The Triangulation of Innovative Methods to End Alzheimer's Disease project will use large, diverse datasets to examine whether interventions targeting alcohol use, depression, vision or hearing impairments, or social isolation can protect people from Alzheimer's disease and related dementias. This project is a collaboration among Dr. Maria Glymour at Boston University School of Public Health, Dr. Jacqueline Torres at the University of California, San Francisco and Dr. Paola Gilsanz at the Kaiser Permanente Northern California Division of Research and colleagues at three other research institutions.
Up to 45 percent of Alzheimer's disease and related dementias (ADRD) cases could be prevented by modifiable risk factors, but current research is limited to observational studies that make it difficult to establish definitive causes.
Dr. Maria Glymour, chair and professor of epidemiology at Boston University School of Public Health (BUSPH), Dr. Jacqueline Torres, associate professor, epidemiology & biostatistics at the University of California, San Francisco, and Dr. Paola Gilsanz, research scientist II at the Kaiser Permanente Northern California Division of Research, have received a $28.8 million grant from the National Institute on Aging to lead an ambitious initiative that will strengthen this research and develop more reliable evidence to guide prevention and treatment strategies for these degenerative neurological diseases.
The five-year award will support the Triangulation of Innovative Methods to End Alzheimer's Disease (TIME-AD) project, which will integrate large, diverse datasets and apply cutting-edge causal inference methods to compare findings and quantify or correct biases in the results. Dr. Glymour co-leads the project with researchers from the University of California, San Francisco and the Kaiser Permanente Northern California Division of Research. The research team also includes researchers at the University of California, Los Angeles, Harvard University, and Kaiser Permanente Northwest. This unique collaboration will enable more definitive evidence than previously achievable.
"Preventing diseases like Alzheimer's and other causes of memory loss and dementia is among the highest priority for older adults, yet, we still lack rigorous evidence on what works," says Dr. Glymour, whose research spans dementia risk and age-related cognitive decline, as well as the social inequalities that persist in unhealthy aging. "Day-to-day decisions or routine medical care may help ensure older individuals maintain healthy brains. The TIME-AD project aims to deliver the best possible evidence on how much these opportunities can make a difference to delay or prevent dementia."
More than 10 million people worldwide are diagnosed with a form of dementia each year, with Alzheimer's disease contributing to the majority of new cases. Some estimates suggest that more than 1 in 4 people think there is nothing they can do to prevent dementia, but a wealth of data suggests otherwise. As there remains no cure for ADRD, it is a public health priority to better understand how to reduce everyone's risk of developing ADRD.
For the TIME-AD project, the research team will investigate four major modifiable risk factors for ADRD: lifetime alcohol use, depression, vision and hearing impairments, and social isolation, aiming to provide more comprehensive and convincing data that could explain whether and to what extent these risk factors contribute to ADRD risk.
"These risk factors were each chosen because we already know how to change them," Dr. Glymour says. "If our study demonstrates these interventions make a difference, then individuals, families, healthcare systems, and policymakers can immediately start to act on that evidence to reduce the epidemic of Alzheimer's disease and dementia."
The team will prioritize health equity throughout their work, examining potential differences in risk by gender, race/ethnicity, and socioeconomic status. ADRD inequities are a major challenge in the United States. For example, Black and Latino people are more likely to develop Alzheimer's disease than White people-;but less likely to be diagnosed. Many studies use data sets that are too small to identify the factors that lead to disparities by gender, race/ethnicity, or socioeconomic status. By combining multiple data sets, TIME-AD will have statistical power to better address ADRD risk in diverse populations.
We have an extraordinary team of health researchers collaborating on this project because we recognize both the urgency of the questions and the potential for progress."
Dr. Maria Glymour, chair and professor of epidemiology, Boston University School of Public Health
Several BUSPH researchers are coinvestigators of this project, including Dr. Rhoda Au, professor of epidemiology; Dr. Ruijia Chen, postdoctoral associate in the Department of Epidemiology; Dr. Yvette Cozier, associate dean for diversity, equity, inclusion & justice and professor of epidemiology; Dr. Phillip Hwang, assistant professor of epidemiology; Dr. Marcia Pescador Jimenez, assistant professor of epidemiology; Dr. Koichiro Shiba, assistant professor of epidemiology; and Dr. Justin White, associate professor of health law, policy & management.
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