Highlights of Alzheimer’s Event Include New Use of PET Scans, a Blood Test and a Protein Imaging Development

A plan to test a multi-dimensional, lifestyle-based approach to preventing cognitive decline and dementia in people at risk of Alzheimer’s was one of the important revelations that surfaced at the 2017 Alzheimer’s Association International Conference, experts said.

Other convention highlights that the Alzheimer’s Association identified included:

• Interim results of a study on using PET scans of amyloid beta buildup to help manage patients’ disease.
• Interim results of a study dealing with whether a blood test can identify amyloid beta buildup.
• Results of a study about a new imaging approach that researchers developed to investigate the pathways through which the tau protein spreads and to look at amyloid buildup over time. Both the tau and amyloid beta proteins play key roles in the development of Alzheimer’s.

The two-year clinical trial will be the first to look at whether a range of lifestyle-related steps can be taken to prevent older people who are at risk of Alzheimer’s from developing the disease.

Researchers will enroll 2,500 older adults with no symptoms but who are considered at risk of cognitive decline, perhaps from developing Alzheimer’s.

The trial will be called US POINTER, for U.S. study to PrOtect through a lifestyle INTErvention to Reduce risk. 

It will build on Finland’s FINGER study — the first randomized, controlled clinical trial that showed it is possible to use a multi-dimensional lifestyle approach to prevent older people from experiencing cognitive decline. FINGER stands for Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability.

One element of the US POINTER study is putting participants on an exercise program. They will also receive nutritional counseling and cognitive and social stimulation. And they will receive tips for managing their health.

The study will look at whether two years of this preventive approach can help older people avoid cognitive decline. Participant recruitment is expected to begin in 2018.

The four-year clinical trial that involves using PET scans to manage patients’ disease is called IDEAS — for Imaging Dementia-Evidence for Amyloid Scanning. It began in 2016.

“Our original hypothesis was that having amyloid PET scan results would change medical management in 30 percent of cases,” Dr. Gil Rabinovici, principal investigator of the study, said in a press release. “Our interim results suggest we are well on track to see an effect of at least that magnitude, and perhaps greater, when the final results are available.”

The study dealing with whether a blood test can be developed to measure amyloid beta is important because it would be easier and much less expensive than the current methods, a PET scan or a spinal tap.

A Washington University School of Medicine team is doing the research. What the St. Louis-based team has found so far suggests that amyloid protein levels in blood could accurately reflect amyloid buildup in the brain.

“These findings are important because they support the idea that blood amyloid interacts with and is derived from the brain,” said Dr. Randall Bateman, who is leading the study. “We’re excited because the results also suggest that blood-derived amyloid-beta may be useful as a rapid and inexpensive screening test for brain amyloidosis.”

This means that the test “may be able to identify people who are at higher risk of Alzheimer’s disease very early in the process,” Bateman added.

The research dealing with tau and amyloid build-up is known as the Harvard Aging Brain Study.

Dr. Jorge Sepulcre’s team developed a new imaging technique to investigate the pathways through which tau spreads and to look at amyloid buildup over time. The researchers found that the tau and amyloid proteins use different brain pathways to reach the areas where they accumulate.

“The findings may improve our ability to track responses to potential therapeutic interventions,” said Sepulcre, who is with Harvard Medical School and Massachusetts General Hospital.

An ability to look at both of the proteins involved in the brain deterioration that marks Alzheimer’s could transform scientists’ understanding of the disease as well as bolster the therapy development process.