認知症の治療の進歩

抄録

Dementia affects over 46 million people in the world with a rapidly increasing prevalence. The global number of people living with dementia is expected to increase to 130 million in 2050. However, drug development for dementia is difficult. No approved disease–modifying treatment for AD has been established, and novel experimental studies are under investigation for preclinical and prodromal AD, as well as AD dementia. These situations, therefore, resulted in necessity of more sensitive biomarkers and more precise classification of stages of AD. This progress has led to the development of numerous therapeutic strategies in the clinical testing. Immunotherapy against Aβ has been pursued extensively as a therapeutic approach to AD dementia, and several other promising trials are currently ongoing. On the other side, it is estimated that about 30% of dementia cased may be attributable to potentially modifiable risk factors including hypertension. This suggests that interventions targeting these factors could perhaps delay or prevent the onset of dementia.

In 2019, these outcomes including verubecestat, crenezumab which are amyloid–based immunotherapy in patients with AD, acetylcholinesterase inhibitors and memantine which are used for present AD treatments (meta–analysis of randomized controlled trials), and other drugs have been reported. This review overviewed recent advances in these larger clinical researches of treatment for dementia and relation between antihypertensive treatment and dementia.