Vast inequalities persist in who gets treatment for Alzheimer's disease, which affects more than six million Americans, but a new drug that can slow progression of the disease is fueling some hope for change.
Research from the National Institute of Health shows that Black and Hispanic patients face a higher tendency to receive delayed or inadequate care for Alzheimer's. Dr. Alvaro Pascual-Leone, a neurology professor at Harvard and senior scientist at the Hinda and Arthur Marcus Institute for Aging, said that can lead to worse outcomes for the patient.
"I think one of the issues that affect particularly Black and Hispanic individuals is that — I'm Hispanic, and so I draw from my own cultural background — I think we tend to feel particularly shy about coming out with concerns of cognition," he said. "Therefore, it is one of those situations where oftentimes people voice their concerns too late."
With a 10-year average patient delay in receiving an Alzheimer's diagnosis, Pascual-Leone points out that waiting for patients to notice an issue and then seek care is an innefective strategy.
"What we need to do is change the way we approach dementia care," said Pascual-Leone, who is also the co-founder and chief medical officer of Linus Health, a medical company makes a screening tool/platform that detects early signs of Alzheimer’s.
In order to address these shortcomings in Alzhiemer's care, Pascual-Leone says healthcare providers need to be more proactive in reaching patients for preventative screenings and early treatment options.
Earlier this month, a major medical breakthrough was announced when the drug Leqembi became the first to gain approval from the Food and Drug Administration for slowing the progression of Alzheimer's disease. The drug, which was developed in part by Cambridge-based pharmaceutical company Biogen, is a major first step to further treatments for Alzheimer's, which affects more than six million Americans.
"For the first time, we have a medication that is truly a disease-modifying drug," Pascual-Leone said.
"98% of patients with mild cognitive impairment ... are thought to be undiagnosed," he added." Yet, it is at that stage that medications and interventions like Leqembi would be particularly effective. So we need a yearly checkup of our brain that considers these kind of issues in the appropriately aged population."
Leqembi has been shown to slow down the progression of Alzheimer's by about 30%, potentially delaying some of the disease's most debilitating sympotoms by months.
"We can debate whether 30% slowing down of the disease is a lot or is a little," said Pascual-Leone, "but the reality is that at an individual level for individual patients, having an additional three months, an additional six months, an additional any amount of time of being themselves to pursue the things that matter to them, to be at their grandchildren's graduation or at their granddaughter's wedding, can make a very big difference."
