How Pitt researchers hope to stop Alzheimer's symptoms before they even appear

University of Pittsburgh researchers are helping embark on a study to treat Alzheimer’s disease before its symptoms even surface, a trial they say holds exciting potential for addressing the debilitating condition.

But they say patients of color too often lack access to opportunities to participate in cutting-edge research like this, even though Black Americans are about twice as likely as white people to suffer from Alzheimer’s disease or other forms of dementia.

So researchers with the AHEAD Study, focused on pre-symptomatic treatment of Alzheimer’s disease, have committed to combat these disparities by enrolling a diverse group of participants. The trial, funded by the National Institutes of Health, will take place across a network of 100 different study locations worldwide, including the University of Pittsburgh.

“We are definitely trying to get the word out that we really want to see better representation,” said Dr. Jennifer Hagerty Lingler, who leads outreach, recruitment and education for the University of Pittsburgh Alzheimer's Disease Research Center. “Also, for scientific purposes, we want to know that the drugs that we're testing work for everyone, and we can’t do that if we don’t see everyone.”

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To promote diverse participation in the trial, AHEAD researchers are following best practices in community-engaged recruitment and working with potential enrollees to minimize transportation challenges and other barriers, Lingler said.

Alzheimer’s disease is the most common form of dementia and gradually impairs a person’s memory and other cognitive skills. About 282,000 Pennsylvanians older than 65 have Alzheimer’s disease, including roughly 4,100 people in Beaver County, according to the Alzheimer’s Association.

Researchers aren’t certain why the disease disproportionately affects Black Americans, Lingler said but are exploring social determinants of health – such as living environment, economic factors and access to medical care – as possible contributing factors.

The AHEAD Study is open to participants aged 55 to 80 and is focused on people who haven’t yet started experiencing the symptoms of Alzheimer’s disease. Instead, prospective enrollees will undergo a brain imaging scan to detect the presence of amyloid plaques, or clumps of proteins that build up between neurons and are linked to Alzheimer’s disease.

Healthy people generally wouldn’t have access to these brain scans through their medical providers, Lingler said, and would only receive them as part of a research study. In addition, insurance would not cover the testing for a person who’s not yet symptomatic.

“Part of the reason that reimbursement structure is not in place is because, right now, there’s no justification for it,” she said. “Because there is no treatment that we can use if someone’s positive.”

In the longer term, she said, health experts hope clinicians will be able to use a simple blood test to screen presence for the buildup of these amyloid plaques – and intervene early in these cases to prevent Alzheimer’s disease from progressing.

This particular study will test the effectiveness of lecanemab, a medication recently approved by the Food and Drug Administration for Alzheimer’s disease, in treating people before their symptoms appear. AHEAD researchers will check to see if lecanemab helps shrink the size of the abnormal protein clumps detected in participants’ brains at the outset of the study, according to Lingler.

The AHEAD Study researchers hope to enroll 1,400 participants.

Participants in the trial must agree to four years of in-person and telephone visits with researchers on a biweekly or monthly basis, according to the AHEAD Study webpage. They should also have a closer relative or friend who is willing to join in one visit each year.

Information on the trial and potential participation is available at aheadstudy.org.

This article originally appeared on Beaver County Times: University of Pittsburgh researchers seek early Alzheimer's treatment