As we mark the 10-year anniversary of the National Plan to Address Alzheimer’s Disease, which arose from the National Alzheimer’s Project Act (NAPA), it’s striking to pause for a moment and consider how far we have come. Thanks to increased congressional funding, NIH spending on Alzheimer’s and related dementias research advanced nearly 4.5-fold between fiscal years 2015 and 2020, reaching $2.87 billion. This momentum has enabled NIA-funded science to take significant strides forward.
Ten years ago, we knew of just 10 genes associated with Alzheimer’s disease, and 20 years ago, we knew of only four. Today, researchers have identified more than 70 associated genetic areas, opening multiple new foci for potential prevention and treatments.
It is extraordinarily difficult to mimic the brain’s complexity in standard lab models. Improving these models will help us better understand brain-related diseases and test existing and novel drugs as potential therapies. Thanks to NIH research, we now have the “Alzheimer’s in a dish” model, the first to contain the amyloid and tau hallmarks of the disease. In recent years, scientists built two additional “disease-in-a-dish” models and have developed more than 50 new mouse models including one that produces a form of the human beta-amyloid protein.
Before biomarker tests were developed in the early 2000s, the only sure way to know whether a person had Alzheimer’s was via autopsy. Researchers can now use brain imaging methods or lab tests to diagnose people living with the disease. NIA-funded scientists continue to explore novel blood biomarkers for various forms of amyloid, tau, and other promising targets. As one result, NIA small business innovation research funding helped validate and commercialize the PrecivityAD™ test, a more affordable and less invasive alternative to traditional Alzheimer’s tests like spinal taps or brain scans. This blood biomarker-based test is now widely available to doctors and researchers across the United States.
The Accelerating Medicines Partnership® Program for Alzheimer’s Disease has aided discovery of more than 550 novel candidate therapeutic targets and is now exploring a precision medicine approach to therapy development. In a parallel effort, the Drug Repurposing for Effective Alzheimer’s Medicines (DREAM) study, investigators found that use of certain rheumatoid arthritis drugs is associated with a lower incidence of Alzheimer’s and related dementias in people with cardiovascular disease.
Scientists are learning more about risk factors and potential lifestyle changes that may help prevent dementia. In 2019, a randomized clinical trial showed that intensive high blood pressure control may significantly reduce the buildup of brain white matter lesions and the occurrence of mild cognitive impairment. In addition, a 2020 study found that individuals who made multiple healthy lifestyle choices may have a much lower risk for Alzheimer’s.