Alzheimer’s, a progressive and highly variable disease, is the most common form of dementia, affecting an estimated 6 million Americans. A study that will track older adults to bring about more effective treatments and ways to prevent the disease has received funding of $55.6 million from the National Institute on Aging, part of the National Institutes of Health. The University of California, Riverside, will receive about $1.5 million of the grant, with the UCR Brain Game Center for Mental Fitness and Well-being, led by psychologist Aaron Seitz, driving the development of new digital cognitive assessments in Riverside.
The study, called the Adult Changes in Thought study, or ACT, is led by Kaiser Permanente Washington, the University of Washington School of Medicine, and the University of California, San Diego. The funds will be used to advance the understanding of Alzheimer’s, and to diversify and broaden participation in the study. Researchers will use the latest technologies to analyze brain structure changes, measure neuronal responses to various drugs, and evaluate cognitive and physical functioning. The study personnel will grow to 41 investigators at 10 research institutions across the United States and Canada.
“At the UCR Brain Game Center for Mental Fitness and Well-being we will develop new digital tests, and through the ACT study, we will validate measures in a sample of older adults in Riverside and then bring these measures to the ACT cohort in Seattle to better determine relationships between cognitive measure and brain pathology with attention paid to participants demographics, health history, activities of daily, and environmental factors,” said Seitz, director also of the UCR Aging Initiative. “The goal is to arrive at a deeper understanding of human aging and identify potentially novel biomarkers that predict health needs related to Alzheimer’s and related diseases.”
Seitz, who is a professor of psychology and the Campbell Endowed Term Chair for Research Excellence and Undergraduate Research Mentoring in the UCR College of Humanities, Arts, and Social Sciences, explained that most cognitive tests currently use paper/pencil approaches. While these serve researchers well in understanding and identifying people with cognitive needs, they are limited in their scope and reach. For example, standard tests require a trained administrator to be in the room with the patient being evaluated. Further, evaluation forms often simply get filed into a drawer and only the overall score from the administrator is logged into digital records used to track patients’ progress.
“With the innovation of new digital tests, we can not only make traditional measures available to telemedicine approaches but in doing so create digital records, allowing for deeper comparisons over patients’ performance across time,” Seitz said. “We can also trace changes in fine motor skills, and more subtle changes in performance can be routinely evaluated by powerful computers, and then reevaluated as computing inevitably gets better with time. This, combined with the addition of new tests that cannot be conveniently delivered via paper/pencil, such as those involving hearing, fine visual skills, as well as newer measures of attention and memory, can revolutionize our understanding of cognitive aging.”
Since it began, the ACT study has enrolled more than 5,800 older adults who receive care as Kaiser Permanente members in the state of Washington. Researchers track participants to find out which ones remain healthy as they age, which ones develop dementia, and how the condition manifests itself. The new five-year grant will increase the current study group of 2,000 Kaiser Permanente members to 3,000 and recruit a more diverse population.
More than 900 study participants arranged for their brains to be donated to the study postmortem, allowing ACT to establish a brain bank. The grant will allow data from ACT to be digitized and shared with researchers worldwide.
As part of the new funding, researchers will pursue three research projects:
- One will examine how device-measured physical activity and sleep over the 24-hour day is related to brain aging and dementia.
- A second project will characterize subtypes of Alzheimer’s dementia.
- A third project will study the effects of commonly used drugs that the ACT study has shown can influence dementia risk.
Seitz is a co-principal investigator of the clinical core that supports all three projects. His team will develop new digital cognitive assessment tools to assess participants’ cognitive status.
“We hope these tools will successfully advance aging research,” he said. “After we develop the assessments and validate them in older adults in the Riverside area, we will integrate them into the studies run in the Seattle area.”
Eric Larson, M.D., a senior investigator at Kaiser Permanente Washington Health Research Institute, founded the ACT study in Seattle in 1994. He is co-principal investigator along with Paul Crane, M.D., professor of medicine at the University of Washington School of Medicine, and Andrea LaCroix, professor of and chief of epidemiology at UC San Diego.
The ACT team also includes faculty and staff from Boston University, Columbia University, Swedish Medical Center in Seattle, University of Pennsylvania, University of Toronto, and University of Wisconsin-Madison.