July 01, 2020

Alzheimer’s and dementia, a growing challenge

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Yesterday was the completion of Alzheimer’s and Brain Awareness Month. Approximately 5.8 million Americans are living with Alzheimer’s disease (AD) right now. Each day, ten thousand people in the baby boomer generation are turning 65, and it is estimated that nearly 500,000 new cases of AD will be diagnosed in the United States per year for the next decade or more. In fact, by 2050 nearly 14 million Americans over age 65 could be living with the disease—with a world total of at least 50 million. We are facing a very distressing, uphill battle.

The science of treating and preventing Alzheimer’s and other memory disorders is still relatively young, and the existing treatments are even younger. None of the pharmacologic treatments currently available slow or stop the damage and destruction of neurons that cause AD symptoms and make the disease fatal. The FDA has approved six drugs, but they only temporarily improve symptoms by increasing the amount neurotransmitters in the brain. In addition to the challenge of fighting the disease, we also have the issue of how to provide quality care for those who are suffering from it. Once in the later stages of the disease, individuals with AD require very attentive caregiving. Right now, that need in America is largely being filled by about 16 million friends and family members of people living with AD. According to a recent study, those unpaid caregivers experience high levels of stress and are more likely to become depressed.

Here at UAB, we are combatting these ominous statistics head-on. Our Alzheimer’s Disease Center (ADC) is actively working to make a difference in the lives of people living with the disease. Dr. Erik Roberson, director of the ADC; Dr. David Geldmacher, clinical core director of the ADC; and other ADC leaders have rapidly grown the center’s impact over the last several years. The center has focused heavily on addressing health disparities in the Deep South. Black/African Americans (B/AA) have historically been very underrepresented in research regarding AD and dementia; nationally, they are represented at under 10%. At the ADC, though, researchers are working with a cohort that is 45% B/AA. Additionally, our researchers’ first racial disparities project uses i2b2 systematically investigate whether there are any racial differences in AD evaluation or treatment, and they are actively working to raise awareness of AD in B/AA communities.

Because of COVID-19, the ADC has had to shift much of their assessment to remote administration. Thankfully, prior to the pandemic, they had already been working for more than two years on an NIH grant that has been developing new online versions of cognitive tests, including a version of the Financial Capacity Instrument developed at UAB to detect when someone is losing their ability to handle money and financial affairs. As for clinical trials, the ADC is currently participating in international trials designed to remove or arrest the spread of two key protein molecules—beta-amyoid and tau—implicated in the origin and progression of AD. Our university participates in the NIH-funded consortia for clinical trials in AD, the Alzheimer's Clinical Trials Consortium (ACTC), as well as the Dominantly Inherited Alzheimer Network Trial (DIAN-TU). Dr. Geldmacher also serves as a member of the Steering Committee for ACTC. Furthermore, the ADC is testing treatments for people with dementia due to AD as well as treatments to prevent the amyloid protein from building up enough to trigger cognitive symptoms, i.e. true prevention. And while they work toward prevention and cure, they are also actively involved in studies to test and evaluate technology-driven approaches to support dementia caregivers through telehealth and apps.

I am extremely proud of the hard work that’s happening on our campus (and remotely) in order to fight AD. Our researchers are driving forward in pursuit of knowledge that will better the lives of people suffering from Alzheimer's and hopefully curb the growing effect this disease has on patients, caregivers, our healthcare system, and much more.