The Alzheimer's Association and the National Institute on Aging (NIA) have published a new Research Framework that proposes shifting the definition of Alzheimer’s disease for research use only. The “NIA-AA Research Framework: Towards a Biological Definition of Alzheimer’s Disease” would define Alzheimer’s disease biologically, by pathologic brain changes or their biological markers, and treat cognitive impairment as a symptom/sign of the disease (rather than its definition).
Other areas of medicine have used this approach to define disease processes using biomarkers, for example in diabetes, successfully. It creates a window of opportunity for treating the disease in its earliest stages, when prevention is still possible and achievable, rather than waiting for dementia symptoms to emerge. We believe this tool will advance exactly the kind of research that will discover more Alzheimer’s biomarkers and test new treatment and prevention strategies.
The NIA-AA Research Framework provides hope for people like me and you, especially those who may be at an increased risk of Alzheimer’s. It gives us a way to define Alzheimer’s disease at the earliest brain changes, and more accurately enroll individuals in research studies to get to more effective treatments sooner by allowing us to specifically target the pathways that are causing the memory loss.
Since the passage of the National Alzheimer’s Project Act (NAPA), Alzheimer’s and dementia research funding at the National Institutes of Health (NIH) has quadrupled. These additional resources have funded new research leading to a better understanding of the disease, which is reflected in the proposed NIA-AA Research Framework.
Though it has undergone an extended period of public comment, this NIA-AA Research Framework is not a finished product—it is a research proposal. This proposal needs to be examined in natural history studies and in clinical trials, especially in diverse populations. Newly available federal research funds can be targeted toward this effort, as we strive together to meet the first goal of the National Plan to Address Alzheimer’s Disease: to effectively treat and prevent Alzheimer’s disease by 2025.
With the aging of the global population, and the ever-escalating cost of care for people with dementia, new methods are desperately needed to improve the process of therapy development and increase the likelihood of success. This new Research Framework is an enormous step for Alzheimer’s research.