Advancing Alzheimer disease research during a pandemic

This is a special guest post by Dr. Suzanne E. Schindler, a neurologist with special interest and training in neurodegenerative disorders including Alzheimer’s disease.

Alzheimer disease has personally impacted most of us in some way.  The growing recognition of the high costs of Alzheimer disease, both on individuals and on society, has led to increased funding and support for Alzheimer disease research.  These investments have led to significant progress in understanding, diagnosing and treating Alzheimer disease.  For example, we have learned that the brain changes of Alzheimer disease begin about twenty years before the onset of cognitive changes.  Brain imaging techniques have been developed that can visualize the changes of Alzheimer disease in living patients.  We have also come to understand that drugs for Alzheimer disease are more likely to be effective when given very early, perhaps even before the onset of significant cognitive changes.   

The Alzheimer disease research community has been enthusiastically working to develop effective drugs to slow or prevent cognitive decline.  So, when the COVID-19 pandemic struck, and work in many labs and clinical trials across the United States was abruptly halted, it was very disappointing.  Would we lose our momentum?  However, partly because many of us believe that Alzheimer disease is also a public health crisis, we learned about the virus and considered how we could safely resume our studies.  We talked to our colleagues to hear their experiences in countries that were hit early in the pandemic (e.g. Spain) and in countries that fared relatively well (e.g. Australia).  Many of us also care for patients in the clinic and/or the hospital.  Clinical care has continued during the pandemic by implementing safety protocols, and we have adapted these safety procedures for research studies.  

The keys to safely conducting research are now well-known: social distancing, increased hygiene measures, and wearing masks.  Most of our research participants are older and at higher risk of COVID-19 complications, which necessitates the utmost caution.  When possible, we have changed from in-person assessments and cognitive testing to virtual testing over the phone.  We have increased home visits for procedures previously done in the clinic, such as infusions and blood draws.  For studies requiring in-person visits, we have implemented rigorous safety protocols.  We have learned to live with the virus in our midst and our research is now continuing, albeit in a modified format.  

The Alzheimer Association International Conference was held virtually, for the first time, in July.  Several investigators, including myself, announced the development of new and very accurate blood tests for Alzheimer disease.  We expect that blood tests for Alzheimer disease will accelerate the process of finding effective drugs for Alzheimer disease, and will also enable earlier and more accurate diagnosis of Alzheimer disease.  Despite this pandemic, we are continuing to move forward.  And although COVID-19 has affected nearly everyone on the planet, the pandemic will subside at some point.  In contrast, without significant research progress, there is no end in sight for Alzheimer disease.  For the estimated 5.8 million Americans living with Alzheimer disease dementia and their families, we are continuing our fight against this disease, even during the pandemic.