Mayo Clinic launches study of rapidly-developing Alzheimer’s disease

While Alzheimer’s disease is typically marked by a slow decline in memory and cognitive ability over a number of years, a small subset of patients faces a dramatically different – and far more devastating – path. In these patients, symptoms snowball quickly, leading to full-blown dementia within a year and complete incapacitation not long after.

Now, researchers at Mayo Clinic are setting out to find out why.

In a new study backed by the National Institute on Aging at the National Institutes of Health, Mayo Clinic neurologist Dr. Gregg Day and his team will explore the biological underpinnings of what’s known as rapidly progressive dementia. Affecting a fraction of patients with Alzheimer’s disease and Alzheimer’s Disease Related Dementias, this form of the illness compresses the usual multi-year deterioration into an alarmingly short time frame.

“The factors that give rise to extreme, rapidly progressive clinical traits are unknown,” Day said in a press release. “These cases are challenging to treat in practice because there are many possible causes and diseases to consider, many tests that can be done, and a clear need to coordinate evaluations rapidly.”

Seeking clues in genes and patient profiles

Over the next three years, the research team will analyze clinical and genomic data from 120 racially and ethnically diverse patients diagnosed with RPD. These cases will be drawn from national Alzheimer's Disease Research Centers and compared with those who exhibit more traditional, gradual progression of the disease.

Among the key questions: Are certain patients genetically predisposed to RPD? What role do toxic brain proteins like amyloid and tau play? Could blood vessel changes or inflammatory processes be the culprits? The team will also dig into factors like age, sex, medical history, socioeconomic conditions, and brain structure for additional insights.

The study’s goal isn’t just to crack the mystery of RPD, it’s also pioneering new methods of conducting research itself. The Mayo Clinic team said it will use a decentralized model that enables patients to take part in the study from their homes or nearby community health facilities.

By incorporating digital health technologies such as telemedicine, mobile phlebotomy, and remote monitoring, the program is designed to remove barriers to clinical trial participation. That’s a big deal in the world of dementia research, where travel and time commitments can be major hurdles, especially for those in the early stages of decline.

“We hope the results of our research will inform new approaches, diagnostic tests, and treatment targets that will improve outcomes in patients with AD/ADRD,” Day said. “The ultimate goal is to slow down the pathologic progression of disease in these patients, independent of their rate of decline.”