NIH State-of-the-Science Conference
Preventing Alzheimer’s Disease
and Cognitive Decline
April 26–28, 2010
Bethesda, Maryland
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Background
For many older adults, cognitive health and performance remain stable over the course of their lifetime, with only a gradual and slight decline in short-term memory and reaction times. But for others, this normal, age-related decline in cognitive function progresses into a more serious state of cognitive impairment or into various forms of dementia, including Alzheimer’s disease. Such loss of cognitive function—the ability to think, learn, remember, and reason—substantially interferes with everyday function. As researchers continue to explore changes in the brain that take place possibly decades before cognitive decline and dementia symptoms appear, they also hope to discover more about the relationship between normal age-related cognitive decline and the development of cognitive impairment or Alzheimer’s disease.
Alzheimer’s disease was first described in 1906, when German psychiatrist and neuropathologist Alois Alzheimer observed the hallmarks of the disease in the brain of a female patient who had experienced memory loss, language problems, and unpredictable behavior: abnormal clumps of protein (now called beta-amyloid plaques) and tangled bundles of protein fibers (now called neurofibrillary tangles). Today, an estimated 2.5 to 4.5 million Americans are living with Alzheimer’s, the most common form of dementia, and those numbers are expected to grow with the aging of the baby boomer population. Age is the strongest known risk factor for Alzheimer’s, with most people diagnosed with the late-onset form of the disease over age 60. An early-onset, familial form also occurs, but is very rare. The time from diagnosis to death with Alzheimer’s ranges from a little as 3 years to 10 or more, depending on the person’s age, sex, and the presence of other health problems.
In addition to investigating the causes and potential treatments for Alzheimer’s and other dementias, researchers are focused on finding ways to prevent cognitive decline. Many preventive measures for cognitive decline and for preventing Alzheimer’s—mental stimulation, exercise, and a variety of dietary supplements—have been suggested, but their value in delaying the onset and/or reducing the severity of decline or disease is unclear. Questions also remain as to how the presence of certain conditions, such as high cholesterol, high blood pressure, and diabetes, influence an individual’s risk of cognitive decline and Alzheimer’s disease.
To examine these important questions about Alzheimer’s and cognitive decline in older people, the National Institute on Aging and Office of Medical Applications of Research of the National Institutes of Health will convene a State-of-the-Science Conference from April 26 to 28, 2010, to assess the available scientific evidence related to the following questions:
- What factors are associated with the reduction of risk of Alzheimer’s disease?
- What factors are associated with the reduction of risk of cognitive decline in older adults?
- What are the relationships between the factors that affect Alzheimer’s disease and the factors that affect cognitive decline?
- What are the therapeutic and adverse effects of interventions to delay the onset of Alzheimer’s disease?
- What are the therapeutic and adverse effects of interventions to improve or maintain cognitive ability, or preserve cognitive function? Are there different outcomes in identifiable subgroups?
- Ifrecommendations for interventions cannot be made currently, what studies need to be done that could provide the quality and strength of evidence necessary to make such recommendations to individuals?
National Institute on Aging
Office of Medical Applications of Research
Co-sponsors
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Center for Complementary and Alternative Medicine
National Institute of Mental Health
National Institute of Neurological Disorders and Stroke
National Institute of Nursing Research
Office of Dietary Supplements
Partners
Centers for Disease Control and Prevention
Centers for Medicare and Medicaid Services
The Agency for Healthcare Research and Quality provided additional conference development support.
Monday, April 26, 2010
| 8:30 a.m. | Opening Remarks Richard Hodes, M.D. Director National Institute on Aging National Institutes of Health |
| 8:40 a.m. | Charge to the Panel Jennifer Miller Croswell, M.D., M.P.H. Acting Director Office of Medical Applications of Research Office of the Director National Institutes of Health |
| 8:50 a.m. | Conference Overview and Panel Activities Nancy C. Andreasen, M.D., Ph.D. Conference and Panel Chairperson Director, Mental Health Clinical Research Center Director, Psychiatric Iowa Neuroimaging Consortium Andrew H. Woods Chair and Professor of Psychiatry University of Iowa College of Medicine |
| General Overview | |
| 9:00 a.m. | Alzheimer's Disease: Nature of the Public Health Problem Mary Ganguli, M.D., M.P.H. University of Pittsburgh Medical Center Department of Psychiatry Western Psychiatric Institute and Clinic |
| 9:20 a.m. | Alzheimer's Disease: Early Diagnosis Ronald Petersen, M.D., Ph.D. Director, Alzheimer's Disease Research Center Department of Neurology Mayo Clinic College of Medicine |
| 9:40 a.m. | Age-Related Cognitive Decline: Nature of the Problem Marilyn Albert, Ph.D. Professor of Neurology Division of Cognitive Neuroscience Johns Hopkins University School of Medicine |
| 10:00 a.m. | Discussion |
| 10:30 a.m. | Age-Related Cognitive Decline: Measurements of Change Dan Mungas, Ph.D. Adjunct Professor Department of Neurology Director, UC Davis Alzheimer's Disease Center University of California Davis School of Medicine |
| 10:50 a.m. | Pathophysiology of Alzheimer's Disease and Age-Related Cognitive Decline David A. Bennett, M.D. Robert C. Borwell Professor of Neurological Sciences Director, Rush Alzheimer's Disease Center Department of Neurological Sciences Rush Medical Center |
| 11:10 a.m. | Interventions in Animal Models of Alzheimer's Disease Carl Cotman, Ph.D. Professor Institute for Brain Aging and Dementia University of California, Irvine |
| 11:30 a.m. | Discussion |
| 12:00 p.m. | Lunch Panel Executive Session |
| What Factors Are Associated With the Reduction of Risk of Alzheimer's Disease? | |
| and | |
| What Factors Are Associated With the Reduction of Risk of Cognitive Decline in Older Adults? | |
| 1:00 p.m. | Nutritional/Dietary Risk Reduction Factors for Alzheimer's Disease and Cognitive Decline in Older Adults: Foods Martha Clare Morris, Sc.D. Rush Institute for Healthy Aging Rush Medical Center |
| 1:20 p.m. | Nutritional /Dietary Risk Reduction Factors for Alzheimer's Disease and Cognitive Decline in Older Adults: Complementary and Alternative Medicine Joseph Quinn, M.D. Assistant Professor Department of Neurology Oregon Health and Science University |
| 1:40 p.m. | Evidence-Based Practice Center Presentation I TBA |
| 2:00 p.m. | Discussion |
| 2:30 p.m. | Risk Reduction Factors for Alzheimer's Disease and Cognitive Decline in Older Adults: Physical Activity Arthur Kramer, Ph.D. Beckman Institute University of Illinois |
| 2:50 p.m. | Risk Reduction Factors for Alzheimer's Disease and Cognitive Decline in Older Adults: Social Engagement and Leisure Activities Laura Fratiglioni, M.D., Ph.D. Karolinska Institute |
| 3:10 p.m. | Risk Reduction Factors for Alzheimer's Disease and Cognitive Decline in Older Adults: Cognitive Engagement Yaakov Stern, Ph.D. Professor Department of Aging and Dementia Sergievsky Center Columbia University College of Physicians and Surgeons |
| 3:30 p.m. | Discussion |
| 4:00 p.m. | Risk Reduction Factors for Alzheimer's Disease and Cognitive Decline in Older Adults: Vascular Factors Charles DeCarli, M.D. Associate Professor of Neurology Department of Neurology and Center for Neuroscience Associate Director, UC Davis Alzheimer's Disease Center University of California Davis School of Medicine |
| 4:20 p.m. | Risk Reduction Factors for Alzheimer's Disease and Cognitive Decline in Older Adults: Depression Constantine Lyketsos, M.D. Professor of Psychiatry and Behavioral Sciences Chair, Department of Psychiatry Johns Hopkins Bayview Medical Center |
| 4:40 p.m. | Risk Reduction Factors for Alzheimer's Disease and Cognitive Decline in Older Adults: Sociocultural and Demographic Jennifer Manly, Ph.D. Associate Professor Department of Neurology Sergievsky Center Columbia University College of Physicians and Surgeons |
| 5:00 p.m. | Discussion |
| 5:30 p.m. | Adjournment |
Tuesday, April 27, 2010
| What Are the Therapeutic and Adverse Effects of Interventions to Delay the Onset of Alzheimer's Disease? Are There Differences in Outcomes Among Identifiable Subgroups? | |
| 8:30 a.m. | Clinical Trials for Alzheimer's Disease Paul Aisen, M.D. Professor Department of Neurosciences University of California, San Diego School of Medicine |
| What Are the Therapeutic and Adverse Effects of Interventions to Improve or Maintain Cognitive Ability or Function? Are There Differences in Outcomes Among Identifiable Subgroups? | |
| 8:50 a.m. | Clinical Trials in Cognitive Aging Frederick Unverzagt, Ph.D. Director, Neuropsychology Clinic in Psychiatry Training Director, Clinical Neuropsychology Associate Professor of Psychiatry Department of Psychiatry Indiana University School of Medicine |
| 9:10 a.m. | Evidence-Based Practice Center Presentation II TBA |
| 9:30 a.m. | Discussion |
| What Are the Relationships Between the Factors That Affect Alzheimer's Disease and the Factors That Affect Cognitive Decline? | |
| 10:00 a.m. | Evidence-Based Practice Center Presentation III TBA |
| 10: 20 a.m. | Factors That Protect Against Alzheimer's Disease and Cognitive Decline David A. Bennett, M.D. Robert C. Borwell Professor of Neurological Sciences Director, Rush Alzheimer's Disease Center Department of Neurological Sciences Rush Medical Center |
| 10:40 a.m. | Commentary: Evidence-based Practice Center Systematic Review Hugh Hendrie, D.Sc., M.B., Ch.B. Professor, Department of Psychiatry Indiana University School of Medicine Center Scientist Indiana University Center for Aging Research Research Scientist Regenstrief Institute, Inc. |
| 11:00 a.m. | Discussion |
| 11:30 a.m. | Adjournment |
Wednesday, April 28, 2010
| 9:00 a.m. | Presentation of the Draft State-of-the-Science Statement |
| 9:30 a.m. | Public Discussion |
| 11:00 a.m. | Adjournment Panel Meets in Executive Session |
| 2:00 p.m. | Press Telebriefing |
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