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For aging populations in the United States and abroad, dementia is a major clinical and public health issue; it is a lengthy and costly condition that creates a large social and financial burden on society. Unless new discoveries are made in the prevention or treatment of dementia, specifically Alzheimer's disease, an estimated 13.2 million Americans will have dementia by 2050. Identifying new and effective approaches to early detection of dementia is critical.
In a recent study involving participants from the Women's Health and Aging Studies and the Ginkgo Evaluation of Memory Study, Johns Hopkins researchers showed that specific blood pressure medications, called angiotensin receptor blockers and angiotensin-converting enzyme blockers, can decrease the risk of memory loss and developing dementia in healthy elderly people.
In addition, researchers in the Division of Geriatric Medicine and Gerontology are currently employing novel technologies measuring levels of angiotensins and angiotensin-converting enzymes in the blood and spinal fluid, in order to better understand how these medications affect changes in cognitive function. The knowledge gained by characterizing biological and cognitive changes that precedes clinical transition to dementia could allow the development of targeted treatments for dementia.
One of the major risk factors for postoperative delirium is an underlying neurodegenerative disease such as Alzheimer's disease. Studies have shown that non-demented individuals who develop postoperative delirium are also at higher risk of subsequent dementia. Recently, cerebrospinal fluid levels of tau and amyloid-beta 42 (Aβ42) have emerged as highly sensitive and specific markers of Alzheimer's disease, and may also be used to establish the presence of Alzheimer's disease pathology in preclinical and mild cognitive impairment phases of Alzheimer's.
Investigators from the Division of Geriatric Medicine and Gerontology are currently collaborating with other investigators from the departments of psychiatry, anesthesiology, and orthopedic surgery to investigate cerebrospinal fluid levels of tau and amyloid-beta 42 in patients without known dementia to determine the association of these markers with the risk of postoperative delirium and subsequent cognitive decline.
Current research studies
- Evaluation of the effect of blood-pressure variability on the risk of developing dementia (Women's Health and Aging Study II)
- Evaluation of the effect of angiotensin-converting enzyme inhibitors, angiotensin receptor blocker, and diuretics on cognitive function in normal elderly and in people with dementia (Ginkgo Evaluation of Memory Study)
- Evaluation of the effect of potassium on the risk of developing dementia in association of inflammatory and oxidative stress markers (Women's Health and Aging Study II)
- Development of plasma biomarkers for Alzheimer's disease using oral glucose tolerance test
- Examination of preclinical Alzheimer's disease as a risk factor for postoperative delirium and cognitive decline in hip fracture patients
Suzanne Craft, PhD
Michelle Carlson, PhD
Neal Fedarko, PhD
Sharon Inouye, MD, MPH
Benjamin Lee, MD
Constantine Lyketsos, MD, MHS
Edward Marcantonio, MD, SM
Simon Mears, MD, PhD
Michelle Mielke, PhD
Paul Rosenberg, MD, PhD
Frederick Sieber, MD
Juan Troncoso, MD