to find ways for people to maintain connections with their loved ones.
Under Dr. Carrillo, the Alzheimer’s Association is launching the U.S. POINTER study, a $100 million, five-site initiative inspired by a groundbreaking study that began in Finland. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was the first randomized controlled trial to show that it is possible to prevent cognitive decline through multi-pronged lifestyle modifications, in particular physical and cognitive exercise, changes in diet (more fresh vegetables, fruits, and lean proteins, and fewer saturated fats and sugars) and monitoring of cardiovascular risk factors. The FINGER trial interventions reduced cognitive decline in participants by 30 percent. Now known as the WW-FINGERS Network, “this has turned into a global movement,” Dr. Carrillo says. “There are now 20 countries that are launching studies like this.” The Alzheimer’s Association has just added POINTER sites in 13 Latin American countries.
The POINTER study fits with the association’s ongoing research focus on what Dr. Carrillo calls middle age risk factors: midlife waist circumference, blood pressure, cholesterol, and smoking. The goal is to “create a recipe” for people in middle age and beyond that will give us all the power to decrease our own risk factors for cognitive decline by making changes in our daily lives. The POINTER study is expected to provide confirmation of what researchers have long believed—what’s good for your heart is good for your brain.
Possible Drug Treatments
The Alzheimer’s Association is also a major funder of drug research, including studies of Biogen’s Aducanumab, the first disease-modifying Alzheimer’s treatment to be considered by the United States Food and Drug Administration. Though the FDA has asked for another Phase 3 trial, which will delay access to Aducanumab for up to four years, Dr. Carrillo sees this type of drug as part of a future in which lifestyle changes plus medication could make Alzheimer’s disease a manageable chronic illness, much like diabetes.
Another significant step forward this year has been the development of a simple blood test to detect Alzheimer’s disease. Though it’s not quite ready for prime time, Dr. Carrillo says that when it is, it will be a huge boon to both family practice doctors and research scientists, because they will be able to verify whether someone has the disease quickly and easily, rather than having to do an expensive PET scan or a lumbar puncture (spinal tap).
The pace and scope of Alzheimer’s research has increased dramatically in the past five years. Federal funding has gone from $631 million in 2015 to $3.1 billion in 2021, due in large part to the Alzheimer’s Association’s tireless advocacy on Capitol Hill. And the association’s own funding capacity was given an enormous boost beginning three years ago with the launch of California philanthropist Mikey Hoag’s Part the Cloud initiative. In 2019, Bill Gates added $60 million to the Part the Cloud Fund, which is currently funding more than 60 studies, many of them exploring areas of brain research that go far beyond the emphasis of the past few decades on amyloid plaques and tau protein tangles.
“There’s so much more happening in the aging brain that can contribute to memory loss, to brain cells changing and not holding onto memories or making new ones,” says Dr. Carrillo, making it essential that research “go beyond amyloid and tau alone at this point.” Some of the newest areas the Part the Cloud/Gates partnership are funding include mitochondria (how brain cells use energy and fuel), autophagy/clearance (how brain cells remove waste and debris to avoid clumping), and vascular contributions (how the blood supply to the brain is maintained).
Alzheimer’s research is personal for Dr. Carrillo. Both her mother-in-law and her father-in-law died of the disease. Knowing that she was watching a relentless biological process did not make it easier to see them reach the point where they could no longer create a memory of so