Mayo Clinic Researchers Study Causes of Rapidly Progressive Dementia

JACKSONVILLE, Florida— Most patients with Alzheimer’s disease and Alzheimer’s Disease Related Dementias (ADRD) experience a gradual onset and progression of cognitive symptoms, leading to decline over years or decades. However, in a small subset of patients, symptoms begin rapidly, leading to dementia within one year and complete incapacitation within two years of symptom onset. Mayo Clinic has commissioned a new study to determine why patients with Alzheimer’s disease and ADRD develop this rapidly progressive dementia (RPD).

Why we need to understand  rapidly progressive dementia

“The factors that give rise to the extreme, rapidly progressive clinical traits are unknown,” says Gregg Day, M.D., a neurologist and clinical researcher at Mayo Clinic in Florida.

“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.”

Dr. Day will lead a team of researchers from Mayo Clinic in Florida and Rochester, Minnesota, to study the biology of rapidly progressive demetia (RPD)  through a project funded by the National Institute on Aging of the National Institutes of Health (NIA/NIH).

Why does rapidly progressive dementia occur?

Specifically, the research team and collaborators aim to:

• Determine the factors that make patients with Alzheimer’s disease and ADRD susceptible to rapidly progressive dementia (RPD).
• Study the contributions of amyloid and tau toxic proteins and vascular changes in the brain to rates of progression in patients with Alzheimer’s disease and ADRD.
• Identify cellular pathways that contribute to rapid declines in patients with Alzheimer’s disease and ADRD.

The researchers plan to collect clinical and genomic information from 120 diverse patients with rapidly progressive Alzheimer’s disease and ADRD over the next three years. Findings in patients with RPD, identified through Alzheimer’s Disease Research Centers studies nationally, will be compared with data from participants with typical progressive Alzheimer’s disease and ADRD enrolled in studies at the Alzheimer’s Disease Research Center at Mayo Clinic.

End note

The team hopes to learn how factors such as age, sex, medical history, structural and social determinants of health, genetic variants and other brain changes may make some patients more susceptible to rapid decline.

Findings will be validated through extensive protein analyses in cerebrospinal fluid from an independent group of patients with autopsy-confirmed rapid progressive Alzheimer’s disease and ADRD. Results will be used to identify biomarkers and disease-modifying targets that may improve diagnosis and treatment of patients with Alzheimer’s disease and ADRD.