Highlights from the Alzheimer's Association International Conference 2022

New research reported at the Alzheimer’s Association International Conference (AAIC) 2022 covered the breadth of Alzheimer’s and dementia research, including the basic biology of aging and the brain, risk factors and prevention strategies, and caregiving and living well with the disease.

AAIC is an annual forum for presentation and discussion of the latest Alzheimer’s and dementia research. This year’s hybrid conference event took place both virtually and in person in San Diego and attracted over 9500 attendees and more than 4000 scientific presentations.

“With record public and private research investment it’s an exciting time for Alzheimer’s and dementia research,” said Heather M Snyder, PhD, Alzheimer’s Association vice president of medical and scientific relations. Below are some highlights from the conference:

Hypertensive disorders of pregnancy and future dementia risk

Hypertensive disorders of pregnancy (HDP) — conditions of high blood pressure including chronic/gestational hypertension and preeclampsia — have been strongly linked to heart disease in later life, but little research has connected these disorders with cognition, according to the Alzheimer’s Association. Experiences of high blood pressure disorders during pregnancy are associated with an increased risk of vascular dementia and accelerated brain aging, according to several studies at AAIC 2022:

• Women with a history of HDP were more likely to develop vascular dementia — a decline in thinking skills caused by conditions that block or reduce blood flow to the brain — later in life, compared to women with non-hypertensive pregnancies.
• Experience of HDP, specifically high blood pressure during pregnancy, was associated with white matter pathology, a predictor of accelerated cognitive decline, 15 years after pregnancy.
• Women with severe preeclampsia had significantly higher levels of beta amyloid, an Alzheimer’s-related brain change, as measured in blood compared to those with non-hypertensive pregnancies.

Loss of smell due to COVID-19 linked to cognitive problems

New insights into factors that may predict, increase or protect against the impact of COVID-19 and the pandemic on memory and thinking skills were revealed by multiple studies at AAIC 2022. A research group from Argentina found that persistent loss of the sense of smell may be a better predictor of long-term cognitive and functional impairment than severity of the initial COVID-19 disease.

In a large study population from nine Latin American countries, experiencing a positive life change during the pandemic, such as more quality time with friends and family, reduced the negative impact of the pandemic on memory and thinking skills. Finally, hospitalisation in the intensive care unit (ICU) was associated with double the risk of dementia in older adults, according to Rush Alzheimer’s Disease Center in Chicago. These findings could be significant given the tremendous upsurge in ICU hospitalisations during the COVID-19 pandemic.

Ultra-processed foods and cognitive decline

A study presented at AAIC 2022 reported that people who eat large amounts of ultra-processed foods have a faster decline in cognition. Researchers studied 10,775 people over eight years and found that high consumption (more than 20% of daily intake) of ultra-processed foods led to a 28% faster decline in global cognitive scores, including memory, verbal fluency and executive function. Ultra-processed foods go through significant industrial processes and contain large quantities of fats, sugar, salt, artificial flavours/colours, stabilisers and/or preservatives. Examples include sodas, breakfast cereals, white bread, potato chips and frozen ‘junk’ foods.

Advances in treatments, clinical trial results

The Alzheimer’s Association highlighted results from a variety of clinical trials at AAIC 2022. Here are two examples:

The EXERT Study is said to be the longest-ever Phase 3 study of exercise in older adults with mild cognitive impairment (MCI). The trial was conducted during the COVID-19 pandemic — 80% of participants complied with their exercise regimen and completed the study. After 12 months, people with MCI in both the aerobic exercise intervention arm and stretching arm showed no cognitive decline. A comparison group of other older adults with MCI showed significant cognitive decline over 12 months. The findings from EXERT suggest that regular physical activity, even modest or low exertion activity such as stretching, may protect brain cells against damage.

At AAIC 2022, T3D Therapeutics reported positive interim results from their Phase 2 trial of T3D-959, which seeks to overcome insulin resistance in the brain and restore the brain’s metabolic health. Final results of the trial are anticipated in 2023.

Also at AAIC, the Alzheimer’s Association announced the launch of the Alzheimer’s Network for Treatment and Diagnostics (ALZ-NET), which will collect long-term clinical and safety data from patients treated with FDA-approved Alzheimer’s disease therapies in real-world clinical settings.

Socioeconomic factors and wellbeing

Socioeconomic status (SES) — reflecting both social and economic measures of a person’s work experience, and of an individual’s or family’s economic access to resources and social position — has been linked to both physical and psychological health and wellbeing. Socioeconomic deprivation, including neighbourhood disadvantages and persistent low wages, are associated with higher dementia risk, lower cognitive performance and faster memory decline, according to several studies:

• Individuals who experience high socioeconomic deprivation — measured using income/wealth, unemployment rates, car/home ownership and household overcrowding — are significantly more likely to develop dementia compared to individuals of better socioeconomic status, even at high genetic risk.
• Lower-quality neighbourhood resources and difficulty paying for basic needs were associated with lower scores on cognitive tests among Black and Latino individuals.
• Compared with workers earning higher wages, sustained low-wage earners experienced significantly faster memory decline in older age.
• Higher parental SES was associated with increased resilience to the negative effects of Alzheimer’s marker ptau-181, better baseline executive function and slower cognitive decline in older age.
   

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