Untitled Document

Research

Mark A. Sager

M.D., University of Wisconsin-Madison
Professor, Department of Medicine
Director, Wisconsin Alzheimer's Institute
masager@wisc.edu
http://www2.medicine.wisc.edu/home/people-search/people/staff/1242/SAGER_MARK_A/

Preventing Alzheimer's Disease

Alzheimer's disease (AD) currently affects between 5% and10% of the population aged 65 and older and is the most frequent cause of institutionalization for long-term care in the United States. In Wisconsin, the number of persons affected by Alzheimer's disease is expected to increase by 58% from 103,000 to 163,000 persons over the next 25 years. The expected rapid increase in the number of persons with AD will translate into higher public and private long-term care costs and significant caregiver burdens for affected families.

Current data indicate that AD is a lifelong disease with a prolonged pre-clinical phase during which prevention strategies would be most effective in delaying or preventing its onset. Neuritic plaques and neurofibrillary tangles, the pathologic hallmarks of AD, have been found in adults without dementia, suggesting that the neuronal deficits leading to AD begin years before any symptoms develop. As in other chronic degenerative diseases of aging, a person's risk of developing symptoms of AD is most likely the result of genetic, environmental, socioeconomic and lifestyle factors which interact to determine age of onset. Because of this, a person's risk of developing symptoms of AD is potentially modifiable, either by changes in the environment or lifestyle or through external interventions.

The Wisconsin Alzheimer's Institute currently is developing a statewide registry of over 1000 participants. This registry will support genetic, epidemiologic and clinical studies at the University of Wisconsin (UW) to identify and evaluate those factors which may delay or prevent the onset of AD. Each registry participant undergoes a 2-hour battery of neuropsychological testing, a complete detailed health history assessment and laboratory testing for risk factors for AD. Registry participants also have the opportunity to participate in University-sponsored research that could contribute to our understanding of how to prevent AD in the future.

This exciting research initiative involves researchers throughout the UW Madison campus including faculty from Neurology, Medicine, Geriatrics and Gerontology.

Representative Publications
Xu, G., McLaren, D.G., Ries, M.L., Fitzgerald, M.E., Bendlin, B.B., Rowley, H.A., Sager, M.A., Atwood, C.S., Asthana, S., & Johnson, S.C. (2009). The influence of parental history of Alzheimer's disease and apolipoprotein E 4 on the BOLD signal during recognition memory. Brain, 132, 383-391.

Asenath, L.R., Hermann, B., Jones, J., Johnson, S.C., Asthana, S., & Sager, M.A. (2008). Effect of family history of Alzheimer�s disease on serial position profiles. Alzheimer�s and Dementia, 4(4), 285-290.

Hermann, B., Seidenberg, M., Sager, M., Carlsson, C.M., Gidal, B., Sheth, R., Rutecki, P., & Asthana, S. (2008). Growing old with epilepsy: the neglected issue of cognitive and brain health in aging persons with chronic epilepsy. Epilepsia, 49(5), 731-740, 2008.

Ries, M.L., Carlsson, C.M., Rowley, H.R., Sager, M.A., Gleason, C.E., Asthana, S., & Johnson, S.C. (2008). MRI characterization of brain structure and function in Mild Cognitive Impairment: A review. Journal of the American Geriatrics Society, 56(5), 920-934.

Xu, G., Fitzgerald, M.E., Wen, Z., Fein, S., Alsop, D., Carroll, T., Ries, M., Rowley, H., Sager, M., Asthana, S., Johnson, S.C., & Carlsson, C.M. (2008). Atorvastatin therapy is associated with greater and faster cerebral hemodynamic response. Brain Imaging and Behavior, 2(2), 94-104.

Carlsson, C.M., Gleason, C.E., Hess, T.M., Moreland, K.A., Blazel, H.M., Koscik, R.L., Schreiber, N.T.N., Johnson, S.C., Atwood, C.S., Puglielli, L., Hermann, B.P., McBride, P.E., Stein, J.H., Sager, M.A., & Asthana, S. (2008). Effects of simvastatin on cerebrospinal fluid biomarkers and cognition in middle-aged adults at risk for Alzheimers disease. Journal of Alzheimers Disease, 13(2), 187-97.

Trivedi, M.A., Schmitz, T.W., Ries, M.L., Hess, T.M., Fitzgerald, M.E., Atwood, C.S., Rowley, H.A., Asthana, S., Sager, M.A., & Johnson, S.C. (2008). fMRI activation during episodic encoding and metacognitive appraisal across the lifespan: Risk factors for Alzheimer's disease. Neuropsychologia, 46(6), 1667-1678.

Johnson, S.C., Ries, M.L., Hess, T.M., Carlsson, C.M., Gleason, C.E., Alexander, A.L., Rowley, H.A., Asthana, S., & Sager, M.A. (2007). Effect of Alzheimer disease risk on brain function during self-appraisal in healthy middle-aged adults. Archives of General Psychiatry, 64(10), 1163-1171.

Trivedi, M.A., Schmitz, T.W., Ries, M.L., Torgerson, B.M., Sager, M.A., Hermann, B.P., Asthana, S., & Johnson, S.C. (2006). Reduced hippocampal activation during episodic encoding in middle-aged individuals at genetic risk for Alzheimer�s Disease: a cross-sectional study. BMC Medicine, 4, 1.

Gleason, C.E., Schmitz, T.W., Hess, T., Koscik, R.L., Trivedi, M.A., Ries, M.L., Carlsson, C.M., Sager, M.A., Asthana, S., & Johnson, S.C. (2006). Hormone effects on fMRI and cognitive measures of encoding: Importance of hormone preparation. Neurology, 67, 2039-204.

Johnson, S.C., Schmitz, T.W., Trivedi, M.A., Ries, M.L., Torgerson, B.M., Carlsson, C.M., Asthana, S., Hermann, B.P., & Sager, M.A. (2006). The influence of AD family history and APOE4 on mesial temporal lobe activation. Journal of Neuroscience, 26, 6069-607.

Ward, M.A., Carlsson, C.M., Trivedi, M.A., Sager, M.A., & Johnson, S.C. (2005). The effect of body mass index on global brain volume in middle-aged adults: A cross-sectional study. BMC Neurol., 5(23), doi:10.1186/1471-2377-5-23.

Schraeder, C., Shelton, P.S., & Sager, M.A. (2001). The effects of a collaborative model of primary care on the mortality and hospital use of community-dwelling older adults. J. Geront., 56A(2), M106-M112.

Shelton, P.S., Schraeder, C., Dworak, D., Fraser, C., & Sager, M.A. (2001). Caregivers' utilization of health services: results from the Medicare Alzheimer's disease demonstration, Illinois site. J. Am. Geriatr. Soc., 49, 1600-1605.

Shelton, P.S., Sager, M.A., & Schraeder, C. (2000). The Community Assessment Risk Screen (CARS): Identifying elderly persons at risk of a hospitalization or emergency room visit. Am. J. Managed Care, 6(8), 926-933.

Mahoney, J.E, Sager, M.A., & Jalaluddin, M. (1999). Use of an ambulation assistive device predicts functional decline associated with hospitalization. J. Gerontology Medical Sciences, 54A, M83-M88.

Mahoney, J.E., Sager, M.A., & Jalaluddin, M. (1998). New walking dependence associated with hospitalization for acute medical illness: Incidence and significance. J. Gerontology Medical Sciences, 53A, M307-312.

Gray, S.L., Sager, M.A., Lestico, M.R., & Jalaluddin, M. (1998). Adverse drug events in hospitalized elderly. J. Geront., 53A(1), M59-M63.

Sager, M.A., Rudberg, M., Jalaluddin, M., et al. (1996). Hospital Admission Risk Profile (HARP): Identifying older patients at risk for functional decline following acute medical illness and hospitalization. Journal of the American Geriatrics Society, 44, 251-257.

Sager, M.A., Franke, T., Inouye, S., et al. (1996). Functional outcomes of acute medical illness and hospitalization in older persons. Archives of Internal Medicine, 156, 645-652.

Sager, M., Dunham, N., Schwantes, A., et al. (1992). Measurement of activities of daily living in hospitalized elderly: A comparison of self-report and performance-based measures. Journal of the American Geriatrics Society, 40, 457-462.

Sager, M.A., Easterling, D.V., Kindig, D.A., & Anderson, O.W. (1989). Changes in the location of death after passage of medicare's prospective payment system. New England Journal of Medicine, 320, 433-439.

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