Michael Jaffee (Text Version)

2018 PRARP Investigator Vignette

Title: Collaborating on Military Risk Factors for Alzheimer’s and Other Dementias

Investigator: Michael Jaffee, M.D., University of Florida

The PRARP is really focusing on military risk factors for Alzheimer’s, dementia, and related dementias. That includes looking at factors such as traumatic brain injury and post-traumatic stress disorder. And it’s important for us to try and better understand how they might lead to this increased risk for dementia. And if we can understand those pathways, then we can better detect them early, better prevent them from progressing to have that problem later in life, with the goal of improving the quality of life.

When the program was first initiated, the focus was on Alzheimer’s disease. As we’ve gone on and gotten more knowledge and information, what we have found is that sometimes our Veterans are suffering from dementia and cognitive problems that may not necessarily be Alzheimer’s disease. And, based on that recognition, the program has been brought in to include Alzheimer’s and related dementias, meaning any types of cognitive aspects that might be affecting an individual. So one example of that could be someone that’s had a significant moderate to severe traumatic brain injury that leads to a sort of progressive deterioration in their memory.

With that increased attention, there’s been increased resources that have been made available through NIH, through Congress, through the Department of Defense, through the Veterans Affairs, which has allowed some of these necessary and important research studies to be done, for which there were not resources in the past.

During the time that I’ve been involved with the DoD Program, the panel has really evolved and has brought in a variety of people with different expertise from a broad variety of different fields of science.

So we can compare notes about where gaps are in the research and work with each other to advance the knowledge and understanding in an impactful way.

Another aspect is facilitating collaboration between researchers in various scientific disciplines that might not necessarily have come together before to combine their knowledge into new and innovative ways to approach the problem. We have a new award mechanism to bring scientists of different disciplines together to apply the latest innovations to the interface between traumatic brain injury and Alzheimer’s.

We are always evolving and following the science and trying to take that to the next level. And sometimes that can involve looking for new and innovative ways of neuroimaging that allows us to get a diagnosis earlier and identifying mechanisms that will allow us to develop treatments, identifying proven methods that can improve the quality of life and decrease the caregiver burden for those caring for our Veterans who are having this problem.

There is a number of focus areas which involve pathophysiology of disease looking at biomarkers, ways to detect whether something is going on. Some of that might include what’s called proteomics or genomics.

We’ve been looking at, not only the cellular deterioration, but looking at the role of the supporting cells, looking at the role of the immune system and how inflammation might be contributing to this degeneration of the brain and how that might open up some windows to newer treatments.

The PRARP is looking for new and innovative ideas and individuals who are going to be rising stars in the field. And they may not have that track record yet, but we’re hoping to kind of take and operationalize a new idea that may be higher-risk, but it may be high-reward.

We’re also now looking at innovative ways of partnerships for senior investigators, so again trying to create a synergy between disciplines that may not have necessarily existed before to create a new way of looking at a problem.

Many of the investigators whom we have supported have risen to become really prominent national leaders in their field, and it has been so gratifying to be a part of the evolution of these investigators, as well as an evolution of the science that will ultimately lead to improvement in care for these patients.