With an estimated 5.5 million Americans now living with Alzheimer’s disease, Dr. Brian R. Ott, director of Rhode Island Hospital’s memory-disorder center, and Lori Daiello, the center’s research scientist and clinical research administrator, are on a mission.
“It’s been estimated,” said Ott, director of the Alzheimer’s Disease & Memory Disorder Center, “that if we can delay the disease by five years, we can reduce the prevalence by almost 50 percent. That’s a reasonable goal.” The Alzheimer’s Association estimates approximately 23,000 Rhode Islanders have the disease.
Positron Emission Tomography scans now allow researchers to examine the brains of living patients in clinical trials to identify the presence of proteins that interfere with normal brain functioning as they accumulate in the brain.
With such information, patients can receive treatment early, even before symptoms appear, said Ott. Earlier, researchers were limited to studying post-mortem patients’ brains to evaluate the presence of such proteins.
Among the multisite Alzheimer’s trials that Ott’s team is involved in is one taking a new approach. Unlike other studies, which address the damage amyloid proteins do to an aging brain, this study is evaluating whether an immunotherapy will attach to tau proteins and prevent their spread.
As RIH’s principal investigator for Alzheimer’s trials, Ott and his team are recruiting volunteers with early Alzheimer’s for this trial. Of this immunotherapy, Ott said, “These [tau] tangles … are more closely associated with symptoms of dementia than amyloid plaques … this may be the better target for people with Alzheimer’s symptoms recently diagnosed.”
RIH is also a site for the international Anti-Amyloid in Asymptomatic Alzheimer’s study, perhaps the largest Alzheimer’s trial to date. It evaluates whether intravenous injections of antibodies against amyloid proteins could slow Alzheimer’s onset in cognitively normal individuals whose brains show some amyloid accumulation.
Ott, a neurology professor at The Warren Alpert Medical School of Brown University, has seen remarkable progress since he came to the state in 1989 to focus on Alzheimer’s. A researcher on 76 – and counting – Alzheimer’s, or other dementia, studies, Ott has seen a paradigm shift, now that drugs, including Aricept, Exelon and Razadyne, are available to treat Alzheimer’s.
The RIH center finds appropriate trials in which to participate, said Ott, by contacting pharmaceutical companies when research on new drugs seems particularly promising, being contacted by drug companies and through clinical-trial consortiums.
Research is not the exclusive focus of the center. Southeastern New England’s largest such memory-loss center, it treats 350 to 400 new patients each year, said Ott. The center provides counseling about patients’ diagnoses and prognoses, information on support services and medications.
With approximately three dozen staff members, the center generally seeks trial participants from its patient cohort; however, it must recruit approximately five times as many people as are actually needed for a clinical trial, as not all applicants fit a trial’s precise parameters.
RIH is not Rhode Island’s only Alzheimer’s research center. Dr. Stephen Salloway leads the Memory & Aging Program at Care New England’s Butler Hospital; Salloway and Ott are principal investigators for several of the same Alzheimer’s clinical trials. Brown University, the University of Rhode Island and a research facility unaffiliated with any hospital, Rhode Island Mood and Memory Research Institute, are also conducting research.
Having two different hospitals conducting Alzheimer’s research, said Ott, “is an advantage. There are a lot of aging people with Alzheimer’s; we need to have a lot of people doing work [on Alzheimer’s] in Rhode Island.”
While there’s no “magic bullet” to cure or prevent Alzheimer’s, Daiello said, “You need to eat better and exercise more for just about every illness.”
She referenced a large study, FINGER, demonstrating that diet, exercise and perhaps nutritional supplements had positive results in decreasing the decline of cognitive impairments among healthy Finnish adults.
In addition, individuals 50 and older who have no or only mild memory-loss symptoms can enroll in the Rhode Island Alzheimer’s Prevention Registry, an RIH and URI collaboration. Registrants, who may be invited to participate in clinical trials, will receive quarterly newsletters about brain health. Established in 2012, the registry now has more than 300 people; Ott’s goal is 1,000 registrants.
Of the future, Ott said, “I would say ‘cautiously optimistic.’ We’ve been doing trials for decades … we think we’re on the right track now.”
For more information, contact memory@lifespan.org.
