Due to the aging population, the prevalence of the disease is high on the island.
Alzheimer’s disease is the most common form of dementia (a syndrome generally of a chronic or progressive nature, characterized by the deterioration of cognitive function). According to the World Health Organization (WHO), it is estimated that this type of dementia represents between 60% and 70% of overall cases.
Alzheimer’s disease – as defined by the Factographic Health Bulletin – causes problems with memory, thinking and behavior. Symptoms almost always develop slowly and worsen over time, until they become so severe that they interfere with daily tasks.
The publication details that this disease is not a normal feature of aging, in that although the most important known risk factor is increasing age, and most people with the disease are over the age of 65.
“While current treatments for Alzheimer’s cannot stop the progression of the disease, they can slow the worsening of symptoms for a time and improve the quality of life for these patients and their caregivers,” he says.
When World Alzheimer’s Day is celebrated, this disease and other dementias are some of the main health problems affecting countries in all regions, including Cuba.
Cuba faces the challenge of being the fourth oldest country in Latin America, and more than 20% of its population is over 60 years of age, precisely the age group most at risk of suffering from Alzheimer’s and other dementias.
According to the 2019 Statistical Yearbook, the mortality rate in the country due to Alzheimer’s disease and other dementias was 5,097 deaths, with a rate of 45.4 per 100,000 inhabitants.
The document illustrates that the prevalence of dementia syndrome was 10.2 % in the population aged 65 years and older, while about 60 to 70 % of the cases corresponded to Alzheimer’s, which is the first cause of disability in older adults and the major contributor to dependence, need for care, economic overload and psychological stress in the caregiver.
However, according to the Bulletin, the country is working on the implementation of a national intervention strategy, in which the participation of all sectors of society is required. Emphasis is placed on reducing the stigma towards dementia, early diagnosis in the area of primary health care, and the defense of the rights of the elderly with cognitive impairment.
NEUROEPO AND OTHER CUBAN HOPES
Faced with the challenge posed by the aging population in our country and the prevalence of Alzheimer’s disease, Cuban science has not lagged behind in the effort to find a solution that at least improves the quality of life of patients.
One of the most relevant is the development of the NeuroEpo molecule, a drug developed by the Center for Molecular Immunology, in collaboration with other BioCubaFarma institutions and the Ministry of Public Health, consisting of a nasal formulation of recombinant human erythropoietin (EPO) with a low content of sialic acid, an isoform similar in composition to natural EPO, which is produced in the central nervous system.
Results in Phase II/III clinical trials, conducted in 174 patients, showed that there is a stop of disease progression and an improvement in cognitive variables in people who received the drug, compared to those who received placebo.
These results allowed the Center for State Control of Medicines, Equipment and Medical Devices to grant, in March of this year, the Conditional Health Registration for the treatment of patients with moderate and mild Alzheimer’s disease.
Currently, work is underway to initiate a Phase III clinical trial, which should begin soon, and which seeks to evaluate the efficacy and safety of this formulation.
For this purpose, NeuralCIM (NeuroEpo’s trade name) will be compared with Donepezil, a drug approved since the 1990s by the U.S. Drug Regulatory Agency; meanwhile, for the first time in Cuba, the patient will undergo a molecular diagnosis for Alzheimer’s disease, not only a clinical one.
Recently, in Geneva, Switzerland, within the framework of the 32nd International Congress of Clinical Neurophysiology, a historic agreement was reached between the International Federation of Clinical Neurophysiology and the Global Brain Consortium, co-directed by Cuban scientist Pedro Valdés-Sosa, head of the Cuban Brain Mapping Project, to develop in the next four years the use of quantitative electroencephalogram for the early diagnosis of Alzheimer’s disease.
Another example of the work of Cuban science to improve dementias, including Alzheimer’s, is the development of the jm-20 product by the Center for Research and Development of Medicines.
This drug, which has been under preclinical research for about ten years, is expected to begin clinical studies in 2023, for the treatment of some dementias, including Alzheimer’s disease.