Arizona Study of Aging and Neurodegenerative Disorders (AZSAND): Predictors of Parkinson's Disease and Parkinson's Disease Dementia
Charles H. Adler, M.D., Ph.D., and Thomas G. Beach, M.D., Ph.D., (Banner Sun Health Research Institute)
Parkinson's disease (PD) is currently diagnosed clinically by finding slowness of movement along with either rest tremor or rigidity. However, the only way to definitively diagnose PD is by autopsy. In addition to being a disorder of movement, 30% to 75% of patients with PD develop dementia that can be very disabling. While there are treatments (medications and surgical procedures) that improve the motor symptoms, there are no treatments that slow or halt disease progression or prevent dementia in PD. Unfortunately, the underlying cause of PD and of dementia in PD is unknown.
Since 1986, the Brain and Body Donation Program at Banner Sun Health Research Institute has been enrolling healthy older individuals and people with Parkinson's disease, Alzheimer's disease and other neurological disorders willing to donate their brains and other organs for research purposes. Currently there are around 800 living subjects enrolled and over 2,000 brains have been collected.
Participants are evaluated annually by a movement disorders specialist, a behavioral neurologist and a neuropsychologist looking for signs of PD and dementia. The major goal is to find the earliest clinical markers for the onset of PD and for the onset of dementia in people with PD so that studies of treatments to slow or stop these disorders can be started earlier. One of the critical features of the program is the confirmation of the clinical diagnosis by autopsy.
Arizona Study of Aging and Neurodegenerative Disorders (AZSAND) has two cores:
- Clinical Core. This core is responsible for assessments of motor and cognitive function as well as smell and autonomic problems in those living individuals enrolled. The major goal will be to develop predictive models for risk of the development of PD, and risk of onset of dementia in PD, by studying populations of individuals that do not have these disorders.
- Neuropathology Core. All of the autopsies are performed by the Neuropathology Core, which undertakes studies of pathological markers of PD in both the peripheral nervous system and the central nervous system. These studies could lead to an earlier diagnosis of PD using laboratory methods.
AZSAND is part of the Arizona Parkinson's Disease Consortium (APDC), a consortium of investigators at multiple institutions throughout Arizona — Mayo Clinic, Banner Sun Health Research Institute, Barrow Neurological Institute — including collaborations with Arizona State University and the Translational Genomics Research Institute. The APDC focuses their research on investigating the causes and diagnosis of PD and dementia in PD, as well as formulating cures and new treatments, including drug discovery and development that may ultimately lead to prevention, better treatments and a cure for the disease.