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Rochester’s Health Community Collaborates on Alzheimer’s Study

Thursday, October 04, 2007

Rochester’s three health systems and its largest insurer have joined together to develop new approaches to early detection of Alzheimer’s disease. The clinical study, which has been named the Rochester Aging Study, is being led by the University of Rochester Medical Center (URMC) and includes physicians and patients of the Unity Health and ViaHealth health systems.  The effort is being funded, in part, by Excellus BlueCross BlueShield. 

“The earlier any human disease can be detected, the more likely treatment will be effective” said URMC geriatrician William Hall, M.D., director of the study. “The purpose of this study is to see if there are ways that Alzheimer’s disease can be diagnosed well before clinical symptoms came forward.  If we can accomplish that then we would have a much better crack at treating or even preventing the disease.” 

There is a growing consensus in the scientific community the pathology in Alzheimer’s disease may start decades before the clinical symptoms become apparent and it is not until the disease reaches a sort of critical mass that it begins to cause cognitive impairment and other manifestations of the disease.  Research in other neurological disorders has demonstrated that it is possible to detect signs of the disease in other parts of the body, namely the blood system.  The Rochester Aging Study will focus on identifying unique aspects in the molecular composition of blood to see if these indicators – or biomarkers – can predict whether an individual will eventually develop Alzheimer’s disease.  

The study represents one of the first times that the three major Rochester area health systems have collaborated on a clinical study of this magnitude. The study will include a multidisciplinary team of clinicians and scientists and will marry the region’s robust health care systems with the University of Rochester’s strength in neurological research. Co-investigators in the study from Unity Health include James M. Haley, M.D., chair of department of Medicine and Michael Nazar, M.D.  Richard Sterns M.D., chair of Medicine, and Steven Rich, M.D. are the co-investigators from ViaHealth. Also participating in the study are neuropsychologist Mark Mapstone, Ph.D., epidemiologist Susan Fisher, Ph.D., and biostatistician Andrei Yakovlev, M.D., all with URMC, and researchers from Georgetown University and the University of California at Irvine.

"This is probably the most unique and possibly the most important study ever to be conducted in Rochester,” said Nazar, Unity Health’s vice president of primary care and community services. “We are happy to be part of this collaboration and hope for wide community support and involvement."

"Fifty years ago, a study in Framingham, Massachusetts allowed us to detect and treat risk factors for heart disease,” said Rich, chief of ViaHealth’s division of Geriatrics.  “The Rochester Aging Study has the potential to do the same for the neurodegenerative diseases that are having an increasingly devastating effect on our aging community. This is truly a community effort, of which Rochester General is proud to be a part.”

The study will look at three different senior populations: individuals at high risk for developing the disease (first degree relative with Alzheimer’s), low risk individuals with no family history of disease, and people who have begun to develop signs of mild cognitive impairment – a precursor of Alzheimer’s.  Blood will be drawn from the study participants once a year.  Scientists will then analyze the tens of thousands of variable genetic (RNA) transcriptions and protein profiles of white blood cells to see if they can identify indicators – or sets of indicators – that are unique to individuals who ultimately develop Alzheimer’s.  Scientists are focusing on white blood cells because they easy to obtain and are cellular in composition and therefore may contain some of the defects that are found in the neurons of individuals with the disease. 

Once identified, researchers believe that these profiles could serve as a predictive biomarker for the disease.  The next step would be to chase these biological changes in the blood back to their earliest point of detection.  This information would give researchers the opportunity, the motivation, and perhaps new insight to develop approaches to treating Alzheimer’s in its earliest stages when the opportunity to slow or potentially reverse the progression of the disease is at it greatest. 

The ultimate goal, explained Hall, would be to develop a diagnostic test that could be administered during an annual physical.  “The objective is to give physicians the tools to much more realistically manage and prevent disease rather than constantly picking up the pieces of the ravages of disease.”

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