John Breitner, MD
The specific mission of the StoP-AD Centre is the study of Alzheimer’s disease in its pre-symptomatic stages. Alzheimer’s Disease is a chronic illness with a biology that extends at least a decade before any symptoms are evident. By measuring the markers of the disease in these stages, it is possible to test whether some forms of treatment might reverse or slow the progress of pre-symptomatic Alzheimer’s Disease.
Finding the right biomarkers
Biomarkers are the key to investigation of pre-symptomatic AD.
Pre-symptomatic AD cannot be investigated by relying on clinical symptoms. Instead, we need other indicators to reveal the development of the biological process. These indicators are called biomarkers. They may include changes in neuroimaging results as well as in the chemistry of cerebrospinal fluid (CSF) or other body fluids. The study of AD biomarkers will provide the best chance of advancing the cause of AD prevention.
Research activities of the StoP-AD Centre
- Clinical investigation of persons who are at risk of AD but who are presently symptom-free. These people will be the participants in a program called PREVENT-AD that will examine the effects of different prevention strategies designed to slow or reverse the disease.
- To support basic science efforts of two kinds
- Investigation of mechanisms that may explain the results obtained from our clinical research. If our research shows that some interventions can slow or reverse the course of pre-symptomatic Alzheimer’s disease, we will want to explore how and why these treatments are effective. This second line of inquiry must await the early results of the PREVENT-AD program.
- Investigation into the biological mechanisms that may cause or accelerate the progress of Alzheimer’s disease in its earliest stages.
A related goal of the StoP-AD Centre is to train and educate clinicians, researchers and students in clinical and basic sciences to apply these efforts toward the prevention of AD. Playing key leadership roles in the Centre are Judes Poirier, PhD, Pierre Etienne, MD, Natasha Rajah, PhD, and Pedro Rosa-Neto, MD, PhD.
Training awards are available to graduate students.
The causes of Alzheimers disease remain unknown. Much more is being learned, however, about the course of the disease over time. In particular, it is now clear that there are brain changes occurring for more than a decade before people begin to develop symptoms. In other words, memory loss and other typical cognitive problems in AD represent an end-stage. The investigators of the StoP-AD Centre are most interested in the changes that take place before these symptoms appear. Ultimately, we want to find ways to slow or stop the process, and so to delay the onset of the symptoms.
We have now been enrolling subjects for more than a year into our research program (PRe-symptomatic EValuation of Experimental or Novel Treatments for Alzheimer’s Disease (PREVENT-AD). Most of these people are participants in a randomized placebo-controlled trial of naproxen (a Nonsteroidal Anti-inflammatory Drug or NSAID) in individuals at high risk for later development of AD dementia.
At this point we have a large body of data collected from participants in this trial and other PREVENT-AD research programs. Although the real “pay-off” of this work will ultimately come from longitudinal observations (collected over a time span of several years), we have already made some fascinating observations in data collected at the time of enrollment (“baseline”) into our studies.
Alzheimer's Disease, a critical situation
Alzheimer's Disease is the most common cause of dementia by far. AD dementia can affect people under age 65, but it occurs most frequently in people over 75.
- Nearly one in five baby boomers will develop dementia
- Today, there are 36 million people worldwide living with dementia
- In Quebec, more than 100,000 people are suffering from dementia
- Today, 25,000 cases of AD dementia are diagnosed in Quebec each year, which will grow to more than 50,000 annually by 2050
- In the year 2000, Canadians spent more than $5.5 billion caring for people with dementia