The Latest in Alzheimer’s Disease Research from AAIC18

At the end of July, 23 faculty and junior investigators from our Center traveled to Chicago to attend the 2018 Alzheimer’s Association International Conference (AAIC18) – the world’s largest conference focused on Alzheimer’s and dementia research. Many new research findings are announced at this venue.

Following the conference, Dr. Bruno Giordani, Associate Director of the Center, traveled the state to share the latest research findings announced at AAIC18. Now, we’re here to share those key findings with you!

Key takeaways include:

• The use of virtual reality in training students. This program, called “Bringing Art to Life” hopes to expand awareness about the reality for patients with the disease, and will be an ongoing project with medical and pharmacy students.
• A few medications showed some promise, including: Aducanumab and BAN2401.
  • Aducanumab is an antibody-based treatment that aims to break apart the beta amyloid plaques. The first late-stage study showed promise in removing amyloid after 12 months.
  • BAN2401, another anti-amyloid compound, was shown to lower levels of beta amyloid accumulation in the brain and slow cognitive decline after 18 months of treatment.
• Other antibody-based treatment studies are ongoing, including Crenezumab and Gantenerumab.
• Some pre-symptomatic treatment trials are also under way, including:
  • Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease Treatment Trial
  • Anti-Amyloid Treatment of Asymptomatic Alzheimer’s Disease (A4)
  • Dominantly Inherited Alzheimer’s Network Therapeutic Trial Unit (DIAN-TU)
  • Alzheimer’s Prevention Initiative APOE4 Treatment Trial
  • TOMMORROW Study
• Research is also exploring the use of antibodies to stop tau from spreading.
• Efforts are under way to incorporate precision medicine (similar to cancer treatment) into Alzheimer’s medical care. Precision medicine optimizes medical care for particular groups of patients, especially by using genetic or molecular profiling.
• There was a particular research focus on special populations, including the LGBT, Oldest Old, and early-onset populations.
  • The LGBT community faces similar health concerns as the general public, but LGB with dementia face unique challenges, including: discrimination, twice as likely to age without a spouse or partner, twice as likely to live alone, and 3-4x less likely to have children who could support them as they age.
  • The ‘conventional wisdom’ in the Oldest Old population was that ‘If you reach age 90+ without dementia, you’re unlikely to get it.’ After studying over 4,100 persons, aged 95-110 in 11 countries, this wisdom is no longer sound.
  • A study comparing survival time for persons with early-onset (less than 65) versus late-onset (over 65) dementia found that, despite early-onset patients being younger, and perhaps physically ‘healthier,’ early-onset and late-onset patients had a similar disease survival time (~ six years).
• Research also explored factors that may contribute to women’s higher risk of developing Alzheimer’s, including:
  • Reproductive history: Having 3 or more children, fewer miscarriages, menstrual periods at a younger age, and later age of menopause are all associated with lower dementia risk.
  • Pregnancy: More months in pregnancy is linked to lower dementia risk, although the reasons for this beyond estrogren exposure remain unknown.
  • Language skills: Women have an advantage in verbal memory which may mask early signs of Alzheimer’s disease. This point underscores the need for better clinical evaluation of Alzheimer’s beyond verbal tests to improve detection in women.
• Lifestyle factors continue to surface as key ties to Alzheimer’s disease. Two primary findings discussed at AAIC18 include high blood pressure and gut health.
  • The SPRINT MIND study showed significant reduction in the risk of Mild Cognitive Impairment (a known precursor to dementia) when systolic blood pressure was intensively lowered to < 120 mm HG.
  • Multiple studies investigated how the digestive system may influence changes in the brain, including:
    • Plasmalogens, a class of lipids, may be tied to increased risk of Alzheimer’s disease by reducing key lipids that the brain needs.
    • High levels of bile acids (synthesized from cholesterol in the liver) correlate with increased tau and decreased brain volume and brain glucose metabolism.
    • Several key genes tied to Alzheimer’s disease risk are also tied to decreased levels of cholesterol components important for the health and repair of brain cell membranes.

For a full list of the research discussed at AAIC18, visit the conference press page here.