Alzheimer’s disease and related dementias (ADRD) is expected to increase three-fold by the year 2050.
The primarily affected age range includes people over 65 who are seeing a 62% increase of developing ADRD and those over age 85 who have an 84% chance.
In addition, as the U.S. population grows, so will its diverse makeup. African Americans are twice as likely and Hispanics 1.5 times as likely as Caucasians to develop ADRD. Having dealt with ADRD developed by his wife’s parents and his grandfather, James E. Galvin, M.D., M.P.H., a neurology expert at the University of Miami Health System, has had first-hand experiences that inspire him to continue looking for improved outcomes through early detection.
The National Institutes of Health has awarded Dr. Galvin, director of the Comprehensive Center for Brain Health, and Neurology Cognitive Sciences chief for Palm Beach and Broward County at the University of Miami Miller School of Medicine, a $13 million grant to conduct a five-year series of studies on dementia in multicultural communities.
Understanding the root causes of disease
“Traditional approaches to medical care failed (patients), in part because of the seriousness of their illnesses, but also because each individual’s unique presentation, needs, and progression required more than the usual ‘one-size-fits-all’ approach embedded in conventional medicine,” Dr. Galvin says.
“To me, the need to understand root causes of disease, provide strategies for early detection of disease that will work in all older adults regardless of background, improve health outcomes while containing health care costs, and do this in a culturally-sensitive and personalized fashion is not just a professional activity. It has been a personal battle.”
Dr. Galvin aims to:
- develop screenings that detect the earliest signs of impairment
- monitor response to interventions and correspondence to biomarkers
- increase the potential benefits from screening
He already laid the foundations in creating the AD8 model — a brief, sensitive measurement that reliably tells the difference between non-demented and demented individuals. He also validated new screening evaluation and staging tools for MCI and ADRD, including the Quick Dementia Rating System. Since joining UHealth, Dr. Galvin has created 10 new dementia screening instruments that will be used in the project.
A “healthy body, healthy mind” approach
The new screening model is set to follow a “healthy body, healthy mind” approach to make the concept of mild cognitive impairment and ADRD screening more acceptable to diverse populations by emphasizing deep phenotyping the acquisition of multiple types of data from the same individual repeated over time with multiple individuals.
“Deep phenotyping enhances the potential research value of data and biospecimens contributed by individual participants and creates opportunities for innovative approaches to data analyses and cross validation of screening efforts,” Dr. Galvin says. “This will link prevalent data to how brain biomarkers and relevant biological (i.e., sex) and sociodemographic variables (e.g., race, ethnicity) may interact to explain differential risk for transition across the amyloid-tau-neurodegeneration (ATN) Framework stages.”
One goal? Increase the rate of early detection of ADRD
All of these processes are part of Dr. Galvin’s goal of increasing accuracy of early diagnosis, developing therapeutic targets, and improving health outcomes in ADRD. The research will also provide the groundwork for future studies to further characterize the mechanism underlying ADRD and its progression. Sharing of plasma, DNA, imaging, and phenotype data with national biorepositories, will enable numerous other investigators to pursue individual and collaborative research in ADRD.
Lastly, the diverse collaborative interactions (behavior and movement disorder neurology, neuropsychology, gerontology, electrophysiology, genetics, imaging, engineering, biostatistics, and epidemiology) will serve as a platform for future research into ADRD.
“We hope to provide the evidence base to develop national dementia screening programs and precision-like medicine approaches to dementia diagnosis, treatment, and care,” Dr. Galvin says.
Written by Joseph Garcia for Inventum.
A.D.H.D. is classified as a neurodevelopmental disorder which, by definition, has onset before age 18,” says Barbara Coffey, M.D., M.S. “There is some controversy currently over whether A.D.H.D. can begin in adulthood." Read more.