“My mom was just 59 when she was diagnosed with Alzheimer’s,” said Claudia Durand, 45, of Lafayette, Louisiana.  “At first, I felt mostly shock and denial, then fear kicked in.”

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An avid cyclist who logs 100 miles a week, Durand pedals to end Alzheimer’s by organizing cycling fundraisers for her local chapter of the Alzheimer’s Association. She thinks of her mother often on those rides.

“In the beginning, she was very sweet, and we had some really special times together,” the office manager told LifeZette. “Then she didn’t know me anymore, and that was the hardest part.”

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Despite this legacy, she doesn’t want to get evaluated.

“I worry about it on a daily basis, but I wouldn’t consider being tested,” Durand said. “I’d rather live the rest of my life to the fullest without having that burden weighing me down.”

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Durand’s attitude is understandable. There are no effective drugs at this time to prevent or reverse Alzheimer’s disease. Medications on the market — Aricept, Exelon, Razadyne and Namenda — treat the symptoms of the disease and temporarily slow its progression. Current drugs do not cure Alzheimer’s disease, nor do they address the primary cause of the disease.

For new therapies to work, they must begin as soon as symptoms of dementia appear.

Promising new research is untangling the complex molecular, biological and genetic factors influencing the onset and progression of Alzheimer’s and other dementias. Julie Andersen, a researcher at the prestigious Buck Institute for Research on Aging in Marin County, California, told LifeZette, “Therapies that prevent or halt the progression of Alzheimer’s disease and that stop the underlying cell loss are key.”

“By the time Alzheimer’s symptoms appear, it is already too late,” Andersen said.

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That is why scientists are focusing on early intervention for mild dementia, or even pre-symptomatic dementia, where some of the markers of Alzheimer’s are present in the brain, but cell loss is still minimal.

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Andersen lists three strategies already in the pipeline:

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Active Immunotherapy: Vaccination with antigens create an immune response to proteins that produce amyloid plaques, removing the plaques from the body. Human trials are now in progress and look encouraging.

Passive Immunotherapy: Pre-formed antibodies also bind with amyloid plaques, clearing them from the brain via a different pathway. Other antibodies clear the hallmark Alzheimer’s tangles. Clinical trials are under way for these and other vaccines.

Oral Drug therapy: BASE inhibitors block the initial production of proteins that create amyloid plaques. Clinical trials are expected to be completed in 2019.

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These promising therapies depend on early intervention. Amyloid buildup may precede symptoms by at least 20 years, according to Andersen.

“By the time an individual gets a diagnosis of Alzheimer’s, that person is already way down the path, and the damage to the brain has been done,” she said.

For new therapies to work, they must begin as soon as symptoms of dementia appear, and sometimes before clinical signs of Alzheimer’s are present.

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New diagnostic tools also will be key. For example, a simple test such as those used to diagnose prediabetes would make a world of difference.

“The earlier disease is treated, the better,” Andersen said.

Asked if she would consider getting such a diagnostic test if treatment were available, Durand said, “I’d consider it.” For now, her “I don’t want to know” barrier is understandable, but if good prevention and treatment options were available that might change.

Rodger Landers, 71, works in import-export logistics for the San Francisco Bay area shipping industry. Durand’s second cousin on her father’s side of the family, he also has been deeply affected by Alzheimer’s disease.

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As for whether he would get evaluated early for Alzheimer’s, he told LifeZette, “I would be a nervous wreck over what I might hear.”

“Still,” he said, “if I knew there was treatment to control the disease if I tested positive, I would be open to it.”

Matthew Norton, head of policy at Alzheimer’s Research in the UK, is optimistic about some treatments presently in clinical trials.

“In the meantime, efforts to improve public health and help people understand how to reduce their risk of dementia will also be important,“ he said.

“Although we don’t currently have a sure-fire way of preventing dementia, people can lower their risk by eating a healthy, balanced diet, taking regular exercise, not smoking or drinking to excess, and keeping blood pressure, cholesterol and weight in check.”