National Plan to Address Alzheimer’s Disease

Fighting Alzheimer’s disease is a priority not just at NIH but across the Department of Health and Human Services and elsewhere in the Federal Government. In January 2011, President Barack Obama signed the National Alzheimer’s Project Act (PDF, 126K) (NAPA), which called for an aggressive, coordinated national Alzheimer’s disease plan and established an Advisory Council on Alzheimer’s Research, Care, and Services, consisting of some of the Nation’s foremost experts on Alzheimer’s disease.

The National Plan to Address Alzheimer’s Disease, unveiled in May 2012 and updated in June 2013, sets ambitious goals and outlines the Federal and private-public sector activities currently underway to meet those goals.

The Plan’s key research goal is to find effective ways to treat or prevent Alzheimer’s disease by 2025. NIH is working to meet that goal by strategically funding areas of study and by awarding funds for highly rated investigator-initiated projects. Further, in recognition of important scientific opportunities, NIH allocated additional funding for Alzheimer’s research in fiscal years 2012 and 2013.

The increased investment in FY 2012 went to basic studies and to the start of two major clinical trials seeking to intervene earlier in the disease process. These initiatives included:

Accelerating identification, through cutting-edge technologies, of new genetic variants influencing increased risk (risk factors) or reduced risk (protective factors) of Alzheimer’s disease.
Using new induced pluripotent stem (iPS) cell methods to obtain insights into the cellular processes of Alzheimer’s.
Awarding small business grants on basic science, the biology and genetics of Alzheimer’s disease, and translational and clinical research to develop and test therapies.

Two major clinical trials to speed testing of therapies in people at highest risk of the disease received awards:

Intranasal insulin. NIH committed $7.9 million to a one-year trial testing an insulin nasal spray for treating Alzheimer’s disease. In a recent pilot clinical trial, investigators found that this treatment improved memory, cognition, and daily functioning, with no side effects in participants with mild cognitive impairment (MCI) or mild to moderate Alzheimer’s disease. The larger, year-long trial will test the effects of intranasal insulin on cognition and function in a larger group of people with MCI or early Alzheimer’s. In addition, cerebrospinal fluid and imaging biomarkers will be assessed.
Alzheimer’s prevention. NIH committed $16 million to an international Alzheimer’s prevention effort, the first to focus on testing therapies in people who are cognitively normal but at extremely high risk of developing Alzheimer’s disease. The study includes approximately 300 adult members of a Colombian clan with a family history of rare, early-onset Alzheimer’s, as well as a smaller number of U.S. participants age 30 and older. This group includes both carriers and non-carriers of a genetic mutation known to cause observable signs of Alzheimer’s around age 45. The study will use brain scans, fluid biomarkers, and cognitive testing to track amyloid levels, changes in brain structure and function, and cognitive performance in participants taking an experimental drug. The trial is co-funded by the Banner Alzheimer’s Foundation and Genentech, a biotechnology company that is also providing the test drug, crenezumab.