Research in AD continues to move forward rapidly, bringing us ever closer to a full understanding of the causes of this devastating disease and to effective prevention and treatment strategies. Findings from basic science are unlocking the secrets of the disease process at a molecular level, involving beta-amyloid, presenilins, tau, and mitochondria, to name just a few. Findings from other types of studies are providing insights about possible risk and protective factors and ways to help caregivers cope as the disease takes hold in a loved one. Knowledge from these studies is giving scientists and clinicians increasing hope about the potential for new therapeutic agents and strategies.
Realizing these hopes for the future, however, requires action on a number of complementary fronts. In the past several years, the NIA, along with other NIH Institutes and Centers, the Alzheimer’s Association, the Institute for the Study of Aging, and additional organizations, have launched several major initiatives to create and nurture the essential research infrastructure that will help NIH move from basic science to fully developed drugs and therapeutic approaches that can be tested in clinical trials and ultimatelyused to help people with AD.
Providing a Planning FrameworkTwo of these initiatives provide a critical framework for overall planning and support for AD and broader neurosciences research.
Supporting a Collaborative Research InfrastructureTwo other initiatives provide venues and mechanisms for interdisciplinary and collaborative research on AD development and progression.
Facilitating Innovation for the FutureAn additional five efforts focus on particular aspects of AD or brain research, including neuroimaging, genetics, drug development and clinical trials, techniques for evaluating change over time in cognitive functioning, and healthy brain aging:
Scientists will correlate this imaging information with clinical and neuropsychological assessments, and biomarkers from blood, cerebrospinal fluid, and urine samples collected at intervals from individuals in the study. Potential markers include levels of beta-amyloid and tau, indicators of inflammation, and meas-ures of oxidative stress. NIA hopes the Neuroimaging Initiative will help create rigorous imaging and biomarker standards that will aid in early diagnosis and provide the yardstick by which the success of future treatments can be measured. This would substantially increase the pace and decrease the cost of developing new treatments.
This landmark Initiative is a public-private partnership among government, industry, foundations, voluntary organizations, and academia. An important aspect of this Initiative is that the clinical, imaging, and biological data collected will be made available to qualified scientific investigators for further analysis. This emphasis on sharing data and resources across research institutions will have an important beneficial impact on future research because it means that larger databases of information and samples of participants will be available. This expanded data will help increase the statistical power of studies and allow for analyses of small subpopulations and infrequent outcomes that wouldn’t be possible otherwise.
Many families already have been recruited but more are needed. NIA has provided funding to the ADCs to help recruit additional study participants, and the ADEAR Center is collaborating with the Alzheimer’s Association to develop media and community outreach programs to foster participation in this Initiative. Results will allow scientists to find new pathways affected in AD and help clinicians accurately identify and counsel people at high risk of developing the disease. Results also will help investigators recruit susceptible individuals into clinical trials, which will reduce the number of participants necessary and the cost and complexity of trials. Shorter trials with fewer participants will allow investigators to be more effective in identifying and testing promising treatments emerging from basic science and translational studies. It also will contribute to future prevention strategies.
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