Relay Podcast - Down Syndrome and Alzheimer's Disease PIA

Dementia Researcher Vodcast

07/01/26

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32m

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Welcome to the seventh season of the Dementia Researcher X ISTAART PIA Relay Podcast. Across six episodes, leading early career and senior researchers hand the mic from one ISTAART PIA to the next, giving you an honest, peer-to-peer tour of where dementia research is actually heading, from wearables and biomarkers to policy and trial design, in the run-up to AAIC.

Almost everyone born with Down syndrome overproduces the amyloid precursor protein from birth, which makes it one of the clearest natural windows we have into how Alzheimer's begins. Dr Patrick Lao, Assistant Professor at Columbia and Programmes Chair of the ISTAART Down Syndrome and Alzheimer's Disease PIA, comes from a medical physics background and uses multimodal neuroimaging to map the disease across its genetic and sporadic forms. With host Lillian Morgado, he explains amyloid and tau PET, Thal phases and Braak staging, and how chronological age can stand in for disease stage in this population, with a typical symptom onset around 54. They talk about why people with Down syndrome were long left out of anti-amyloid trials and how that is now changing, and the risk and resilience research asking why some people fall off the expected timeline. Patrick also previews the PIA's AAIC PIA Day session on returning results, plus the separate DSAD/ADAD conference coming to London next year.

Takeaways

Genetic forms of Alzheimer's, including Down syndrome, let researchers study the earliest disease pathways before symptoms appear.
In Down syndrome, chronological age can approximate disease stage, with symptoms typically expected around age 54.
Imaging shows where amyloid and tau sit in the brain, the spatial detail a blood test cannot give.
People with Down syndrome were historically excluded from anti-amyloid trials; that is shifting, with a lecanemab safety extension now underway.
Not everyone follows the population timeline, and risk and resilience work asks what pushes onset earlier or later.

The Alzheimer’s Association International Society to Advance Alzheimer’s Research and Treatment (ISTAART) convenes the global Alzheimer’s and dementia science community. Members share knowledge, fuel collaboration and advance research to find more effective ways to detect, treat and prevent Alzheimer’s and other dementias. Professional Interest Areas (PIA) are an assembly of ISTAART members with common subspecialties or interests.

There are currently 30 PIAs covering a wide range of interests and fields, from Neuroimaging to Diversity and Disparities and everything in between.

Find out more at https://istaart.alz.org/

A transcript of this show, links and show notes and profile on all our guests are available on our website at https://www.dementiaresearcher.nihr.ac.uk.

If you prefer to watch rather than listen, you will find a video version of this podcast on Apple Podcasts, YouTube, and on our website.

Leave us a tip:

https://dementia-researcher.captivate.fm/support

Follow us on social media:

Download and Register with our Community App:

https://www.onelink.to/dementiaresearcher

We gratefully acknowledge the support of our funders: Alzheimer’s Association, Race Against Dementia, Alzheim...

Previous Episode

Relay Podcast - Health Policy PIA

June 30

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28m

If we cured Alzheimer's tomorrow but did no work on cost, distribution or access, we would have cured it only for the richest people in the world. That line from Lillian Morgado sits at the centre of this episode. Lillian is a research coordinator at Georgia State University and Communications Chair of the ISTAART Health Policy PIA, working mainly in qualitative research and legal epidemiology. With host Dr Vanessa Young, she talks through what qualitative work actually involves, her research on caregivers and people with dementia in the justice system, and the question that opened up next: what happens to someone with no caregiver to advocate for them. They get into why AI and blood-based biomarkers are as much policy problems as scientific ones, how regulation differs across borders, and why policy is the bridge that decides whether science reaches the people it was meant for. Lillian also runs through the Health Policy PIA's busy week at AAIC, from PIA Day to a featured research session on dementia care across countries.

Takeaways

Policy is the bridge from the lab to the patient; without it, a breakthrough only reaches the few who can already afford care.
Qualitative interviews and coding surface the right questions before the big quantitative money goes in.
Caregivers matter enormously when someone with dementia meets the justice system, which raises the question of those who have none.
AI and blood-based biomarkers carry legal and access questions, and the rules differ between, say, the US and Europe under GDPR.
You do not join a PIA because you already belong; you belong because you get involved, and you need not be an expert to contribute.

There are currently 30 PIAs covering a wide range of interests and fields, from Neuroimaging to Diversity and Disparities and everything in between.

Find out more at https://istaart.alz.org/

A transcript of this show, links and show notes and profile on all our guests are available on our website at https://www.dementiaresearcher.nihr.ac.uk.

If you prefer to watch rather than listen, you will find a video version of this podcast on Apple Podcasts, YouTube, and on our website.

Leave us a tip:

https://dementia-researcher.captivate.fm/support

Follow us on social media:

Download and Register with our Community App:

https://www.onelink.to/dementiaresearcher

We gratefully acknowledge the support of our fu...

Next Episode

Relay Podcast - Lewy Body Dementias PIA

July 2

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36m

Lewy body pathology shows up in roughly 30% of the brains of people who had dementia, yet it gets diagnosed in only about 5% of cases. Closing that gap has shaped much of Dr Joe Kane's career. Joe is a geriatric psychiatrist at Queen's University Belfast and outgoing Chair of the ISTAART Lewy Body Dementias PIA, and with host Dr Patrick Lao he traces his work from the Diamond Lewy programme to consensus diagnostic guidelines built by Delphi process. They discuss the symptoms clinicians often miss because they don't think to ask, from constipation to loss of smell, the cardiac scans and seed amplification assays now detecting pathology in CSF and even skin, and the TOP HAT trial repurposing an anti-sickness drug for hallucinations. Joe makes the case for a Lewy body specific rating scale, explains why the prodrome may be psychiatric or delirium rather than cognitive, and runs through the PIA's biggest AAIC programme in years, including a PIA Day panel on seed amplification assays.

Takeaways

Lewy body dementia is heavily underdiagnosed: pathology appears in about 30% of brains but is diagnosed in around 5%.
Much of the disease shows outside the brain, in constipation, blood pressure and smell, so it gets missed if nobody asks.
Seed amplification assays, now usable on CSF and even a small skin biopsy, are changing how the pathology is detected.
Trials can fail on the wrong yardstick, which is why the PIA is building a Lewy body specific rating scale.
The prodrome is not only cognitive; the first sign can be depression, psychosis or delirium, and those gaps need data.

There are currently 30 PIAs covering a wide range of interests and fields, from Neuroimaging to Diversity and Disparities and everything in between.

Find out more at https://istaart.alz.org/

A transcript of this show, links and show notes and profile on all our guests are available on our website at https://www.dementiaresearcher.nihr.ac.uk.

If you prefer to watch rather than listen, you will find a video version of this podcast on Apple Podcasts, YouTube, and on our website.

Leave us a tip:

https://dementia-researcher.captivate.fm/support

Follow us on social media:

Download and Register with our Community App:

https://www.onelink.to/dementiaresearcher

We gratefully acknowledge the support of our funders: Alzheimer’s Association, Race Against Dementia, Alzheimer’s Research UK, Alzheimer’s Society, and the National...

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