1. Alzheimer's Prevention Research and Inflammation Whitney Wharton, PhD Associate Professor, SON, SOM Emory University

2. Overarching Research Goal:
To identify modifiable risk factors that may delay or prevent AD
Implement pharmaceutical and lifestyle interventions
Vascular risk factors and AD biomarkers (NIA K01)
RCT with a BP med in African Americans (Alz Assoc PTC)
Caregiver Stress (NIA Admin supp. to address health disparities)
Inflammation and immune cell profiles (R01)
Tango for African American female AD family caregivers (VA, NIA R01)
Painting / Photography for AD patients and family caregivers
Caregiver intervention (Savvy Caregiver) in LGB AD caregivers
Sex hormones (CSF and blood) and CSF AD biomarkers, inflammation, sleep, and brain blood flow and volume (pending R01)
RCT with a DRI on AD CSF biomarkers, neuroimaging and the RAS (pending R01)

3. Early Detection MCI Mild AD Moderate AD Severe AD Increasing Age
Normal Cognition
MCI
Mild AD
Worse Cognitive Abilities  better
Start Treatment HERE
Moderate AD
Severe AD
95 Years
Increasing Age

4. Shifting the curve What factors can we identify that….
Are linked to cognitive decline
Are linked to the pathological hallmarks of AD (plaques and tangles)
Occur during Midlife
TREATABLE / REVERSIBLE

5. Risk Factors and Alzheimer’s disease Alzheimer’s is associated with:
Midlife Hypertension
Midlife Hypercholesterolemia
Inflammation
Obesity
Diabetes
Sleep Disruption
Sex Hormones
What are the environmental risk factors?

6. Who is most at risk for AD?
African Americans
Women
Middle Age
Increased Vascular risk
Family History (genetics +….)
Caregivers
To Help the Most people Possible, You Must Target Those Most at Risk!!

7. Race differences in CSF p-tau and t-tau, but not Abeta
Race modified the relationship between t-tau & IL-9 (p=0.018), and p-tau and IL-9 (p<0.001)

9. Sex and Inflammation
Postmenopausal women taking HT, but not women opting not to take HT, had significantly different IL-7 levels in plasma and CSF vs. premenopausal women. Direction of change in IL-7 differed according to the biofluid.

10. A cohort of middle age FH+

11. Available Data for Collaboration
Health Data
Medical and medication history
Cognition
Vascular ultrasound (PWV, FMD, EndoPat)
Ambulatory BP
Stress, nutrition, exercise, sleep
Biomarkers
Blood (plasma, buffycoat, serum, whole blood)
CSF (AD biomarkers, RAS biomarkers, inflammation)
Urine

12. Thank You