University of Kentucky works to understand how to prevent Alzheimer’s
Published 10:36 am Tuesday, February 21, 2023
By Sarah Ladd
Every two weeks, Jim and Sharon Jackson travel an hour from Morehead to Lexington to help scientists better understand how to treat Alzheimer’s disease.
Jim is a study participant in a clinical trial called AHEAD, and the University of Kentucky is one of about 75 study sites around the country.
During regular visits, Jim, 83, gets an infusion in his left arm — in a favorite vein that’s a “pretty easy one to get.”
Other times, less frequently, he gets MRIs, PET scans, memory testing. The brain scans are meant to measure the size of the brain and its changes over time. Sharon, 74, goes with him to help answer questions about his mind and note any changes over time.
During some especially long days in Lexington, the couple tries different restaurants, trying never to eat the same place twice.
They described their trips for the trial — their first — as a rewarding experience.
“I realized down through the years that the way we make progress is through these types of studies,” said Jim, a retired pediatrician who received an Alzheimer’s diagnosis in 2020. “So it’s very important.”
Sharon said the mindset all along has been: “It hopefully will help me, but it will help future generations.”
The AHEAD study
Through AHEAD, researchers hope to learn more about the long term benefits of lecanemab, an antibody that targets — and in some cases, may remove — amyloid plaques from the brain. Participants either get the real drug or a placebo, chosen at random. Amyloid plaques “are lumps of material in the brain that are outside of nerve cells, and they appear to be toxic to the nerve cells around them,” explained Dr. Greg Jicha, the director of clinical trials at UK’s Sanders-Brown Center on Aging.
In a brain with Alzheimer’s, these plaques serve to keep cells from properly functioning, according to the National Institute on Aging. Targeting them is a way to target Alzheimer’s itself, rather than just treat its symptoms, said Jicha.
The human body produces antibodies, but “humans don’t make enough antibodies to actually affect Alzheimer’s disease,” he explained.
The most common form of dementia, according to the Centers for Disease Control and Prevention, Alzheimer’s is characterized by memory loss and affects millions nationwide.
The U.S. Food and Drug Administration approved the drug Leqembi in January under an accelerated approval pathway. (Leqembi is the brand name for lecanemab).
The approval, said Jicha, is a “big deal.” But, there is more work to do.
“That accelerated approval is based on the fact that there is a clear demonstration that this drug will remove the amyloid plaques from someone’s brain,” he explained. “But that’s not all that we need to know. We also need to know, does that matter? Is that going to change things for people; is it going to help them do better? Is it going to slow the disease, stop the disease?”
These questions need answers before full and traditional approval.
How does Alzheimer’s affect people of different races?
“Alzheimer’s disease is an equal opportunity destroyer,” Jicha said. “It doesn’t care what your racial or ethnic background is. It doesn’t care what your socioeconomic status is. It’s coming for us.”
The CDC says African American and Hispanic people — as well as women — are more likely to develop Alzheimer’s, though.
In fact, the CDC predicts that by 2060, 14 million people will have Alzheimer’s and cases among Hispanic and Black people will rise.
“At the end of the day,” said Jicha, “when we look at the brain tissue of someone with Alzheimer’s disease, skin removed, right, you cannot tell the difference between somebody whose skin is black or brown or tan or white.”
When will the study yield results? Getting study results could take a while — years, even. Participant recruitment will continue for the next year at least, Jicha said.
“Prevention studies require large numbers of participants,” he explained. It’s also important to make sure participants are widely diverse. “We do not want to develop a medicine that’s only proven effective for one type of person from one racial or ethnic background.”
Interested persons go in for a blood test first, Jicha said, “to determine are they likely to have the buildup of amyloid plaques in the brain.” If the answer is “yes,” those people can come back for PET scans to see if they have plaque buildup. If those are positive, the person can enter the study.
The Jacksons hope more people join them.
“I’ve been tickled to death to be in this study,” said Jim. “So, you know, it’s very worthwhile, we feel like.”