But I wouldn't say it was surprising. ” He'd been expected t0 have Alzheimer's long before death, and saymg prevention has a better shOt Of success than I haven t yet, says Blackerby, 82 , a retired technical writer whose mother died from the disease, as did treatment for years. Another leading prevention proponent is Dr. Paul her three siblings. "lf l'm going to have it, I want to AISen , a neurologistvvho¯difeets-th€Älzheimer's e lnvolved ⅲー the study to try to keepothers,e The rapeutic Re se arch lnstitute at the Unive rsity Of cially my descendants, from having to go through the hell l've seen family members go through ・ Southern California. ln 2014 , Aisen teamed up with Sperling for a 1,150-person trial called A4. Short for Last December, Blackerby drove more than 100 miles from his home in southern Oklahoma to the Anti Amyloid Treatment in Asymptomatic Alzhei- mer's, A4 tests solanezumab for prevention. The University Of Texas Southwestern Medical Center drug iS given tO semors WhO have no signs ofdemen- in Dallas to receive his first infusion. He will make this same four-hour round-trip trek every month for tia but d0 have elevated amyloid levels, as measured by a PET scan ofthe brain. lt is looking for changes the next three years. over a 39-month periOd in cognitive function, self- For Don, a retired insurance agent, the motiva- c are abilitie s, brain tissue he alth and Othe r indic ators tion tO participate in A4 was his partner, Fran. He first noticed her Alzheimer's four years ago when he arrived at her house expectmg a dinner ofmeat stew, only t0 find a ne ar- empty pot. "She had remembered the onions, ” he recalls. "But she had forgotten everything else ・ Don (who asked that his last name not be used because he didn't want tO come across as self-promotional) tried to enroll Fran in A4, but her disease was t00 far advanced. Only he was eligible—a PET scan showed he had the hallmark amyloid logjam in his brain. He started gettlng infusions last fall at Brigham and Women s Hospital in BOSton. On a rainy day in late Novem- ber, Don, with a plaid-blue shirt sleeve rolled up past the elbow and an IV catheter in his right arm, remmisced about meeting Fran mne ye ars ago at a single S dance at Vincent's Nightclub EXPENSIVE in the suburbs south Of Boston. FAILURE: He's mild-mannered and surprisingly youthful for of Alzheimer's. "we still need to find out what the About 5.4 million Amer- benefits and risks are ' in patients not yet showing a 76-year-01d, gray-haired grandfather who raised icans suffer symptoms, Aisen says. SiX children on hiS own after hiS Wife died in a car from AIzhei- ー第 e 「 ' S. け no The trial asks a lot of its participants. A4 subjects crash 33 years ago. He beams when he talks about therapies are must be willing tO come tO a hospital once a month Fran retaining her sense Of humor and ability tO found soon, that number for more than three years tO recelve infusions con- play tennis, but he turns solemn when he describes is expected tO an unproven medicine for a disease they hOW it tOOk four tries tO explain tO her why he was triple by 2050 , don't have and might not get. There's no guarantee going t0 the hospital today. "She knows," he says at which point the cost of 0f benefit or even safety. And the trial is not partic- "but she forgets ・ care could top larly remunerative. Some participants can receive while .he's talking, a nurse comes tO deliver the $ 2 trillio up t0 $ 2 , 480 ifthey complete all the study protocols, saline flush that always follows Don s infusion. She including tW0 PET scans, four MRI scans, tW0 spinal introduces herself, although Don recognizes her from a prevlous visit. I can't forget your face, ” he taps and 42 infusion visits. But many dO not get any t01d you, You 100k just like mycousin ・ ' compensatlon, un ess you coun par lng validation. The amyloid in Don's brain has clearly not None of that dissuaded Jerry BIackerby from taking part in A4. "With my family history, I have impaired his memory, but it's there. And perhaps S01 0 (Z) dV 乙 0 コ > NVAA NEWSWEEK 31 02 / 24 / 2017

THE ANNOUNCEMENT came the day before Thanks- giving, but there was nothing in it t0 be thankful for: An exp erime ntal Alzheimer 's drug many thought would slow the disease s steady cognitive decline had failed tO make a significant difference ⅲ a masslve trial ofpeople with early signs ofthe illness. Marty ReiSW1g took the news hard. "I was Just sad," he says. "I was really hopeful that it would be life-changing for us. ” ReiSW1g doesn't have Alzhei- mer's disease—he's a 38-year-old real estate agent in good health. But he is part 0fa large extended family that's been afficte d by Alzheimer's for generations. His Uncle Roy died 0f the disease. SO did Grandpa Ralph. EIeven gre at-aunts and gre at-uncles. D ozens ofcousins. And now, Reismg says, 。 I ve got a 64-year- 01d father who's almost dead ofAlzheimer s. His family is one ofaround 500 in the world with a genetic mutation that means its carners will develop Alzheimer's at a much younger age than those with- out the mutation, for whom the age Of onset is typi- cally about 80. For the Reisw1gs, those with the gene become sick around their 50th birthday. Other high- risk familie s c an start showlng symptoms as e arly as their 1 id -30S or, ln some cases, their late 20S. Reiswig decided not tO learn his own gene status— there's a 50 ー 50 chance he inherited his father's 信 ul 収 DNA, and he prefers livingwith the uncertainty. HOW- ever, he isn't just idly waitlng tO me et his fate. Three ye ars ago, he signed up for an innovative drug study that could alter his family's genetic destiny. Once a month, a nurse comes tO hiS home,mserts a needle in his arm and watches as a bag 血Ⅱ ofliqtud slowly drips intO his bloodstream. As with most trials designed tO te st whether an experimental drug works—even for diseases that are akin t0 de ath sentence s—Reismg might be gettmg a placebo. But there 's also a chance his monthly ⅲ血 - sions include a drug that could stop him, his family members and others like them from losing loved ones t0 Alzheimer's. Or, at the very least, delay the disease long enough t0 give them many more good years, genetics be damned. The key is early intervention, before symptoms are evident and brain damage is t00 extensive. "That's how you stop the disease, says Rudy Tanzi, director Of the Genetics and Aging Research Unit at Massa- chusetts General Hospital. “ You don't wait. P U S H B A C K T H E 0 N S し A U G H T 0 THIS AGGRESSIVE attempt tO prevent Alzheimer S rather than treating it is the most exciting new devel- opment in decades, as well as a radical departure for researchers and the pharmaceutical industry. Tradi- tionally, drug companies have tested their therapies on patients whO already have memory IOSS, trouble thinking and Other signs ofdementia. lt's been a 10S - ing tactic: More than 99 percent 0f all Alzheimer s drugs have failed tests in the clinic, and the few that have made it tO the market only ameliorate some symptoms. NOt a single medicine has been shown tO slow the relentless progression Ofthe disease. But with this new approach, even partial success— an appreciable slowing 0f brain dege neration— could have a big impact, says Dr. Reisa Sperling, a neurologist whO directs the Center for Alzheimer s Re s e arch and Tre atme nt at B 0 ston's Brigham and Women's Hospital. If a drug therapy can push back the onslaught of dementia by five or 10 years, she says, many more people would die 0f ballroom dancing instead Ofin nursing homes. lt's a strategy being te ste d in five big clinic al tri- als that collectively will cost anywhere from $ 500 million t0 a whopping $ 1 billion. But prevention More than 99 percent of all Alzheimer's Prevention, a coalition Of leading lnitiative and co-chair Of the Collaboration for utive director Of the F-Prime Biomedical Research designing better trials, says Stacie Weninger, exec- made huge progress" in learning from mistakes and because we see failure after failure, but we have while gamble. "lt sometimes doesn't feel like it, advocates are confident these studies are a worth- in the CliniC. Alzheimer's dmgs have failed tests NEWSWEEK 26 02 / 24 / 2017