinfo-interview: Katrin Holenstein

Key facts

90,000 people in Switzerland suffer from dementia.
Wettstein expects that number to rise to 120,000 in 20 years.
Up to 8% of people over 65 are affected by the disease, and that rises to 30% of those over 85.
Three out of five Alzheimer’s sufferers lives at home.

In brief

Alzheimer’s is the most common form of dementia, which is defined as the loss of acquired intellectual abilities, particularly memory.

The disease was first described by the German physician, Alois Alzheimer (1864-1915) in 1906.

The causes of Alzheimer’s are not known. Age is the most important known risk factor.