A team from the Stop Alzheimer Centre at the Douglas Institute will be talking prevention at the AAIC2015 (Alzheimer Association International Conference) from July 18 to 23 in Washington.

Session chair(s): John Breitner, Marilyn Albert

Dementia is the end-stage of Alzheimer's disease, a chronic disorder that spans at least 30 years. Over much of this time symptoms are absent. Outwardly, the illness is therefore 'latent' but it may be revealed by biomarkers that change as the illness progresses. Thus, one might use biomarkers to identify participants for prevention trials. If preventive interventions retard the later onset of symptoms, they should also slow the progress of pre-symptomatic disease. By studying biomarker trajectories, therefore, one may assess the probable efficacy of preventive interventions. The BIOCARD study obtained serial cerebrospinal fluid (CSF) markers for four years and has now followed its sample up to 18 years with psychometric and neuroimaging measures. BIOCARD is thereby testing the validity of these markers as predictors of subsequent symptoms. The Canadian PREVENT-AD study has observed two years of change in multiple biomarkers among 241 high-risk individuals. PREVENT-AD assesses sensorineural abilities (olfaction, central auditory processing) as well as CSF and novel neuroimaging markers. It also includes a nested placebo-controlled biomarker-endpoint trial of naproxen. Because no one marker can likely assess all the stages of pre-symptomatic AD, both studies rely on multiple biomarker measures. Specialized analytic methods are therefore needed to interpret the multimodal biomarker results. Here we report findings from BIOCARD and PREVENT-AD that assess the validity of longitudinal biomarker findings as indicators of pre-symptomatic disease, the potential of such markers to show pre-symptomatic treatment effects, and an approach to the analysis of these topics.

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A collaboration between McGill and the Douglas

McGill University and the Douglas Institute have long recognized an urgent need to develop new strategies to fight the scourge of Alzheimer’s Disease (AD). The faculty of these institutions already possess considerable expertise in the basic and clinical aspects of AD.

Now, McGill and the Douglas have joined hands to create the Centre for Studies on Prevention of Alzehimer's Disease (StoP-AD Centre) dedicated to the prevention of AD. To bring this expertise together into a coherent whole, the Centre has recruited John Breitner, MD from the University of Washington.

The specific mission of the StoP-AD Centre is the study of Alzheimer’s disease in its pre-symptomatic stages. Alzheimer’s Disease is a chronic illness with a biology that extends at least a decade before any symptoms are evident. By measuring the markers of the disease in these stages, we can test whether some forms of treatment might reverse or slow the progress of pre-symptomatic Alzheimer’s Disease.