One is no longer the loneliest number, as a Florida Atlantic University researcher wants to focus on individuals to revolutionize dementia and Alzheimer's disease treatment. Rather than approach clinical trials with large populations and a single treatment, the strategy proposes a study group of one patient who receives 100 personalized trials.
James E. Galvin, neuroscientist and FAU Charles E. Schmidt College of Medicine associate dean for clinical research, pioneered the approach for dementia and Alzheimer's care. Not only does he believe his strategy could alleviate cost concerns for clinicians and patients, but he also expects it will produce results faster because it doesn't require a large, homogenous population. Plus, the plan doesn't need observation periods that could span years or decades.
In particular, the Dementia Prevention Initiative focuses on risk factors specific to the patient via a two-year clinical trial. These facets include sociodemographics, co-existing diagnoses, genetic traits, lifestyle choices and biomarkers like electrophysiology, blood and imaging. Another target is brain health, as Galvin cites halting the progression of neurodegeneration even before onset as crucial.
Taking cues from cancer treatment
While Galvin's plan is groundbreaking for dementia and Alzheimer's, it's not new to the world of medicine. The DPI borrows its foundations from cancer treatment.
"The DPI focuses on a risk factors specific to the patient."
According to the American Cancer Society, the effort received stimulus from former U.S. President Barack Obama's Precision Medicine Initiative, which put $215 million toward this type of research and care. For cancer, the need for such an approach arose from the disease's complex origins. A combination of factors prompt cell mutation and growth, and blanket approaches likes chemotherapy and radiation can damage healthy cells.
Even targeted drug therapies that arrived in the 1990s and 2000s couldn't produce treatments that had the needed amount of personalization. Because of each patient's cocktail of mutations, identifying the ones that will react to the drugs from one tumor to the next presents challenges. This obstacle prompted the push toward the personalization strategy, which Galvin expects will be a boon for dementia and Alzheimer's patients.
Tracking more than age
Like the previous focus on certain genetic factors in cancer research, neurodegenerative disease observations typically returned to a single area of risk: age. The DPI takes that dimension into account with others while also determining how how each one interacts.
"While we know that a well-balanced, healthy lifestyle may be the cornerstone of disease prevention and brain health, each risk factor such as vascular, lifestyle choices, psychosocial behavior may both act independently and potentiate the effects of each other," Galvin said. "Therefore, a prevention initiative needs to be multimodal and tailored to address individual risks."
Galvin believes personalized treatment and research could curb comorbidities even if it doesn't become the end-all, be-all pathway to preventing dementia and Alzheimer's.