Alzheimer's prevention trial to evaluate, monitor participants' reactions to learning of higher disease risk status

March 19, 2014

A new clinical trial will soon begin testing whether early medical intervention in people at risk for Alzheimer's can slow down progression of disease pathology before symptoms emerge, as outlined in Science Translational Medicine. For the first time, people with no Alzheimer's disease symptoms will be told of their risk status before being asked to join the randomized controlled trial. As part of the overall prevention trial, Penn Medicine neurodegenerative ethics experts will monitor how learning about their risk of developing Alzheimer's impacts trial participants.

Alzheimer's disease afflicts more than 13 percent of individuals over the age of 65, and remains one of the most feared consequences of aging.

"In order to ethically conduct a study where patients will learn they have a greater chance of developing Alzheimer's disease dementia, we've integrated continual assessments of potential participants throughout the process, to ensure that they are ready to receive information about their amyloid status and aren't having any adverse reactions after finding out," said Jason Karlawish, MD, professor of Medicine and Medical Ethics and Health Policy in the Perelman School of Medicine at the University of Pennsylvania and Associate Director of the Penn Memory Center.

Dr. Karlawish directs the Penn Neurodegenerative Disease Ethics and Policy Program. "This study is an important step in determining the consequences of being tested for Alzheimer's disease before the person has disabling cognitive impairments."

The A4 trial requires that patients enrolled must have one of the pathologies typically seen in Alzheimer's disease dementia, which will be assessed using a brain PET scan that measures amyloid. Given that studies have shown that about one third of clinically normal older individuals have evidence of amyloid plaque accumulation but may not develop any cognitive symptoms within their lifetime, the patients who are enrolled in the trial based on positive amyloid results may or may not go on to develop Alzheimer's disease dementia.

"In addition to the study's primary aims - looking at whether early treatment can slow cognitive decline - we will carefully measure how disclosure impacts cognitive test performance, the perception of , quality of life and perceived risk of Alzheimer's in participants with and without evidence of amyloid accumulation," said Karlawish.

Explore further: Plaques detected in brain scans forecast cognitive impairment

More information: "The A4 Study: Stopping AD before Symptoms Begin?," by R.A. Sperling et al. Science Translational Medicine, 2014. stm.sciencemag.org/content/6/228/228fs13.abstract

Related Stories

Plaques detected in brain scans forecast cognitive impairment

March 11, 2014
Brain imaging using radioactive dye can detect early evidence of Alzheimer's disease that may predict future cognitive decline among adults with mild or no cognitive impairment, according to a 36-month follow-up study led ...

Penn expert addresses ethical implications of testing for Alzheimer's disease risk

July 17, 2012
Diagnostic tests are increasingly capable of identifying plaques and tangles present in Alzheimer's disease, yet the disease remains untreatable. Questions remain about how these tests can be used in research studies examining ...

Researchers agree that Alzheimer's test results could be released to research participants

August 21, 2013
A leading group of Alzheimer's researchers contends that, as biomarkers to detect signals of the disease improve at providing clinically meaningful information, researchers will need guidance on how to constructively disclose ...

Inherited Alzheimer's damage greater decades before symptoms appear

March 7, 2014
(Medical Xpress)—The progression of Alzheimer's may slow once symptoms appear and do significant damage , according to a study investigating an inherited form of the disease.

Highest risk Alzheimer's genetic carriers take positive steps after learning risk status

July 16, 2013
People who found out they carried an uncommon genetic risk for Alzheimer's disease did not experience more anxiety, depression or distress than non-carriers, and were more active in efforts to reduce their risk of Alzheimer's ...

It's not just amyloid: White matter hyperintensities and Alzheimer's disease

February 19, 2013
(Medical Xpress)—New findings by Columbia researchers suggest that along with amyloid deposits, white matter hyperintensities (WMHs) may be a second necessary factor for the development of Alzheimer's disease.

Recommended for you

Lifestyle changes to stave off Alzheimer's? Hints, no proof

July 20, 2017
There are no proven ways to stave off Alzheimer's, but a new report raises the prospect that avoiding nine key risks starting in childhood just might delay or even prevent about a third of dementia cases around the world.

Blood test identifies key Alzheimer's marker

July 19, 2017
A new study led by researchers at Washington University School of Medicine in St. Louis suggests that measures of amyloid beta in the blood have the potential to help identify people with altered levels of amyloid in their ...

Steering an enzyme's 'scissors' shows potential for stopping Alzheimer's disease

July 19, 2017
The old real estate adage about "location, location, location" might also apply to the biochemical genesis of Alzheimer's disease, according to new research from the University of British Columbia.

Brain scans may change care for some people with memory loss

July 19, 2017
Does it really take an expensive brain scan to diagnose Alzheimer's? Not everybody needs one but new research suggests that for a surprising number of patients whose memory problems are hard to pin down, PET scans may lead ...

Can poor sleep boost odds for Alzheimer's?

July 18, 2017
(HealthDay)— Breathing problems during sleep may signal an increased risk for Alzheimer's disease, a trio of studies suggests.

Hearing is believing: Speech may be a clue to mental decline

July 17, 2017
Your speech may, um, help reveal if you're uh ... developing thinking problems. More pauses, filler words and other verbal changes might be an early sign of mental decline, which can lead to Alzheimer's disease, a study suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.