Recent new drugs for treating Alzheimer’s disease have been heralded as breakthroughs—with the potential to slow the progression of dementia and give people a little more time with their memories. But they’re expensive. Really expensive. Leqembi, as an example, has a list price of $26,500 per patient, per year. And it reportedly only slows cognitive decline by about six months.
But what if there was a way to prevent dementia—without those high costs?
A major new project co-led by Boston University, the University of California, San Francisco, and Kaiser Permanente Division of Research will examine whether public health interventions that target alcohol use, social isolation, depression, and sensory impairments (like hearing loss) could also help reduce the risk of developing Alzheimer’s disease and related dementias. According to the World Health Organization, 55 million people around the world have dementia. The Triangulation of Innovative Methods to End Alzheimer’s Disease project was recently given a $28.8 million grant from the National Institute on Aging (NIA) to drive its work.
“There are multiple etiologies that contribute to dementia,” says Maria Glymour, a BU School of Public Health chair and professor of epidemiology, who will be the University’s lead on the project. “Your brain is just one organ. And all the bad things you do to it, those all come together to influence how you can use it; that also means there are lots of potential opportunities to keep it healthier.”
According to a Lancet commission report, 45 percent of dementia cases could potentially be prevented by addressing key lifestyle and risk factors, from substance use to loneliness to hypertension. And some of the solutions might be as simple as reducing alcohol use, promoting an active social life, or helping people lower their cholesterol in middle age.
Over the next five years, Glymour and the project team will analyze a wealth of health and clinical data and research to provide more robust evidence on how risk and lifestyle factors contribute to dementia. The overall goal of the project is to fill both a science gap and a public knowledge gap. With more evidence of what prevents dementia, Glymour says they can better inform policymakers and clinicians on prevention and treatment strategies, while also educating the public on changes they can make to reduce their dementia risk.
“The reason this [NIA] grant is so big is that we’re bringing together many, many data sources to be able to analyze them in a way that we can integrate the evidence from across all of them,” says Glymour. “If you want to provide guidance on what to intervene on, you need to really try to be right. It’s very important not to go out and say, ‘Hey, change your behavior,’ if you don’t actually have good evidence about what the health effects would be.”
She says there’s a lot of research out there on dementia, but that every study has its pros and cons: some may include lots of people, for example, but not follow them over a long period of time. The triangulation project’s goal is to analyze diverse sets of data to help fill in the gaps. Glymour gives the example of alcohol use, which has been tied to a higher risk of dementia.