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.

CAREGIVERS: Volunteers Assisting the Elderly in Ventura County presented the Norm Weitzel Award at the Evening of Gratitude on May 19 for 2020, 2021 and 2022 to Volunteers Keith York, Carol Boatner and Louise Dunlap in memory of her husband, Jesse Dunlap.

Keith York started volunteering with CAREGIVERS in 1984 and still volunteers to this day, having served in every capacity from Board to Advisory to Honorary.  Each year, he donates roses for at least 50 seniors on Valentine’s Day–some of whom have never had a Valentine delivered.

Carol Boatner volunteered with CAREGIVERS for the first 20 years before she joined the staff, helping to pilot one of the original programs that launched more than 1,000 volunteer caregiving organizations throughout the nation.  See nvcnetwork.org

Louise Dunlap champions Jesse Dunlap’s legacy with CAREGIVERS to this day.  His service began after he retired from the United States Air Force and stepped up as an Assembly Delegate for the Senior Legislature.  Jesse was a huge advocate for seniors back when the Silver Tsunami was just a theory.  He knew what was ahead and he brought his advocacy and his helping hands to CAREGIVERS, and Louise has continued that support year after year.

Lori Franco, Karen Jensen, Ann Romero and Ginny Camarillo serve as the scholarship selection committee for student volunteers in CAREGIVERS’ Building Bridges Intergenerational Program. Student Engagement Coordinator, Lori Franco, has rebuilt this program using Adult Team Leaders who supervise 2-3 high school students for one-hour visits to do household chores throughout Ventura County.

Recently, CAREGIVERS forged new partnerships with ARC and Cole Vocational Services giving seniors a total of 45 home visits per month, a 225% in service.  Adult Team Leaders are needed throughout the County.  Scholarship recipient Maria Bernal was not present.

The number of older Americans is rising, so the number of people with dementia is predicted to increase. However, some studies have shown that incidence rates of dementia — meaning new cases in a population over a certain period of time — have decreased in some locations, including in the United States. Based on observational studies, factors such as healthy lifestyle behaviors and higher levels of education may be contributing to such a decline. But the cause and effect is uncertain, and such factors need to be tested in a clinical trial to prove whether they can prevent dementia.

A review of published research evaluated the evidence from clinical trials on behavior and lifestyle changes to prevent or delay Alzheimer’s or age-related cognitive decline. The review found “encouraging but inconclusive” evidence for three types of behavioral changes (called interventions): physical activity, blood pressure control, and cognitive training. The findings mean that interventions in these areas are promising enough that researchers should keep studying them to learn more. Researchers continue to explore these and other interventions to determine whether — and in what amounts or forms — they might prevent dementia.

Although there is no effective treatment or proven prevention for Alzheimer’s and related dementias, in general, leading a healthy lifestyle may help address risk factors that have been associated with these diseases.

Control high blood pressure. High blood pressure, or hypertension, has harmful effects on the heart, blood vessels, and brain, and increases the risk of stroke and vascular dementia.

Manage blood sugar. Higher than normal levels of blood sugar, or glucose, can lead to diabetes and may increase the risk of heart disease, stroke, cognitive impairment, and dementia.

Maintain a healthy weight. Being overweight or obese increases the risk for related health problems such as diabetes and heart disease. Being active and choosing healthy foods can help maintain a healthy weight.

Eat a healthy diet. Aim for a mix of fruits and vegetables, whole grains, lean meats and seafood, unsaturated fats such as olive oil, low-fat or nonfat dairy products, and limit other fats and sugars.

Keep physically active. Physical activity has many health benefits, such as helping to prevent being overweight and having obesity, heart disease, stroke, and high blood pressure.

Stay mentally active. Lots of activities can help keep your mind active, including reading, playing board games, crafting or taking up a new hobby, learning a new skill, working or volunteering, and socializing.

Stay connected with family and friends. Connecting with people and engaging in social activities can prevent social isolation and loneliness, which are linked to higher risks for cognitive decline and Alzheimer’s disease.

Treat hearing problems. Hearing loss may affect cognition and dementia risk in older adults and can make it more difficult to interact with others.

Sleep well. Sleeping well is important for both your mind and body. Try to get seven to eight hours of sleep each night. Talk with your doctor if you are not getting enough sleep, sleeping poorly, or think you may have a sleep disorder.

Drink less alcohol. Drinking too much alcohol can lead to falls and worsen health conditions such as diabetes, high blood pressure, stroke, memory loss, and mood disorders. The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, recommends that men should not have more than two drinks a day and women only one. Learn more at NIAAA’s Rethinking Drinking website.

Stop tobacco use. At any age, stopping smoking can improve your health and lower the risk of heart attack, stroke, and lung disease.