The Alzheimer's Association has awarded more than $800,000 to support the SPRINT MIND 2.0 Study, which will further investigate the impact of intensive blood pressure treatment on reducing risk of dementia. The newly funded study will continue and extend follow up of the SPRINT MIND trial participants.
SPRINT MIND, which published its results Monday, January 28, 2019 in the Journal of the American Medical Association (JAMA), is the first randomized clinical trial to demonstrate that intensive treatment to reduce blood pressure can significantly reduce the occurrence of mild cognitive impairment (MCI).
"SPRINT MIND 2.0 and the work leading up to it offers genuine, concrete hope," said Maria C. Carrillo, Ph.D., Alzheimer's Association Chief Science Officer. "MCI is a known risk factor for dementia, and everyone who experiences dementia passes through MCI. When you prevent new cases of MCI, you are preventing new cases of dementia,"
However, the study's outcome on reducing risk of dementia was not definitive. The estimated reduction in risk for dementia was in the same direction and of the same magnitude as MCI, but it was not statistically significant, though there was a positive trend. According to the researchers, the success of the heart disease portion of trial resulted in early termination of the intense intervention meant the duration of the study was not long enough to definitively answer the dementia question.
"The Alzheimer's Association finds these data to be compelling, and is committed to getting clarity and certainty on the dementia outcome by following participants for a longer period of time," Dr. Carrillo said.
The Alzheimer's Association is taking rapid action to build on these results by providing seed funding for SPRINT MIND 2.0, an extension of the SPRINT MIND study that will re-engage the original trial's participants. SPRINT MIND 2.0 adds two years of follow-up and assessment to allow for a more definitive statement on reducing dementia risk.
With this financial commitment, the Alzheimer's Association enables SPRINT MIND 2.0 to begin in early 2019, which will make results available approximately one year earlier than anticipated with other funding sources. Discussions with other potential funders are ongoing.
"The Alzheimer's Association is committed to getting the answers about treating and preventing Alzheimer's and other dementias. We are filling the gaps in Alzheimer's research, and - with the support of our donors and partners - we act rapidly to maximize opportunities," Dr. Carrillo added. "Proof that lowering blood pressure can lower risk for dementia may be key to improving the lives of millions of people around the world."
The award is made to SPRINT principal investigator Jeff D. Williamson, M.D., M.H.S., Chief of the Section on Geriatric Medicine and Gerontology at Wake Forest School of Medicine.
SPRINT MIND compared two strategies for managing hypertension in cognitively healthy older adults: an aggressive strategy versus a standard care strategy.
- The intensive strategy used a systolic blood pressure goal of less than 120 mm Hg.
- The standard care strategy used a goal of less than 140 mm Hg.
The researchers reported a statistically significant 19 percent lower rate of new cases of MCI among participants receiving intensive treatment, and a 17 percent reduction in a combined outcome of MCI or probable dementia. For probable dementia alone, the results were not conclusive because they were not statistically significant.
"Dementia takes longer to develop than MCI. Consequently, the early termination of the study likely affected the number of dementia cases detected," Williamson said. "Further cognitive assessment of the SPRINT MIND study participants might discover enough additional cases of probable dementia to support a more definitive conclusion."
MCI is a noticeable and measurable decline in cognitive abilities, including memory and thinking skills. A person with MCI is at an increased risk of developing Alzheimer's, but progression to dementia is not certain. Some people with MCI return to normal cognition with proper treatment.
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer's is the most common cause of dementia.
High blood pressure is very common in persons over the age of 50 and a leading risk factor for heart disease, stroke, and kidney failure. A growing body of research suggests it may increase risk for dementia.
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