Cognitive Behavioral Research

The Emory Alzheimer's Disease Center

The Emory Alzheimer's Disease Center (ADC) is a leader in multidisciplinary research, diagnosis, and treatment of Alzheimer's disease and related disorders. The Emory ADC is the only comprehensive program in Georgia and one of the few in the Southern United States. A variety of health care specialists and researchers provide a comprehensive, compassionate, collaborative, and caring approach to Alzheimer's disease and related disorders. This approach includes the development of new prevention strategies, comprehensive diagnostic procedures and tools, groundbreaking laboratory investigations seeking new therapies, and the latest clinical trials and treatment regimens.

The Grady Memorial Hospital Memory Assessment Clinic

Since its inception in October 1992, several thousand patients have been evaluated in the Emory ADC satellite clinic at Grady Memorial Hospital. This critical component of the ADC provides access to care for an underserved aging minority population, and allows these patients to participate in pharmacological treatment trials and other research studies sponsored by the Emory ADC in a culturally sensitive environment. Grady memorial hospital is easily accessible to Atlanta's large African American community, and 90% of the patients seen at this clinic are African Americans. A multi-cultural outreach coordinator of the greater Georgia Chapter of the Alzheimer's Association is onsite to provide educational materials and information about available community resources. A collaborative relationship has been forged between the ADC satellite clinic, the Department of Geriatric Medicine at Grady Memorial Hospital, and the Neuroscience Institute at Morehouse School of Medicine to advance our understanding of aging and neurodegenerative diseases in traditionally underserved populations.

Laboratory Research

The Emory ADC and the Emory Center for Neurodegenerative Disease bring together researchers from neurology, human genetics, pharmacology, biochemistry, cell biology, and pathology who work collaboratively to share resources and ideas. The "team" approach fosters discovery of the molecular factors that contribute to Alzheimer's disease and related disorders and will enable development of more effective treatments.

Explosive growth in Alzheimer's research has been driven by molecular discoveries that have generated key insights into the fundamental causes of the disease. Many advances in the past decade have focused on the senile plaques that are found in the brains of Alzheimer's patients. Senile plaques largely consist of a toxic protein know as beta amyloid. Abnormal accumulation of beta amyloid is believed to trigger a cascade of events that injures brain cells. Factors that contribute to the production of senile plaques and brain cell injury represent important targets for new treatments. Active research projects are examining the role of a novel lipoprotein receptor in amyloidogenesis, characterizing new Alzheimer's susceptibility genes, applying large scale proteomics to analyze brain pathology, and using new lentivirus-based approaches to develop new animal models of Alzheimer's disease.

Emory researchers are also leading efforts to understand a neurotransmitter called acetylcholine, a chemical messenger within the brain. A deficiency of acetylcholine has been implicated in Alzheimer's disease since the 1970's. A major research focus at Emory is the muscarinic acetylcholine receptor, which allows acetylcholine to bind to cells and plays a critical role in the disease. These receptors are a primary target for current drug therapies. Although some drugs are helpful, they produce only modest improvements in most patients. Recent findings from ongoing studies at Emory of muscarinic acetylcholine receptors suggest new possibilities to improve the effectiveness of the next generation of Alzheimer's drugs.

Clinical Research

Research advances in Alzheimer's disease are being increasingly translated into methods for earlier diagnosis and new ways to ameliorate symptoms and to slow disease progression. A number of active clinical trials are currently being conducted at Emory to examine the effectiveness of new diagnostic approaches and treatment measures. Experts at Emory are also conducting exciting studies exploring the ways in which sleep is disturbed by Alzheimer's disease and other neurodegenerative diseases, how specific sleep disorders may cause or contribute to the development of cognitive decline as individuals age, the effects of vascular risk factors such as hypertension on disease symptoms and progression, and the detection of preclinical Alzheimer's disease. The rapid pace of progress in Alzheimer's research will continue to generate abundant opportunities for patients to partner with Emory clinicians and investigators in cutting-edge research to aggressively pursue a cure for this debilitating disease.

Currently enrolling clinical research studies (grouped by type):

Treatment of behavioral problems in Alzheimer's disease and related dementias
  • A Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Efficacy of Divalproex Sodium (Depakote) Therapy for Agitation in Nursing Home Residents with Probable or Possible Alzheimer's Disease.
  • Comparative Effectiveness of Antipsychotic Medications in Patients with Alzheimer's disease.
  • A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study of Three Fixed Doses of Aripiprazole in the Treatment of Institutionalized Patients with Psychosis Associated with Dementia of the Alzheimer's Type.
  • Agitation and Psychosis in Dementia/Parkinsonism 1. (TAP/DAP) A double-blind, placebo-controlled, study to determine whether quetiapine [Seroquel] is effective in management of agitation and psychosis of Dementia/Parkinsonism. This study includes 4 clinic visits over a 12-week period and includes memory testing, blood sampling and other measurements for caregivers.
Treatment of Mild to Moderate Alzheimer's disease
  • (CLASP) A multi-center, randomized, double-blind, placebo-controlled trial of simvastain [Zocor] to slow the progression of Alzheimer's disease. This study has 8 study visits over a period of 18 months, includes memory testing and blood sampling and other measures for study partners.
  • (VITAL) A multi-center, randomized, controlled clinical trial to determine whether reduction of homocysteine levels with high dose Vitamin B supplements will slow the rate of cognitive decline in subjects with Alzheimer's disease. This study has 8 clinic visits spaced over 18 months and includes memory testing, blood sampling, and other measures.
New Treatments for moderate to severe Alzheimer's disease
  • A Randomized, Double-Blind, Placebo-Controlled Evaluation of the Safety and Efficacy of Memantine in Patients with Moderate to Severe Dementia of the Alzheimer's Type.
  • A 24 Week, Multicenter, Randomized, Double-blind, Placebo-controlled Evaluation of the Safety and Efficacy of Donepezil Hydrochloride in Patients with Severe Alzheimer's Disease Followed by a 12 Week Open Label Extension Period.
Reducing anticholinergic side effects of medications
  • A Randomized Double Blind Study to Evaluate the Anticholinergic Burden in Subjects with Psychosis of Dementia Treated with Risperidone or Olanzapine.
  • Behavioral and Physiological Changes in Alzheimer's disease Patients as a Function of Incontinence Medications.
  • Quality of life issues and medications for urinary dysfunction due to neurological disease. For further information please contact Dr. Jewart at 404-728-6414.
  • Assessment Measures for Mild Cognitive Impairment: The purpose is to determine whether cognitive measures administered via a computer can detect and track cognitive difficulties. The study involves a single two hour session of computerized cognitive tests, with one visit per year for up to three years.
  • Eye-Tracking Study: The purpose of this study is for researchers to adapt behavioral memory tasks developed for use with NHPs and combining them with noninvasive, infrared, eye-tracking technology to detect impaired memory in humans before major damage occurs in the brain. The current human studies are based on results from NHP-based research in which researchers identified the important role the hippocampus plays in memory function. Damage to the hippocampus has been implicated in the early memory problems of MCI patients.
Effects of Other Medical Conditions on AD Patients
  • Vascular Risk Factors and Neurobehavioral Functioning: This study is examining whether vascular risk factors such as hypertension, heart disease, and high cholesterol affect the symptoms and their progression in AD patients. It involves one visit during which patients undergo measurement of vascular risk factors via a blood test, EKG, and blood pressure monitor and also receive paper and pencil cognitive tests.

Please contact Janet Cellar at 404-728-6453 or Andie Kippels at 404-728-6443 for additional information regarding these studies.

The Clinical Registry in Neurology is offered to all clinic patients to allow researchers to study clinical determinants, genetics, environmental and other factors that influence risk of dementia, diagnosis, treatment responsiveness, and disease progression.