Last week, nearly 12,000 attendees, both in-person and virtual, joined the Alzheimer's Association International Conference® (AAIC) — the world’s largest and most influential international meeting dedicated to advancing dementia science. As the hybrid conference comes to a close, here are five learnings as the research community continues to seek treatments, earlier detection and prevention strategies for Alzheimer’s and all other dementia.
What is the Long-Term Cognitive Impact of COVID-19?
It’s vital to study how Alzheimer's — a global health crisis — relates to the global pandemic that is COVID-19. With over 4 million deaths worldwide, COVID-19 has especially impacted older, vulnerable populations, including people living with Alzheimer’s and other dementia.
While an unwelcome opportunity, the pandemic has enabled researchers to study the impact of viral infection on the brain. Initial data presented at AAIC 2021
suggest older adults may suffer lasting cognitive impairment after recovery from COVID-19 infection.
As these symptoms persist for many, researchers are working to understand why, and what this may mean for long-term cognitive health. One study conducted over six months in nearly 300 older adults from Argentina who had COVID-19 found more than half had continuing problems with forgetfulness, and 25% had additional problems with cognition. These difficulties were also associated with an enduring lack of smell.
This new data comes from first reports from an international consortium
evaluating the long-term impact of COVID-19 on the brain. With guidance from the World Health Organization, the consortium includes scientific leaders from the Alzheimer’s Association and study teams representing nearly 40 countries.
While we work to understand the long-term impacts of COVID-19 on our bodies and brains, the “take home” message to protect cognition is simple: don’t contract COVID-19. The best way to prevent getting COVID is to get vaccinated. If you do contract the virus, it’s especially important to take care of your cardiovascular health.
If you have been infected with COVID, it doesn’t necessarily mean you’re at an increased risk for dementia or Alzheimer’s. We're still trying to understand what that relationship is, but if you are experiencing symptoms such as “brain fog” or memory loss, you should talk with your doctor.
Improved Air Quality May Decrease Dementia Risk
Multiple studies presented during AAIC 2021 are the first to suggest that reducing pollution is associated with lower risk of dementia and Alzheimer’s disease. When looking at air quality over time, findings include:
- Reduction of fine particulate matter and traffic-related pollutants over 10 years was associated with 14% and 26% reductions, respectively, in dementia risk in older U.S. women.
- Long-term exposure to air pollutants was associated with higher beta amyloid levels in the blood, showing a possible biological connection between air quality and physical brain changes that define Alzheimer’s disease.
We know that air pollution is bad for our health — including our brains. This new data indicates that improving air quality may actually reduce
the risk for dementia.
More research is needed in low and middle income countries that we know experience high levels of air pollution, and as areas of the U.S. with high levels of pollution tend to be populated by low income individuals and people of color, it’s important that we continue to study this relationship. The hope is that this research will help to inform policies and actions — likely including coordination with federal and local governments — to address air pollutants and to develop effective strategies to reduce risk in all communities.
Transgender Adults Experience Higher Rates of Subjective Cognitive Decline
The first dementia prevalence data for U.S. lesbian, gay and bisexual individuals was reported
at AAIC 2018, and researchers have since explored experiences of cognitive decline and dementia in these and other LGBTQ communities.
Nonetheless, little is known about the intersection of gender identity and cognition, and AAIC 2021 included some of the first-ever reports of cognitive changes in transgender individuals (those who identify with a gender different than the one assigned to them at birth) and gender nonbinary individuals (those who identify outside the male/female binary).
- One team examined data from the Behavioral Risk Factor Surveillance System and found that transgender adults were nearly twice as likely to report subjective cognitive decline, and more than twice as likely to report subjective cognitive decline-related functional limitations, such as reduced ability to work, volunteer or be social.
- Another team used the same data set and found that depression — a risk factor for dementia — was significantly higher for transgender and gender nonbinary adults (37%) compared to cisgender adults (19.2%).
More research is needed to understand cognition in the transgender and nonbinary communities, and all sexual orientations and gender expressions. The Alzheimer’s Association has partnered with SAGE (Advocacy & Services for LGBT Elders) to help support LGBTQ community members living with Alzheimer’s or other dementias, and their caregivers. Learn more
Global Prevalence of Alzheimer’s Predicted to Triple by 2050
It’s a stark number: According to the World Health Organization, more than 50 million people
are living with dementia worldwide. Now, new data presented at AAIC 2021 forecasts global dementia prevalence will triple
to 152 million by 2050. Without effective treatments, this number will only continue to grow, creating an unsustainable burden on families and health care systems.
While positive global trends in education access are expected to decrease dementia prevalence worldwide by 6.2 million cases, upward trends in smoking, high body mass index (BMI) and high blood sugar are predicted to increase prevalence by nearly the same number — 6.8 million
Other statistics reported at AAIC 2021 provide new insight into global rates of younger onset Alzheimer’s
, and differences in regional U.S. mortality rates due to Alzheimer’s:
- Each year, an estimated 10 in every 100,000 individuals develop dementia with early onset (prior to age 65). This corresponds to 350,000 new cases of early onset dementia per year, globally.
- We’ve learned that from 1999 to 2019, the U.S. mortality rate from Alzheimer’s in the overall population increased from 16 to 30 deaths per 100,000, an 88% increase.
- Also from this study, among all areas of the U.S., mortality rates for Alzheimer’s were highest in rural areas in the East South-Central region of the U.S., where the death rate from Alzheimer’s is 274 per 100,000 in those over 65.
While new analysis shows a decrease in prevalence due to education, it is countered by the increase due to heart health risk factors. We must continue to work toward effective treatments to stop, slow or prevent Alzheimer’s and all dementia, or this number will only grow and continue to impact individuals, caregivers, health systems and governments on a global scale.
Clinical Trial Diversity is Crucial
A major hurdle in developing treatments for Alzheimer’s disease that work for people of all backgrounds is the recruitment and retention of underrepresented groups into clinical trials. Minorities have historically been left out of clinical Alzheimer’s research — in fact, all clinical research — and these are the very populations at a higher risk for developing Alzheimer’s.
Data from the Alzheimer’s Association’s 2021 Facts & Figures special report found nearly two-thirds of Black Americans (62%) believe that medical research is biased against people of color — a view shared by substantial numbers of Asian Americans (45%), Native Americans (40%) and Hispanic Americans (36%). Only half of Black Americans trust a future cure for Alzheimer’s will be shared equally regardless of race, color or ethnicity.
At AAIC 2021, researchers shared new, evidence-based insights into why people from communities of color choose to participate in clinical trials — or not:
- Individuals are most willing to volunteer if invited to participate (85%), if they want to contribute to research (83%) or have a family member with the disease (74%).
- Black, Latino and American Indian respondents are significantly more likely to volunteer if asked by a person of the same race.
- According to a review of National Institute on Aging-funded Alzheimer’s and dementia clinical trials, commonly used exclusion criteria disproportionately affect Black Americans and Hispanics/Latinos, and may play a role in their reduced enrollment in research.
Simply put, diversity is crucial to the success of clinical trials. The Alzheimer’s Association is proud to support the bipartisan Equity in Neuroscience and Alzheimer’s Clinical Trials (ENACT
) Act, legislation introduced to increase the participation of underrepresented populations in dementia clinical trials by expanding education and outreach to these populations.
Today, the Alzheimer’s Association is leading the way with two clinical trials that focus on diverse participation. The New IDEAS study
is recruiting 2,000 Latinos/Hispanics and 2,000 Blacks/African Americans to investigate the impact of a brain amyloid PET scan on clinical care outcomes. The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER
), is a two-year clinical trial studying the effects of multi-component lifestyle interventions on risk of cognitive decline in a diverse population in the U.S.
To address the growing need for clinical trial participants, there is Alzheimer’s Association TrialMatch
®, a free clinical studies matching service with a current database of more than 550 studies being conducted across the country and online.
Alzheimer’s disease and other dementias are a global health crisis, one that can only be solved through research. As scientists continue to advance new discoveries, we are filled with hope as we continue our work toward a world without Alzheimer’s and all other dementia.
As the largest, private, non-profit funder of Alzheimer’s and dementia research, the Alzheimer’s Association leads, convenes and accelerates research in order to create a world without Alzheimer’s and other dementias.
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