Physicians Launch First Large-Scale Study on Alzheimer's Prevention

January 30, 2001

Doctors at the University of Rochester Medical Center are helping to initiate the first large-scale national study to prevent Alzheimer's disease, marking a milestone in physicians' efforts to maintain a high quality of life for more and more people who are living longer than ever.

A team of University physicians based at Monroe Community Hospital is one of four groups nationwide taking part in the Alzheimer's Disease Anti-Inflammatory Prevention Trial, or ADAPT. Eight hundred healthy volunteers from the Rochester area are needed for the seven-year study, which will follow the development of people age 70 and older who have a relative with the disease but who show no symptoms themselves.

The study seeks to address a tantalizing question: Do common medicines known as cox inhibitors help delay or even prevent the onset of Alzheimer's disease? Several studies have indicated that people who regularly use medications that inhibit enzymes known as cox-1 or cox-2 for several years may be less likely to get the disease. Now the National Institute of Aging seeks to settle the question, investing an initial $25 million for the first five years of the ADAPT study. Besides the University of Rochester, other institutions taking part are Johns Hopkins University in Baltimore, Boston University, and the Sun Health Research Institute in Sun City, Ariz.

"Just 10 years ago there were no treatments for Alzheimer's disease. Now we have a stable of medicines to treat the disease, and already we're talking about prevention," says Pierre Tariot, M.D., director of the University's Geriatric Neurology and Psychiatry Clinic at Monroe Community Hospital, the University's main Alzheimer's treatment site.

"The question is simple: Can we delay or prevent the onset of Alzheimer's disease? It's really quite remarkable that we have progressed to the point where we can even ask that question."

Researchers are recruiting a total of nearly 3,000 people, including 800 from upstate New York, to take part in the research study. Physicians will compare the health of people older than 70 who are taking one of three medications: naproxen, a traditional medication that inhibits both the cox-2 and cox-1 enzymes; a more potent cox-2 inhibitor, celecoxib; and a placebo, or pill with no active drug. Both naproxen and celecoxib are commonly used to treat arthritis.

The study comes as researchers are uncovering more and more evidence that inflammation within the brain is a key factor in the development of the disease. Since the newest cox-2 inhibitors developed within the last decade are among the most potent anti-inflammatory agents available, it wasn't long before researchers began asking whether they, or perhaps even the older anti-inflammatory medications, might be effective for people at risk of developing Alzheimer's disease.

It's only natural that such questions are being asked at the University of Rochester, where several research groups are at the forefront of developing and testing new treatments for Alzheimer's disease. Tariot's team has been involved in nearly every large-scale national study testing the effectiveness of medications in Alzheimer's patients, giving Rochester residents access to new treatments long before they're generally available. Researchers also serve as a resource that helps keep primary-care physicians throughout the area abreast of the latest methods to treat the disease.

Tariot's research group of about 30 doctors, nurses, and other staff has conducted more than 100 studies of Alzheimer's disease involving more than 2,000 patients from the Rochester area. The group sees about 800 new patients every year and treats several thousand on an ongoing basis, drawing patients from all of upstate New York and parts of Pennsylvania and Ohio.

"Every day I witness the devastation that Alzheimer's disease can wreak on a person and family," Tariot says. "Losing your memory is not a normal part of aging; it's something that should not be happening. This is a tremendous public health imperative. Age is a major risk factor for developing Alzheimer's disease, which is an ironic downside to the increased life expectancy that Americans are enjoying. We have a staggering number of Baby Boomers who will be at increased risk over the next two decades - 75 million people will turn 65 in the next 20 years alone.

"Long ago I resolved to do everything in my power to prevent people from suffering with this disease, and in the 15 years since we started our research program, our number-one goal has been to help initiate the first prevention study for Alzheimer's disease. And here we are, doing so today," says Tariot, who is also professor of psychiatry, medicine, and neurology at the University.

Anyone 70 years of age or older, with a family member who has or had Alzheimer's disease, or typical symptoms such as serious memory loss, is invited to participate. Participants will come to Monroe Community Hospital for medical checkups twice each year and will be interviewed by phone twice more each year.

Those interested in possibly volunteering for the research study should call (716) 760-6574 or toll-free 1-866-2-STOP-AD (1-866-278-6723). Additional information is available on the Web at www.2stopad.org.

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