NIH awards $13.8 million to conduct studies on pre-dementia and Alzheimer's disease

Joe Verghese, M.B.B.S., M.S., , an international leader in aging and cognition research at Albert Einstein College of Medicine and Montefiore Health System, has received two grants from the National Institutes of Health totaling $13.8 million to conduct studies on pre-dementia and Alzheimer's disease.

The first grant totals $7.6 million over five years and will fund a study of a pre-dementia condition called motoric cognitive risk syndrome (MCR) in 11,000 older adults living in six countries. The second five-year grant of $6.2 million will enable researchers to evaluate the effectiveness of a non-invasive brain stimulation technique intended to alleviate symptoms of Alzheimer's disease and improve brain function.

Approximately 50 million adults worldwide have dementia, which puts an enormous burden on individuals, their families and caretakers, and the healthcare system. Our ultimate goal is to develop treatments that can prevent or treat Alzheimer's disease, which is the most common form of dementia."

Dr. Joe Verghese, Director, Montefiore Einstein Center for the Aging Brain

Dr. Verghese is chief of the integrated divisions of cognitive and motor aging and of geriatrics at Einstein and Montefiore. He also is the Murray D. Gross Memorial Faculty Scholar in Gerontology, director of the Resnick Gerontology Center, and professor in the Saul R. Korey Department of Neurology and of medicine at Einstein.

Exploring the Biology of Pre-Dementia Dr. Verghese first identified and described MCR, a condition in which older adults have an abnormally slow gait and cognitive complaints, in a 2014 study . He found that MCR affects almost one in 10 older adults and those diagnosed were twice as likely as other older adults to develop dementia within 12 years.

The first grant will allow Dr. Verghese and his colleagues to investigate the biological roots of MCR and identify biomarkers for the condition. Researchers will establish a consortium of eight ongoing studies of aging, evaluate biological and genetic data from the participants, and track their structural and functional brain changes over time. Hundreds of participants will be enrolled from current studies at Einstein, including the LonGenity Study , the Central Control of Mobility and Aging, and the Einstein Aging Study.

"We've already uncovered clues about the biological pathways and brain structures implicated in MCR, which appear distinct from other pre-dementia conditions, and now we can dig deeper to refine our understanding of this syndrome," said Dr. Verghese. "The large number of study participants will give power to our findings and, we hope, help us to identify new ways to prevent or treat MCR and slow or stop its progression to Alzheimer's." Einstein-Montefiore collaborators on the grant include Nir Barzilai, M.D., Helena Blumen, Ph.D., M.S., Carol Derby, Ph.D., and Richard Lipton, M.D.

Studying a Novel Non-Invasive Approach for Treating Alzheimer's Dr. Verghese's second grant will focus on treatment, specifically, the at-home use of transcranial direct current stimulation (tDCS) therapy, delivered with a bathing-cap style head covering. The randomized, double-blind study will evaluate the effects of six months of at-home tDCS on improving cognitive performance and selected symptoms in 100 patients with mild-to-moderate Alzheimer's disease. The co-primary investigator on the grant is Helena Knotkova, Ph.D., D. Phil. , associate professor of medicine at Einstein and director of clinical research and analytics at the MJHS Institute for Innovation in Palliative Care.

Study participants or their caregivers will be trained to use the headgear and a companion telehealth tablet. Participants will receive either placebo or actual tDCS treatments for 30 minutes, five times a week, over six months. Researchers will use established tests and surveys to measure cognitive performance, attention, and mood. Immediately after the six-month period, and again at two later dates, investigators will assess functional and structural brain changes using functional magnetic resonance imaging (fMRI).

"There is a compelling need for new, low-risk treatment approaches for Alzheimer's disease," said Dr. Verghese. "Transcranial direct current stimulation has been effective in animal research and in some limited human studies, and there appear to be very few side effects. If we can demonstrate the effectiveness of this treatment, it could potentially become an important part of dementia care."