Prevention is the activity which reduces the burden of mortality or morbidity from disease, and can be primary, secondary, or tertiary depending at what point it is introduced in the disease process. • Primary: prevents the clinical development of disease. Health promotion activities are primary prevention, and in AD take the form of lifestyle interventions and disease modifying drugs to prevent clinical onset of cognitive impairment and dementia. • Secondary: seeks to slow the progression of disease in its earliest stages. In AD, researchers are seeking drugs to prevent or halt the progression of disease while individuals are still functional. • Tertiary: decreases the harmful consequences of an established disease by restoring function and reducing disease-related complications. In AD, care management is employed to ameliorate complications such as functional impairment, pneumonia, and other infections.
Mary Sano, PhD
Mount Sinai Medical Center
New York, NY
Effect of High-Dose Supplements on Blood Homocyteine in Alzheimer’s Disease
Award: $178,801
Duration: 2000 – 2001
See an abstractEffect of High-Dose Supplements on Blood Homocysteine in Alzheimer\'s Disease Investigator(s): Mary Sano, PhD, Paul S. Aisen, MD and Ramon Diaz-Arrastia, MD, PhD Institution(s): Columbia University, New York, NY, Georgetown University, Washington D.C. and the University of Texas, TX
Duration: 2000 – 2001
Summary:
Homocysteine is a known risk factor in the development of vascular diseases such as heart attack and stroke. More recently, homocysteine has been identified as a possible risk factor for Alzheimer’s disease. Levels of homocysteine are elevated in AD patients compared to aged match controls and can be reduced by administration of high doses of three vitamins; folate, vitamin B12, and vitamin B6. This suggests that nutritional supplements may be of benefit in AD, but clinical evidence to support this observation is lacking. However, in the U.S., supplementation already occurs in many food products, and it is not known if additional vitamins will provide additional benefit by lowering homocysteine. Dr. Sano and colleagues propose to carry out a pilot 8-week clinical study in 80 AD patients to determine if folate, vitamin B12, and vitamin B6 can decrease homocysteine levels. Cognitive improvement will also be evaluated as a secondary outcome. The results of this study will be used to plan a larger trial to determine if use these nutritional supplements have a clinical benefit in AD.
Thomas T. Perls, MD
Boston University School of Medicine
Identifying Genes Predisposing to Successful Cognitive Aging
Award: $522,132
Duration: 1999 – 2002
See an abstractIdentifying Genes Predisposing To Successful Cognitive Aging Investigator(s): Thomas Perls, MD, MPH, Assistant Professor of Medicine Institution(s): Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
Duration: 1999 – 2002
Summary:
These investigators are studying a unique cohort of families with multiple cognitively intact centenarians. Evidence suggests that genes may play a role in this survival advantage. This research will focus on identifying the genes that may contribute to the ability to live to at least one\'s mid-nineties cognitively intact. Discovery of these genes could ultimately lead to promising targets for drug discovery.
John P. Blass, MD, PhD
Burke Medical Research Institute
White Plains, NY
Nutritional Treatment for AD
Award: $100,250
Duration: 1999 – 2000
See an abstractA Nutritional Treatment for Alzheimer\'s Disease: Clinical and Experimental Studies Investigator(s): John Blass, MD, PhD, Director Institution(s): Dementia Research Service, Burke Medical Research Institute and Cornell University Medical College, New York, NY
Duration: 1999 – 2000
Summary:
Dr. Blass\'s hypothesis is that disorders of energy metabolism are involved in neuronal death in Alzheimer’s disease. His work has shown a deficiency in a key energy metabolism enzyme (alpha ketoglutarate dehydrogenase) in brain cells of AD patients. Dr. Blass will investigate whether a new nutritional supplement can help treat this energy deficit.
Robert P. Friedland, MD
Case Western Reserve University School of Medicine
Cleveland, OH
Genetic and Environmental Risk Factors for Alzheimer’s Disease in Israeli Arabs
Award: $50,000
Duration: 1999 – 2000
See an abstractGenetic and Environmental Risk Factors for Alzheimer\'s Disease in Israeli Arabs Investigator(s): Robert P. Friedland, M.D., Chief, Laboratory of Neurogeriatrics and Amos Korczyn, M.D., Chief of Neurology, Tel Aviv University, Israel Institution(s): Case Western Reserve University, Cleveland, OH and Tel Aviv University, Tel Aviv, Israel
Duration: 1999 – 2000
Summary:
These investigators have discovered there is a very high prevalence of Alzheimer\'s disease in Israeli Arabs. The grant proposes to identify gene(s) and/or environmental factors that may be involved. This work represents a unique collaboration of U.S., Israeli Jewish, and Israeli Arab investigators. The work may lead to the discovery of new genes that cause AD and could lead new treatment strategies for AD. The National Institute on Aging is co-funding this program with the Institute.