Research Opportunities at the UC Davis Alzheimer’s Disease Center
In addition to acting as a center for diagnosis and treatment recommendations, the UC Davis Medical Center Alzheimer’s Disease Center carries out numerous clinical trials aimed at improving the treatment and diagnosis of Alzheimer’s Disease (AD). We currently have trials available for both persons with AD and for those who are unaffected but want to contribute to AD research.
Current epidemiologic research suggests that statins – lipid lowering agents commonly used for heart disease- may delay or prevent the development of dementia. This potential effect could be due to modified amyloid processing in the brain or a reduced risk of stroke. In order to investigate whether statins slow the rate of cognitive decline in persons with AD a national randomized, placebo-controlled trial of simvistatin is underway. As part of this trial, we are currently enrolling persons with AD who are not already taking a statin and do not have known heart disease.
Epidemiologic evidence also suggests that elevated levels of homocysteine, a pro-oxidant amino acid associated with low levels of folic acid and vitamin B12, is associated with an increased risk for AD. We currently have 2 trials investigating the role of this amino acid. The first trial is open to persons with and without AD – couples are ideal. This trial involves observing the correlation between homocysteine levels with findings on brain MRI and the response in homocysteine levels to vitamin supplementation. The second trial is a national randomized, placebo-controlled trial investigating the effect of B-vitamin supplementation on slowing the progression of cognitive decline in persons with AD.
Intuitively, many of us suspect that stress and associated elevated stress hormones may be harmful for our health. Preliminary information suggests that the APOE-4 gene which itself is associated with an increased risk for AD may have part of it’s effect through increased spinal fluid levels of the stress hormone cortisol. In this study APOE genotype and spinal fluid cortisol levels obtained through lumbar puncture are being measured in persons with AD and young, middle aged, and elderly persons without AD. This study is opportunity for non-affected persons to contribute, as the association between APOE-4 and cortisol will be measured in persons of all ages and with and without AD.
Our center is also participating in a national study of Huperzine A, a natural cholinesterase inhibitor derived from the Chinese herb Huperzia serrata which appears to compare favorably in symptomatic efficacy to cholinesterase inhibitors currently in use (Aricept, Reminyl, Exelon). In addition, Huperzine A has antioxidant and neuroprotective properties that suggest that it may be useful as a disease-modifying treatment for Alzheimer’s disease (AD). The drug is currently available as a nutriceutical in this country, and is being used by some U.S. clinicians to treat AD. However, there have been no controlled clinical trials outside China assessing its toxicity and efficacy. This randomized, placebo-controlled, study will assess the tolerability and effectiveness of Huperzine A in persons with AD. Participants cannot take one of the currently available cholinesterase inhibitors during the trial as this could result in toxicity, but may take Memantine.
Our last trial is aimed at understanding the genetics of AD. Although we know that early onset AD (onset before 60 years of age) is associated with various gene mutations, the genetics of late-onset AD (LOAD), the most common type of AD, is not well understood. We are participating in a national trial whose goal is to identify 1,000 families with multiple members diagnosed with LOAD (age of onset after 60 years of age) over the next 3 years. Blood samples and other clinical information will be collected from these family members and stored without identifying information in a national repository for future genetic research in AD. To be eligible, families must include at least 3 living members. At least 2 members must be siblings with AD and age of onset older than 60 years of age. The third and any additional members can be children, parents, or cousins and can be affected or unaffected. Unaffected persons must be older than 60 years of age. With this trial, we hope to further the understanding of the genetic causes of AD.
In addition, we are carrying out three additional trials, which have either completed enrollment or have very specialized enrollment. The first follows elderly persons with normal cognitive function over a period of three years and is aimed at elucidating predictors and measures of cognitive decline. The second examines the role of Positron Emission Tomography or PET scanning in distinguishing between AD and Frontal Temporal Dementia. The last examines whether intensive computer-based training can improve the cognitive performance of patients with mild cognitive impairment, impairment in cognitive function such as memory loss that is generally seen as a prelude to developing Alzheimer’s Disease (AD).
If you are interested in participating in any of the above studies or would simply like to be on a list for future studies which may arise, please contact Casandra Conover, Clinical Trials Coordinator at 916-734-5496. Our website, alzheimer.ucdavis.edu, also has a description of current trials.
CENTER CONTACTS
FOR RESEARCH SUPPORT
Principal Investigator:
Charles DeCarli, M.D.
Telephone: (916) 734-6280
email: charles.decarli@ucdmc.ucdavis.edu
Research
Coordinators:
For Martinez and Oakland:
Carole Bibeau, R.N., M.S., Clinical Nurse & Research Coordinator
(925) 372-2485
email: cabibeau@ucdavis.edu
For Sacramento and San Joaquin:
Esther Lara, M.S.W., Research Coordinator (Se habla Español)
(916) 734-5496
email: ellara@ucdavis.edu
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Dr. William Seavey, MD.