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Prevention and Treatment Research

Alzheimer’s and related dementias are highly complex conditions. They usually develop gradually: Changes in the brain take place over years and decades, long before the first symptoms appear. These complexities can be exceptionally challenging for researchers committed to discovering, developing, and disseminating new drugs and other approaches to treat and prevent these devastating diseases.

Currently, physicians can prescribe medicines that help abate some of the symptoms of Alzheimer’s and related dementias. These therapies may help people temporarily maintain mental function, reduce symptoms of agitation or aggression, and slow the worsening of memory loss. Although treatments may help some people remain independent for a longer time, the dementias invariably worsen.

While researchers worldwide continue to work tirelessly to find ways to prevent and more effectively treat Alzheimer’s and related dementias, it is unlikely that any single intervention will successfully halt or reverse the effects of these diseases for everyone. Much like what has been achieved for cancer treatments, which can be directed specifically against subtypes of that disease for targeted interventions, the hope for improved dementia treatment is to be able to tailor a therapy or combination of interventions to an individual’s unique disease characteristics.

With this precision medicine approach in mind, NIH is advancing research through its support of large-scale genetic mapping of people with dementias, molecular studies of existing groups of research participants, identification of biomarkers that can distinguish between different subtypes of dementia, and novel behavioral, social, and environmental factors associated with risk in long- term population studies. As precision medicine researchers uncover how the variety of genetic, biological, environmental, social, and lifestyle factors interact to elevate or reduce the risk of Alzheimer’s and related dementias, there will be more scientific avenues for developing precise treatments and preventions for the different types and subtypes of Alzheimer’s and related dementias.

The tremendous public investment in NIH-funded research over the past five years has enabled scientists to pursue many of these avenues simultaneously as they study promising drug treatments that act upon many different elements of the disease pathway. Concurrently, researchers are using data from population studies to find additional risk and protective factors that will help them develop and test specific treatment and prevention strategies. Some approaches do not rely on drugs; rather, they focus on behavior changes and lifestyle choices such as the careful control of high blood pressure, which is an established risk factor for dementia.

NIH-supported, collective advances in genomic and population research, as well as in data science, have contributed significantly to enhanced understanding of the underlying biology of Alzheimer’s and related dementias. Simultaneously, technological innovations, such as the use of machine learning to create better disease models from vast amounts of data, as well as investments in research infrastructure, have enabled more scientific discovery and greatly propelled us further along in finding more effective treatments and ways to delay symptoms and disease progression.

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