Alzheimer's Disease and Related Dementias Research

Transcript

Introduction

I’m Dr. Dani Cabral, I’m the principal investigator at the IMA Phoenix Site. It took me a long time to realize why I’m so drawn to the field of Alzheimer’s disease and related dementias and I realized that it’s because the disease affects not just the person that has the brain disease, but also family and friends. And what makes it so hard? Well, yes, a person may have memory loss. What is the most difficult about the memory loss is that it affects the person’s identity, sense of self, those relationships; and that causes lots of grief and grieving.

Besides a PI, I am also a clinician, and so being able to support patients and families and participants in all of those ways and knowing that it’s a really long road and it’s often unpredictable and I personally feel comfortable being in that kind of environment and then being open minded about the possibilities for treatments.

Early Detection

Maybe one of the biggest advances in the field of Alzheimer’s disease is that we now have highly accurate, valid blood tests to identify the Alzheimer’s disease changes in the brain even before there are any symptoms. So years before the symptoms start, we can detect a change in the tau and amyloid levels. Which that’s the first thing to change, which can even start 25 years before there’s any symptoms. And so these blood tests, of course, are so much more accessible and less invasive.

What I’ve seen and this has been at this point strictly in clinical trials of individuals who have no symptoms but get these blood tests while they’re screening for a clinical trial of a treatment to start before there’s any symptoms. If they have changes in the brain when they find out it is abnormal, they do have the Alzheimer’s changes in the brain. There is a process of coming to terms with that. But people often feel like they’re taking control of their lives. They were worried about this because probably they have a family member who’ve experienced this in the past and now they’re actively taking steps to try to significantly slow down or stop this in its tracks. And so that information can really change the trajectory of that person’s life.

Possible Treatments in the Future for Alzheimer’s Disease

What I think is going to be essential is to have combination therapies, treatments and also lifestyle treatments, because we know there’s a huge component of cardiovascular disease that then affects the blood vessels in the brain that can contribute to and worsen or expedite the disease in the brain. So it’s going to be multifactorial, multimodal the treatments. And so ultimately, I think it’s about being open minded to this.

Positive Outcomes in Alzheimer’s Clinical Research

Probably the most rewarding experience I’ve had  which was in the Alzheimer’s treatment trial, which, as most people know, there have been only negative trials up until very recently. And so I’m so grateful to now be in this new world where there are positive trials; and I was a PI on one of those. And to have that participant and their spouse say, “yes, we definitely have Alzheimer’s disease, it’s biologically confirmed.” And yet after being in the study for over a year, there’s really been little decline cognitively and functionally.”

And that’s just so exciting and such a game changer.