Improving Alzheimer’s prevention and care

America is aging. The U.S. population is older today than it has ever been, and the number of people aged 65 and up is expected to rise from 58 million people in 2022 to 82 million in 2050. 

As the number of older Americans grows, so will the number of people with Alzheimer’s disease — unless we can find better ways to prevent and treat it.

Researchers at Arizona State University have greatly advanced our understanding of Alzheimer’s. They are finding new ways to reduce our risks, get earlier diagnoses, slow progression of the disease and improve quality of life. With studies across neuroscience, nursing, engineering, speech pathology and even anthropology, ASU is examining this devastating disease from all angles to find creative solutions.

The following are a few examples of how ASU scientists are helping people live healthier, longer.

Most Alzheimer’s research focuses on symptoms of the disease, like amyloid plaques, tau tangles, inflammation and cellular dysfunction. But no one has provided a single explanation to unify these effects — until now.

Scientists at ASU’s Biodesign Institute propose that stress granules in brain cells sabotage those cells’ activities. Stress granules are clumps of proteins and RNA that form in response to cell stress. They can be caused by many factors, including gene mutations, inflammation, and exposure to pesticides, viruses and air pollution.

Normally, stress granules protect a cell during stressful conditions and dissolve when the danger goes away. But in Alzheimer’s disease, the granules stick around, disrupting the cell’s internal transit system long term.

Glyphosate is the active ingredient in many weed killers. While farmworkers and landscapers have the highest exposure to glyphosate, most Americans are exposed to the chemical daily by eating foods sprayed with the herbicide. 

Biodesign Institute researchers have found that glyphosate can cross the blood-brain barrier, allowing it to interact with brain cells. In a later study, they showed that exposure to glyphosate caused brain inflammation and Alzheimer’s-like symptoms in mice. The damage occurred even at a low dose and lasted long after the exposure ended.

The ASU findings suggest that eating foods sprayed with the herbicide could pose a health hazard, even at levels presumed to be safe.

Researchers in the Biodesign Institute have discovered some surprising links between herpesviruses and Alzheimer’s disease. There are eight types of herpesviruses that infect humans, including the ones that cause chicken pox, cold sores and mononucleosis.

Cytomegalovirus, or CMV, is a common herpesvirus that most humans are exposed to early in life. The ASU researchers found that, in some people, CMV can linger in the gut, where it may travel to the brain via the vagus nerve. There, it can alter the immune system and contribute to other changes associated with Alzheimer’s.

In an earlier study, researchers from ASU and their collaborators examined the brains of 944 brain donors with and without Alzheimer’s disease. The people with Alzheimer’s had greater amounts of two specific herpesviruses (HHV 6A and 7) in areas of the brain known to be highly vulnerable to the disease. Most people around the world are infected with HHV 6A and 7 at some point, typically without symptoms.

Understanding the role viruses play in Alzheimer’s disease could set the stage for researchers to find antiviral or immune therapies to combat the disease, even before onset of symptoms.

Inside the brain, Alzheimer’s is characterized by the growth of amyloid plaques, clumps of abnormal proteins that form in the gaps between neurons. New treatments such as lecanemab target these plaques. To track how these drugs are working, subjects in clinical trials are injected with a radioactive tracer that sticks to the amyloid so that it shows up on a PET scanner.

There are five different FDA-approved tracers, all with different properties. Different clinics use different tracers, making it hard for researchers to compare data.

But AI can help.

Researchers in ASU’s School of Computing and Augmented Intelligence are using AI to harmonize PET scans taken with different types of tracers. Their model generates what a brain scan taken using one type of tracer would look like if it had been taken with a different one, enabling easier comparison and research.

Another project uses AI and deep learning to predict a person’s biological age from MRI brain scans. If the biological age does not match their true age, that could be an early sign of neurodegenerative disease.

The engineering team is also working with the Biodesign Institute to train doctoral students to develop new AI tools that can improve the lives of people with Alzheimer’s disease. The program partners with health care providers and research institutions across Arizona, as well as the Mirabella senior living community on the ASU campus.

The essential nutrient choline could make a big impact in the fight against Alzheimer’s.

Multiple studies from ASU’s Biodesign Institute have linked low choline with the disease. One study found choline deficiency led to brain changes found in Alzheimer’s, while another showed that people in the most advanced stages of the disease have the lowest levels of choline in their bloodstream.

The scientists also showed that taking choline supplements throughout life reduced the inflammatory state in the Alzheimer’s brain in mice. If these results can be replicated in humans, they could offer a safe and inexpensive option for reducing disease symptoms. 

An Edson College of Nursing and Health Innovation professor led a pilot randomized controlled trial that included 96 older adults living with mild to moderate Alzheimer’s disease. The study found that a six-month aerobic exercise routine significantly reduced cognitive decline compared with the natural course of changes for Alzheimer’s.

Building on this preliminary work, the National Institutes of Health awarded the researcher $4.5 million for a Phase 2 clinical trial. The study examines the best exercises to improve aerobic fitness in older adults with early Alzheimer’s and explores how those exercises impact their memory.

The lead researcher said that, as a nurse, she works directly with patients and is familiar with their daily limitations. She said that recumbent stationary exercise bikes are one of the safest and most effective ways for people with limited mobility or with the beginnings of cognitive decline to get aerobic exercise.

Speech carries far more than words — it’s a rich, untapped signal of brain health, revealing critical insights into neurological function long before other symptoms appear. Researchers in ASU’s College of Health Solutions have developed noninvasive technology that detects subtle changes in speech patterns associated with conditions like Alzheimer’s, Parkinson’s and ALS.

Their tools gained national attention after uncovering signs of cognitive and motor decline in the speech of Ronald Reagan and Muhammad Ali years before their official diagnoses. More recently, the team’s speech analysis software earned FDA Breakthrough Device designation for its ability to track ALS progression. The work could lead to earlier detection and more timely treatment of devastating neurological conditions.

In 2024, the Edson College was awarded $5.8 million from the National Institute on Aging to create the Roybal Center. The center seeks to help older adults maintain their independence while managing the challenges of cognitive change. This year, the center launched two new projects to support older adults who are living alone and experiencing cognitive decline.

I-PASS (Increasing Physical Activity through Social support and Stress resilience) works with people 60 years and older who are physically less active. The ASU team will guide and monitor their physical activity and foster social engagement and stress management. All three factors are known to reduce dementia risk and help maintain independence.

EPIC-LA, or Early Partners In Care Living Alone, helps people experiencing cognitive decline to plan for the rest of their lives. The seven-week program includes skill building and care planning through group and individualized sessions.

Caregivers also face tremendous challenges. That's why Edson College faculty developed CarePRO to reduce stress and enhance emotional well-being in family caregivers of people with dementia. The program has been successfully embedded into local Alzheimer’s Association chapters across Arizona and Nevada since 2009. In 2023, the team launched CarePRO LTC, a five-week skill-building program for family caregivers who have placed loved ones in long-term care.

Studying what happens to people who have Alzheimer’s disease is important. But we can also learn from the people who don’t get it. 

Researchers in ASU’s School of Human Evolution and Social Change and the Center for Evolution and Medicine study Indigenous populations in Bolivia. They found that two of these groups, the Tsimané and the Mosetén, have some of the lowest rates of dementia reported in the world. They also have a lower loss of brain volume as they age compared with people living in the U.S. and Europe. 

Prior research has shown that the Tsimané also have extremely healthy hearts, with low rates of coronary artery calcification, high blood pressure, Type 2 diabetes, obesity and smoking. They live a traditional lifestyle of fishing, foraging and farming, with high levels of physical activity, but also high parasite and pathogen loads.

The researchers say that to fully understand what healthy aging looks like throughout time, we need to look at more diverse populations and not just wealthy industrialized nations.