World Alzheimer’s Month 2023

Alzheimer’s disease (AD) is a global public health issue; it is currently the 7th leading cause of mortality worldwide and a major cause of disability [1-3].

Worldwide, 87 million people are living with early AD and 32 million with mild, moderate or severe forms of AD dementia [4]. The global prevalence of dementia (of which AD accounts for 60–80%) [1] is predicted to triple by 2050, primarily due to population aging [5].

AD is characterised by the presence of amyloid beta plaques, tau tangles and neuroinflammation in the brain [6,7]. These cause loss of neuron function and synaptic failure, resulting in a progressive decline in a person’s memory and thinking skills (dementia) over time, changing a person’s behaviours and personality, and eventually leaving people unable to carry out relatively simple tasks unassisted. At later stages, people with AD become confused, unable to communicate and are completely dependent on others for care [8].

Symptoms can start to impact people with AD decades before diagnosis, most commonly memory issues, which can be incorrectly attributed to normal aging [8]. By the time many people with AD see a physician, they have mild cognitive impairment (MCI). For people with MCI due to AD, progression to dementia is inevitable.

The burden of care on partners, and other family members, of people with AD is greater than for most other chronic diseases [9]. AD impacts on the daily life, work productivity, emotional health, and overall quality of life of care partners and family members. Care partners of people with AD exhibit high levels of stress, depression and anxiety, and burden increases with increasing AD severity [10].

At present there is no cure for AD. Historically management has been limited to symptomatic treatments with temporary benefit, and no effect on long-term outcomes. However, the past few years have seen the development of disease-modifying treatments (DMTs) that modify AD progression. Most recently, lecanemab was granted accelerated approval by the FDA [11] and accepted for review by the EMA, [12] and donanemab has hit the headlines due to the positive results of phase 3 studies [13]. Both of these anti-amyloid immunotherapies have been shown to slow cognitive decline in people with MCI and mild AD-related dementia. Clinical trials looking at other potential DMTs and investigating multiple aspects of disease mechanism are ongoing. While not a cure, DMTs would allow people with AD to maintain a higher quality of life for longer, relieving burden from them, their care partners and the healthcare system.

HEOR are supporting activities to demonstrate unmet need in the treatment of early AD. Our project team has gained a deep appreciation for the true scale of the problem, and we are committed to playing our part in getting new treatments to people with AD, sooner. Like our clients, we want to see a world where AD is a manageable condition, and where people with AD can thrive into their later years.