As our populations live longer, Alzheimer’s disease, the progressive neurodegenerative disorder that causes dementia in older adults, is a growing concern in the United States. It is the third-leading cause of death in the U.S. behind heart disease and cancer, according to the Centers for Disease Control (CDC). Currently, more than 5 million individuals are living with Alzheimer’s disease, and that number is estimated to rise to 16 million by 2050.
Yet while there are more than 1,500 clinics devoted to cancer research across the nation, only 31 Alzheimer’s research institutes exist. The cost of Alzheimer’s each year is substantial, with an estimated $259 billion health care dollars going to managing the disease in 2017 alone, according to the Alzheimer’s Association.
Idaho will be hit especially hard by this increase in Alzheimer’s cases. Ours is the fastest-growing state in the nation and has become particularly attractive as a retirement destination – more than 15 percent of our state’s population is 65 or older, which is when late-onset Alzheimer’s is usually diagnosed. Because of our demographics, the CDC predicts that Idaho will see a 44 percent increase in Alzheimer’s by 2025, making it the fifth-highest increase in the nation.
And partly because of a dearth in research, misconceptions about the disease abound among the general public.
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“People think that it’s all hereditary – if their grandma has it, they’re going to get it,” explained Troy Rohn, a biology professor at Boise State University who has specialized in Alzheimer’s research for more than 20 years.
Lately, this misconception has been flamed by the popular DNA genetic testing kit 23andMe, which tests for a gene associated with Alzheimer’s risk. Historically, testing for this gene was available only through clinical tests and research trials. Now, any person can order their test results through a simple saliva test, which can pose problems when individuals fail to differentiate between genetic predictors and genetic susceptibility.
“The truth is, less than 5 percent of all Alzheimer’s cases have a genetic basis. Most people don’t understand that at all,” Rohn said. “The biggest risk factor is age – period. If you don’t want to get Alzheimer’s, don’t age. You won’t get the disease.”
Nevertheless, educating individuals on their 23andMe test results has become routine for Rohn. This is because he and Stephanie Hall, a clinical assistant professor of kinesiology at Boise State, are two of the only researchers in Idaho working to discover how Alzheimer’s may be triggered on the cellular level, or how its symptoms may be arrested and alleviated. Both Rohn and Hall rely on each other, as well as collaborators from outside the state, to conduct their research.
Rohn focuses his research on better understanding the APOE4 gene, which poses a risk factor for late-onset Alzheimer’s. No one knows why APOE4 poses an enhanced dementia risk. In fact, another variant of the gene (APOE3) is neutral in terms of disease risk, and yet another variant (APOE2) actually lowers an individual’s risk. Rohn devotes much of his research to understanding the molecular difference between APOE3 and APOE4, and how those differences could affect the pathology of the disease.
Hall, meanwhile, focuses her research on how exercise may be used as a tool in both the prevention and treatment of Alzheimer’s. While Alzheimer’s patients often experience significant muscle atrophy, it’s unclear whether that atrophy is the product of inactivity caused by the disease, or whether actual skeletal muscle changes occur.
“I’m looking at skeletal muscle changes that take place with Alzheimer’s and how exercise can protect against Alzheimer’s,” Hall said. “There’s no cure, no known way to slow down the disease, but if you exercise for as little as six months, you can increase the volume of your hippocampus, which is the center for memory and the area that is most targeted by Alzheimer’s disease.”
In other words, if Hall can understand how exercise protects Alzheimer’s patients, it could put researchers on a treatment pathway for the disease.
The work both Rohn and Hall are doing is incredibly important to the future of Idaho and its residents, some of whom will end up with Alzheimer’s, while others will act as their caregivers and medical champions.
Yet they are not the only ones in the state working hard to ensure Alzheimer’s research gets adequate attention and funding. A local Treasure Valley couple, one of whom received an Alzheimer’s diagnosis, began raising money for Rohn’s lab by hosting raffles at restaurants with donated gifts. In years past, the couple’s fundraising helped keep his lab bolstered between research grants.
“I’ve used their contributions to pay students for research and for supplies,” Rohn said. “It really showed me that people can have an impact on research in their community and in Idaho if they care enough to get involved.”
Mark Rudin is vice president for research and economic development at Boise State, where he oversees the Office of Sponsored Programs, the Office of Research Compliance, and other administrative and technical offices.