What we are learning
from all of your hard work!
Reisa Sperling, MD
Research Participant Appreciation Day
September 13, 2014
Alzheimer’s - the tip of the iceberg….
Image courtesy of
Ralph Clevenger
The Continuum of Alzheimer’s Disease
Cognitive
function Preclinical
Normal Aging
Mild
Cognitive ImpairmentI
(MCI)
Dementia
Years
Pathology of Alzheimer’s Disease
How do we detect evidence of
asymptomatic Alzheimer’s disease
changes in the living brain?
PET Amyloid Imaging
Harvard Aging Brain Study
Sperling, Johnson NeuroMolecular Med 2010
Amyloid associated memory changes
Face-name associative
memory exam
Subjective Memory
Concerns
Cognitive Decline
Rentz D Neuropsychologia 2011
Amariglio R et al
Neuropsychologia 2012
Mormino et al Neurology 2014
Does amyloid “fan the flames” of tau?
Amyloid and Tau PET imaging
K. Johnson HAI 2014
Longitudinal Memory Decline (Retrospective)
Related to T807 Tau PET Binding
3
3
1
0
-1
-2
-3
0.9
1.0
1.1
1.2
1.3
1.4
2
SRT dr (change/year)
2
SRT dr (change/year)
SRT dr (change/year)
3
1
0
1
0
-1
-2
-1
-3
1.5
-2
1.6
0.9
AβAβ+
T807 (EC)
R=.26 p< 0.01
2
-3
0.9
1.0
1.0
1.1
1.2
1.3
1.4
1.5
1.6
T807 (Inf Temp)
R=.40; p< 0.001
1.1
1.2
1.4
1.5
Johnson
K
et al1.3AAIC
2014
Why would we want to detect AD
a decade before dementia?
The Great Wave off Kanagawa – Hokusai circa 1832
The continuum of Alzheimer’s disease
A4
Cognition
Healthy Aging
Preclinical
MCI
}
Dementia
Years
Resilience
Maximizing Resilience!
• Choose your parents wisely!
• Stay physically, mentally, and socially active
• Participate in clinical research!
Harvard Aging Brain Study
Keith Johnson, MD
Dorene Rentz, PsyD
Aaron Schultz, PhD
Trey Hedden, PhD
Rebecca Amariglio, PhD Beth Mormino, PhD
Gad Marshall, MD
Kate Papp, PhD
Willem Huijbers, PhD
Jas Chhatwal, MD
Brad Hyman, MD, PhD
David Hsu, MD
J. Alex Becker, PhD
Deborah Blacker, MD
Yakeel Quiroz, PhD
Randy Buckner, PhD
Dennis Selkoe, MD
Nancy Donovan, MD
Tamy-Fee Meneide, Sarah Wigman, Margaret Chute, Molly LaPoint,
Catherine Munro, Alex Dagley, Sehilly Jaimes, Nayiri Arzoumanian,
Emily Shaw, Alison Pietras,,Jon Bruno, Samantha Mauro, Jeanette
Gunther, Kristen Andreozzi, Jon Bruno, Steve Weise, Donald McLaren,
PhD, Brad Dickerson, MD, Jorge Sepulcre, MD, Mykol Larvie, MD
Support: NIA, Alzheimer’s Association, HNDC, AHAF
Information
• Clinical Trials
– 617-643-5200
– madrc.mgh.harvard.edu/trials_studies
• The “A4” Prevention trial
– A4study.org
WE CAN’T DO THIS WITHOUT YOU!
THANK YOU!