Breaking new ground in the battle against Alzheimer's

Timing is everything

Alzheimer's research is largely focused on prevention, early diagnosis, and treatment to slow its progression. Thanks to a number of scientific advances, many of them made at Brown, researchers can now detect changes in the brain years before memory loss occurs. These discoveries set the stage for even more impactful research, and that is what Brown hopes to do at the Center for Alzheimer’s Disease Research.

“Brown is in such an amazing situation right now with a tremendous infusion of resources and a focus on trying to protect the brain and allow for healthy brain aging,” says Karen Furie '87 MD'90 RES'94 F'95, P'19 MD'23, chair of neurology at The Warren Alpert Medical School and the Samuel I. Kennison, M.D., and Bertha S. Kennison Professor of Clinical Neuroscience. “One of the most frightening things patients tell us repeatedly is that they're afraid they're going to lose their capacity to think, to read, to make decisions, to be independent. It's more frightening than something like a heart attack. Being able to leverage the incredible brain power and research infrastructure that Brown affords gives us such a head start in trying to make a difference in this truly frightening disorder.”

Over the past few years, the National Institutes of Health has dramatically increased funding for Alzheimer's research because they recognize the magnitude of the problem. One of their initiatives is to involve people from other fields who haven't been working on Alzheimer's but have a technique that could be applicable to the problem. Providing funding for that type of transition and translation is really smart, says Salloway.

“That's going to accelerate the field and provide incentive for more people to work on drug discovery and development for Alzheimer's.” One of the things Salloway is excited about is the potential the center has to bring people together for that purpose.

When the center launched, there were already more than 60 faculty working on Alzheimer's disease at Brown. From brain scientists to computer scientists and from engineers to neurologists, the center provides new opportunities for partnership and entrepreneurship by connecting The Warren Alpert Medical School, the Carney Institute for Brain Science, the Memory and Aging Program at Butler Hospital, and the Alzheimer's Disease & Memory Disorders Center at Rhode Island Hospital.

“Science tends to be incremental, and you need a critical mass,” says Salloway. “You have one advance and then someone else uses that in their experiment and creates a new advance, and it keeps building. I think we're really breaking new ground, and Brown is in a position to be a pioneer in Alzheimer's research.”

Another great reason to strengthen Brown’s efforts in Alzheimer’s is recent advances in the field, one being personalized medicine. “We now have the tools to detect who's at risk and what stage they are at in their brain, which we didn't have before,” says Salloway. “And then hopefully we can institute treatments that target just that pathology for that specific person — rather than giving sort of a blanket treatment for everyone.”

Dr. Furie believes Brown has the right people and right perspective to radically change how Alzheimer's patients are diagnosed and managed, and that gives her an incredible amount of optimism.

“I suspect that we will make the greatest advances in patients who already have cognitive dysfunction and are already diagnosed with Alzheimer's disease,” she says. “But that's just the first step.”

After making those strides, she says, it will be critical to go back and identify the earliest signal of potential risk and try to intervene before patients become symptomatic.

“When I trained several decades ago, we didn't have very much to offer patients who came in with acute neurological injuries or chronic degenerative processes. Now we have a whole armamentarium of diagnostic tools that didn't exist.”

And from a research perspective, she says, we're gaining an amazing amount of information about brain function, brain recovery and understanding, and physiologic processes that regulate brain function and brain repair. “I'm very confident that we're going to change the trajectory of Alzheimer's disease.”

Join the fight, reduce your risk

Diane Lipscombe, director of the Center for Alzheimer’s Disease Research at Brown, describes the brain as the most complex of the organs in our bodies, but says it’s important to understand some of the biggest predictors of Alzheimer's, like diabetes and uncontrolled high blood pressure.

“The cardiovascular system is critically important when you're thinking about finding ways to prevent Alzheimer's disease, as is the immune system and infections,” says Lipscombe, who serves as the Thomas J. Watson, Sr. Professor of Science and the Reliance Dhirubhai Ambani Director of the Robert J. and Nancy D. Carney Institute for Brain Science. “You can't think about brain function without thinking about all of these complex interactions…and the need to feed and oxygenate the brain.”

The rate of Alzheimer's is expected to triple as the population ages, which means there will be 150 million people worldwide with Alzheimer's by 2050. There is some good news, though. About 40% of the risk for Alzheimer's might be modifiable through lifestyle changes, like following a Mediterranean-type diet, taking care of your risk for cardiovascular diseases (like high blood pressure, cholesterol and diabetes), not smoking, and getting enough sleep. Staying physically active, engaging with other people, and doing stimulating activities for your brain helps, too.

These types of modifications are being studied in a new trial, and Brown is one of five sites in the U.S. to participate. Investigators are exploring whether a healthy lifestyle can promote brain health and delay memory loss or improve memory.

“We also have an Alzheimer’s Prevention Registry that has grown to nearly 5,000 people,” says Salloway. “It is an opportunity for people to find out what research is going on that they may be interested in or eligible to participate in. That citizen science is really important, and it’s a great way for people to come together to advance the fight against Alzheimer's.”

Future growth

As Brown continues to broaden its expertise in Alzheimer's disease, there are a few critical areas at the top of the list. One of them is big data. Brown already has outstanding leadership and faculty within the Brown Center for Biomedical Informatics. Adding an expert who is specifically focused on big data related to Alzheimer's disease will enable the use of machine learning to develop an algorithm that detects who is at risk, allowing clinicians to be much more efficient about screening, according to Salloway.

Another key action will be recruiting experts to study the role inflammation plays in Alzheimer's and other neurodegenerative diseases. Researchers want to know how immune cells get into the brain and how to regulate them, says Salloway, but he notes that it's tricky to enhance the good response to clear out the debris, while turning off what causes a toxic response and actually makes the problem worse. The science of this is very sophisticated, he says, requiring experts specifically focused on this type of neuro-immunology.

Salloway notes that the center is also committed to studying the differences in diagnosis and care among diverse community groups.

“Alzheimer's actually affects people of color at a much higher rate, and we don't understand that very well,” says Salloway, noting that drug trials usually don't involve a high percentage of participants from underrepresented groups, which is an issue that needs to be addressed.

Brown has made a major commitment to Alzheimer's disease with this new center, and Lipscombe says that makes all the difference.

“There is this incredible urgency that we all feel,” says Lipscombe. “Five years ago, a number of my colleagues weren't working in the area of Alzheimer's disease and now they are because of the resources available.”

Salloway concurs. “I think it is a transformative moment,” he says. “Alzheimer's affects so many families, so any advances researchers make will improve matters for generations to come.”

For more information about how to Alzheimer’s disease research, please contact:

Cailie Burns
Assistant Dean for Biomedical Advancement
+1 (401) 368-8155
cailie_burns@brown.edu