On May 1, the National Institutes of Health issued recommendations for a revised framework for Alzheimer’s disease research. These guidelines were formulated by a panel of 60 experts in Alzheimer’s and chronic diseases who participated in the Alzheimer’s Disease Research Summit 2015, convened by the National Institute on Aging (NIA) and the U.S. Department of Health and Human Services, February 9 to 10 in Washington, D.C. (see Part 1 and Part 2 of this conference series).
After being reviewed and approved by the NIA National Advisory Council on Aging at its meeting on May 12 and 13, the recommendations will help update the research milestones of the National Alzheimer’s Project Act, which were developed after the 2012 AD Summit. The NIH will in turn use those milestones to propose an AD funding budget, as required by the recently passed Alzheimer’s Accountability Act (see Apr 2014 news).
The recommendations run the gamut of topics covered at the summit. They call for scientists to maximize their understanding of the genetic, epigenetic, and lifestyle factors underlying AD in both existing human cohorts and in vivo models. They encourage researchers to explore environmental and health factors that influence disease risk across the lifespan and examine how race and gender modify those risks.
Regarding clinical trials, the expert panel suggests that scientists pay particular attention to people who escape AD as they age, especially those who do so despite being at high genetic risk for the disease. They also advise researchers to integrate molecular, cellular, and physiological data along with information from developing technologies, such as wearable sensors and mobile phone apps, into comprehensive predictive models of AD. At the same time, trials should take advantage of updated designs and incorporate failure analysis to better understand whether and why a drug didn’t work. The recommendations urge that systems biology and systems pharmacology be used to construct models of disease that aid the search for drug targets and drug repurposing.
The panel also dealt with patient care, suggesting improving early diagnosis and addressing disparities among ethnic minorities. Researchers should explore new models of care, while also developing ways to enhance caregiver support, education, and partnerships with community health services.
More should be done to engage culturally and ethnically diverse participants in research projects, such as by more effectively reaching out to the community and including representative people among faculty and staff. Scientists should make trial participation less burdensome for participants while harnessing crowd-sourcing to speed up data analysis.
The recommendations also suggest infusing the field with new blood by incorporating people from various specialties into cross-disciplinary groups that can both develop new monitoring technologies and help translate findings. To facilitate collaboration, they recommend that scientists and funding agencies build infrastructure that encourages wider data sharing.
View the full set of recommendations on the NIA website.—Gwyneth Dickey Zakaib
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