Aging and Alzheimer’s disease research at Washington University School of Medicine in St. Louis recently received a $9.6 million boost. The five-year grant from the National Institute on Aging launches the University’s Healthy Aging and Senile Dementia program into its 21st year.
The grant will advance the team’s current efforts to identify biological markers that ultimately may help predict who will develop dementia and how individual patients will respond to treatment. The researchers also plan to examine whether their diagnostic approach is useful in detecting early signs of dementia in African-Americans and if it can be easily adapted to a variety of clinical settings.
The team’s diagnostic approach is one of the most well recognized achievements of the program to date. Originally developed in the early years of the project as a tool for research on Alzheimer’s disease, the Clinical Dementia Rating system proved equally valuable in clinical diagnosis and has become the standard global scale by which clinicians rate the severity of dementia. The group also pioneered the use of collateral source interviews, in which information provided by a patient’s relative or close friend is incorporated into the clinical assessment.
“Over the past two decades, our program and its approach to studying dementia have come to stand for a very careful, clinical characterization of individuals, even those at the very earliest symptomatic stages of Alzheimer’s,” says the study’s principal investigator, John C. Morris, M.D., who also is principal investigator of Washington University’s Alzheimer’s Disease Research Center, the Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology and a neurologist at Barnes-Jewish Hospital.
“We also have amassed a lot of data on a remarkable group of healthy elderly people,” he adds. “That has enabled us to learn a great deal about aging, to the point where we’ve challenged some commonly held assumptions and shown that elderly individuals who do not develop Alzheimer’s disease do, by and large, maintain their cognitive abilities.”
Having already made significant strides in detecting the earliest clinical symptoms of Alzheimer’s disease, the group has begun searching for biological markers, including protein levels in blood or characteristic patterns in brain images. Such tests could in the future help physicians determine the ideal course of treatment for individual patients.
“Though there are no cures for Alzheimer’s disease yet, there are many treatments being studied,” says David M. Holtzman, M.D., the Andrew B. and Gretchen P. Jones Professor and head of the Department of Neurology, the Charlotte and Paul Hagemann Professor of Neurology, professor of molecular biology and pharmacology and a neurologist-in-chief at Barnes-Jewish Hospital. “If we don’t simultaneously develop ways to predict the progression of a patient’s disease and his or her response to different types of treatment, we’ll be way behind when therapies finally arrive.”
Pinpointing biological markers of dementia also may help predict, and ultimately prevent, the onset of the disease, according to Holtzman, who will lead the effort to identify biological markers. Scientists believe brain changes associated with Alzheimer’s begin developing decades before symptoms appear. The School of Medicine team is therefore following a group of adults whose parents have the disease to see if there are any signs that distinguish those who eventually develop Alzheimer’s from those who remain healthy.
The full-time and volunteer faculty of Washington University School of Medicine are the physicians and surgeons of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked second in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.