In 2011, the National Alzheimer’s Project Act (NAPA) allocated resources “to prevent and effectively treat Alzheimer’s by 2025.” Since then, the National Institute on Aging (NIA) and the National Institute of Neurological Disorders and Stroke (NINDS) have held multiple research summits to assess the needs and opportunities relevant to this goal for Alzheimer’s Disease (AD) and Alzheimer’s Disease Related Dementias (ADRD). In particular, the NINDS has convened expert panels in 2013 and again in 2016 that were tasked with recommending research priorities for advancing the state-of-the-science for the Lewy Body Dementias (LBD) as well as other types of dementias. During both summits, panel members identified critical new research targets and tools that will be essential for understanding and developing treatments for these disorders. LBD panel members specifically emphasized the need to “…detect PD (Parkinson’s Disease) patients with a high risk of cognitive decline leading to PDD (Parkinson’s Disease Dementia)”.
PDD is classified as one of the LBDs, along with Dementia with Lewy Bodies (DLB). By convention, patients who develop motor signs consistent with parkinsonism at least one year before the onset of dementia are diagnosed with PDD, while patients who develop dementia at least one year before the onset of parkinsonism are diagnosed with DLB. It has been estimated that up to a third of patients with PD will have some cognitive impairment at diagnosis and more than half will develop dementia (and PDD) over the course of their disease. PDD is particularly debilitating because patients often experience delusions and hallucinations along with the dementia, leading to extreme caregiver burden. Although research has begun to address the problem of who is at risk, it is currently not possible to predict which PD patients will develop dementia and how rapidly it will progress.
The purpose of this FOA is to encourage applications that seek to identify neurophysiology and/or biospecimens that predict which patients with Parkinson’s disease will 1) develop cognitive impairment or dementia, 2) experience gradual versus rapid progression of cognitive impairment and/or 3) develop aberrant behavioral or frankly psychotic symptoms as a part of their dementia. Research to evaluate new candidate biomarkers, or to further update, expand upon, or validate previously-published biomarker candidates, is considered appropriate. Applications should discuss whether the proposed marker is applicable to one particular stage of disease (e.g., minimal cognitive impairment versus dementia), whether it is expected to progress in tandem with disease-progression, or whether a “panel” of markers is optimal for tracking disease/symptoms. Since cognitive decline can occur over many years, applicants are strongly encouraged to leverage existing longitudinal cohorts of PD and PDD patients that are more likely to be followed to autopsy, so that confirmation of diagnosis and evidence of biomarker validity can be obtained.
Deadlines: March 8, 2019 (non-AIDS applications); May 7, 2019 (AIDS applications)