1. Ongoing Research With Vascular Risk Factors and the RAS in Individuals at Risk for AD Whitney Wharton, PhD Assistant Professor, Neurology Emory University

2. Funding, Disclosures No Disclosures Funding NIH / NIA, NINR
Alzheimer’s Association
ADCS VA
Emory Neurology

3. Overarching Research Goal:
Identify modifiable risk factors that may delay or prevent Alzheimer's disease in individuals at highest risk.
Implement pharmaceutical and lifestyle interventions
Blood Pressure Medications
Caregiver Stress
Tango for African American female AD family caregivers
Painting / Photography for AD patients and family caregivers
Exercise vs balance / yoga in MCI
The gut – brain study

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

5. 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

6. Vascular Risk Factors and Alzheimer’s disease
Alzheimer’s is associated with:
Midlife Hypertension
Midlife Hypercholesterolemia
Obesity
Diabetes
Sedentary lifestyle
Sleep Disturbances
What are the environmental risk factors?

7. Who is most at risk for AD?
African Americans
Middle Age
Female
Increased Vascular risk
Family History
Caregiver
To Help the Most people Possible, You Must Target Those Most at Risk!!

8. Women and Caregiving

9. Adult Child Caregiver:
Caregiving
Poor Nutrition
Lack of exercise
Sleep disturbances
Stress
Financial complications
Healthcare neglect
….Can lead to serious health and cognitive problems

10. AD Caregiver Stress Caregivers report more depression and stress
60% of AD caregivers rate the stress of caregiving as high or very high and about 40% suffer from depression
both are themselves independent risk factors for AD
Different reports depending on
Race, relationship to patient, age, in home vs. assisted living

11. Race and Caregiving
In the general population, African Americans report more depression and stress
Caregivers report more depression and stress.
African American family caregivers
Adult child
Woman
Increased vascular risk factors

12. The HEART Trial
Study to determine if a blood pressure medication can help prevent AD.
African Americans, 45-65, family history
5 visits over 8 months, $150 compensation
MRI, blood, CSF, cognitive testing, ambulatory blood pressure, (sleep, exercise, nutrition, stress)