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Is Alzheimer disease a disease?
Amos D Korczyn1, Lea T Grinberg2,3,4
1Departments of Neurology, Physiology and Pharmacology, Tel Aviv University, Tel Aviv, Israel. Amoskor@tauex.tau.ac.il.
Nature Reviews. Neurology
|February 29, 2024
Summary
Alzheimer disease (AD) lacks a cure despite extensive research. Current approaches targeting amyloid-β plaques and tau tangles are insufficient, necessitating multifaceted strategies for this complex syndrome.
Area of Science:
- Neuroscience
- Gerontology
- Pathology
Background:
- Dementia, particularly Alzheimer disease (AD), significantly impacts aging populations.
- AD is characterized by amyloid-β plaques and tau tangles, but their direct toxicity and formation mechanisms remain unclear.
- Current treatments targeting amyloid-β have not halted neurodegeneration, questioning existing therapeutic paradigms.
Purpose of the Study:
- To critically evaluate the progress in understanding and treating Alzheimer disease.
- To explore the complex nature of AD as a syndrome resulting from converging pathogenic pathways.
- To advocate for a shift towards multifaceted therapeutic strategies for AD.
Main Methods:
- Review of existing research on Alzheimer disease pathogenesis, including amyloid-β and tau.
- Analysis of the limitations of current diagnostic and therapeutic approaches.
- Synthesis of evidence supporting AD as a complex syndrome with diverse contributing factors.
Main Results:
- Conclusive evidence for amyloid-β toxicity is lacking.
- Mechanisms of plaque and tangle accumulation are not fully understood.
- Amyloid-β removal has not proven effective in halting neurodegeneration.
Conclusions:
- Alzheimer disease is a complex syndrome, not a single disease, with multiple contributing factors.
- A single 'silver bullet' approach is inadequate for treating AD.
- Simultaneous application of multiple strategies is required for improved recognition, classification, and treatment of AD.
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