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2017 Grants - Stojkovic
Strategies to Prevent Cognitive Decline in Non-Demented Subjects
Tanja Stojkovic, Ph.D.
University of Belgrade
2017 Alzheimer's Association Clinician Scientist Fellowship to Promote Diversity (AACSF-D)
Can exercise, brain training and other non-drug therapies help slow the loss of brain health leading to Alzheimer's disease?
Age is the primary risk factor for Alzheimer's disease. Age-related changes in the brain, such as the development of toxic protein clumps called amyloid plaques and tau tangles, may lead to the loss of memory and other cognitive functions in dementia. An individual's risk for Alzheimer's is also affected by a gene known as APOE. People with the e4 variant of this gene (APOE-e4) are more likely to develop the disease than are people with other APOE variants.
Recent studies, however, have found that certain activities may moderate the effects of age and APOE-e4 on dementia risk. For example, physical exercise and cognitive training (or undergoing mentally-stimulating activities) can slow the rate of cognitive decline in middle age, possibly delaying the onset of Alzheimer's later in life. Another procedure that may improve brain function is called repeated transcranial magnetic stimulation (rTMS). It uses electromagnetic pulses to stimulate nerve cell function in the brain. While these activities have shown promise in earlier research, scientists have not yet determined exactly how they affect the aging brain — and how they affect people with APOE-e4 compared with people who have other variants of APOE.
Tanja Stojkovic Ph.D., and colleagues plan to clarify the benefits of exercise, cognitive training and rTMS on Alzheimer's disease risk. For this effort, they will recruit around 200 participants who range in age from 30 to 60. Some individuals will have APOE-e4, while others will have different variants of the APOE gene. Each participant will receive one of four therapy programs — exercise, cognitive training, rTMS, or no therapy — over a three year period. Throughout the study, Dr. Stojkovic and her team will administer cognitive tests and magnetic resonance imaging (MRI) brain scans to their participants. Data from these procedures will be analyzed to measure how the different therapy programs affected cognitive function and the development of Alzheimer's-related brain changes in their participants. The team will focus especially on how the therapies may have had different effects on people at different ages and with different APOE variants.
Results of this effort could shed new light on how APOE and Alzheimer's disease risk are linked, especially in regards to lifestyle. They could also offer concrete, statistical evidence for how non-pharmaceutical therapies may slow the cognitive and neurological decline leading to Alzheimer's. Ultimately, such evidence could promote effective strategies for preventing dementia.