A consortium of academic medical centers will receive $55 million over the next five years to research early stage Alzheimer's treatments and examine medication to reduce agitation for people with Alzheimer's dementia, the National Institutes of Health Institute on Aging announced Monday.
The Alzheimer's Disease Cooperative Study, set up by NIH in 1991, is the national consortium of medical centers and clinics that will receive $11 million in fiscal year 2013, as the first of a five-year project. The current series of studies will test drug and exercise interventions for people with early stage Alzheimer's, examine medication to cut agitation in existing patients and test new approches to speed up clinical drug testing.
Four studies will be made possible in the first year's funding award.
The University of Washington Alzheimer's Disease Research Center in Seattle will study the use of a generic drug, prazosin, to determine if it can be effective in the treatment of agitation. Disruptive behavior and agitation are often chronic problems for people with Alzheimers and increase their distress. In addition, it can be particularly hard on caregivers, often the spouses or children of the patient. The agitation and its burden on caregivers often leads to long-term care outside the home, according to NIH.
Current drugs to treat agitation have been generally ineffective and may increase the risk of stroke or excessive sedation. The ADCS will test prazosin as a treatment for agitation that may be useful for frail and elderly people, according to NIH.
A second study, by Wake Forest University researchers, will test the value of supervised aerobic exercise can influence cognitive decline and slow brain atrophy or mitigate Alzheimer's pathology in older adults with mild dementia symptoms. Exercise is widely recommended to maintain physical function and reduce risk in a number of age-related conditions such as diabetes and heart disease. The researchers will recruit sedentary older volunteers to participate in a year-long randomized study to determine if high-intensity aerobic exercise and stretching will help.
At Harvard Medical School another group will investigate the amyloid protein fragments that develop plaques in the brain and are a key feature of Alzheimer's disease. No clinical trial of drugs to stop the build-up of amyloids has been successful in people with mild to moderate Alzheimer's. The Harvard study will move to people who do not yet show signs of Alzheimer's disease to test 1,000 symptom-free older volunteers who have brain images that show abnormal levels of amyloid accumulation.
This is an effort to see if build-up of the plaque can be stopped or slowed earlier in the disease progression.
And lastly, an Indiana University Alzheimer's Disease Center in Indianapolis, will test potential new drug therapies that target disease pathways. Scientists will use cerebrospinal fluid and blood plasma biomarkers to track the relationship between blood levels and central nervous system effects. This will be used to track levels of several Alzheimer's-related proteins to help researchers understand how drugs influence the disease. This will aid in selecting which new drugs warrant more clinical study.
"With this newly funded work, the goal is to expand the range of individuals participating in ADCS clinical trials from those at risk for the disorder to those with Alzheimer's dementia, so that the full spectrum of the disease is represented," said Laurie Ryan, the Alzheimer's disease clinical trials program director.