Clinical trial NCT02485730: Early Identification of Markers in Alzheimer's Families / ALFA
Official title: Cohort Study for Early Identification of Markers in Cognitively Healthy Family Members of Patients With Alzheimer's Disease
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: Alzheimer's Disease
Keywords: Prevention
Cohort Analysis
Healthy Participants
Lead sponsor: Barcelonabeta Brain Research Center, Pasqual Maragall Foundation
Sponsor class: OTHER
Collaborators: name: Obra Social La Caixa, Spain
First posted: 2015-06-30
Enrollment: 419
Sex: ALL
Minimum age (years): 45
Maximum age (years): 64
Standard ages: ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Offsprings of subjects diagnosed of probable AD before reaching 75 years of age, according to McKhann et al. \[McKhann et al., 1984\] criteria, will be selected from spontaneous volunteers and Alzheimer's patients associations members.

Brief summary: The ALFA study is a long term, prospective, observational study of AD patients' adult children aimed at studying and characterizing key physio-pathological features of the preclinical phase of AD.

Detailed description: The natural history of AD includes an asymptomatic or preclinical phase characterized by pathological cerebral alterations without any evident symptoms of the disease. The beginning of the preclinical phase can be detected using a series of biological and neuroimaging markers that indicate the presence of Aβ deposition in the brain. A variety of factors such as inflammation, genetic load (e.g., APOE4), diet, cardiovascular risk, sleep disorders and cognitive reserve, produced by endogenous or exogenous factors, vary among individuals and may determine the beginning and evolution of the preclinical phase of the disease. It is possible to identify subclinical, biological, cognitive and neuroimaging changes, in the AD preclinical phase. The longitudinal study of intra-individual changes will be more sensitive than cross-sectional inter-individual studies to detect the cognitive evolution during the AD preclinical phase. Similarly, it would be possible to identify factors in subjects at the preclinical phase that will influence their evolution to the clinical stage of the disease.

The study will start with a screening of 3.000 recruited volunteers (NCT01835717) complying as much as possible with study selection criteria and perfectly aware of the study needs.

The selected 400 participants fulfilling the inclusion criteria will undergo detailed phenotyping consisting in: clinical history, AD family history, full cognitive evaluation, cognitive reserve determination, CSF sample collection, blood and urine sample collection, neuroimaging (MRI), quality of life and habits of life questionnaires (physical activity, diet, sleeping habits, social activity, toxics habits, pollution exposure).

The longitudinal study will consist in a every 3-year follow-up visit in which the participant will undergo a review of the clinical history data, a full cognitive evaluation, neuroimaging (MRI), samples collection (blood, urine, CSF) and update of the life habits changes.

Eligibility criteria: Inclusion Criteria:

* Adult children of AD patient: First-degree descendant of an AD patient (following diagnosis as define in protocol).
* Age: 45 to 64 years old.
* Long-term commitment to the study: baseline and follow-up visits. Potential participants have to agree to undergo to all the procedures described in the protocol.

Exclusion Criteria:

* Cognitive impairment: to be included the participant must show no signs of objective cognitive impairment.
* Any significant systemic illness or unstable medical condition which could lead to difficulty complying with the protocol.
* Illiteracy or functional illiteracy.
* Any contraindication to any test or procedure at the time of study inclusion.
* Family history of monogenic AD.
* Not willing to undergo one or more of the tests and procedures described in the protocol at baseline.

Primary outcomes:
measure: Change from preclinical phase of AD to Mild Cognitive Impairment.
timeFrame: Every 3 years, from date of inclusion until the date of first documented progression, fulfilling mild cognitive impairment criteria, or date of death from any cause, whichever came first, assessed up to 12 years.
Secondary outcomes:
Other outcomes:
Locations:
city: Barcelona
country: Spain
facility: Barcelonabeta Brain Research Center
Study officials:
affiliation: Scientific Director
name: Jose Luis Molinuevo, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Akinci M, Pena-Gomez C, Operto G, Fuentes-Julian S, Deulofeu C, Sanchez-Benavides G, Mila-Aloma M, Grau-Rivera O, Gramunt N, Navarro A, Minguillon C, Fauria K, Suridjan I, Kollmorgen G, Bayfield A, Blennow K, Zetterberg H, Molinuevo JL, Suarez-Calvet M, Gispert JD, Arenaza-Urquijo EM; ALFA Study. Prepandemic Alzheimer Disease Biomarkers and Anxious-Depressive Symptoms During the COVID-19 Confinement in Cognitively Unimpaired Adults. Neurology. 2022 Oct 4;99(14):e1486-e1498. doi: 10.1212/WNL.0000000000200948. Epub 2022 Aug 2.
citation: Mila-Aloma M, Brinkmalm A, Ashton NJ, Kvartsberg H, Shekari M, Operto G, Salvado G, Falcon C, Gispert JD, Vilor-Tejedor N, Arenaza-Urquijo EM, Grau-Rivera O, Sala-Vila A, Sanchez-Benavides G, Gonzalez-de-Echavarri JM, Minguillon C, Fauria K, Ninerola-Baizan A, Perissinotti A, Kollmorgen G, Suridjan I, Zetterberg H, Molinuevo JL, Blennow K, Suarez-Calvet M; ALFA Study. CSF Synaptic Biomarkers in the Preclinical Stage of Alzheimer Disease and Their Association With MRI and PET: A Cross-sectional Study. Neurology. 2021 Nov 23;97(21):e2065-e2078. doi: 10.1212/WNL.0000000000012853. Epub 2021 Sep 23.
citation: Mila-Aloma M, Shekari M, Salvado G, Gispert JD, Arenaza-Urquijo EM, Operto G, Falcon C, Vilor-Tejedor N, Grau-Rivera O, Sala-Vila A, Sanchez-Benavides G, Gonzalez-de-Echavarri JM, Minguillon C, Fauria K, Ninerola-Baizan A, Perissinotti A, Simon M, Kollmorgen G, Zetterberg H, Blennow K, Suarez-Calvet M, Molinuevo JL; ALFA study. Cognitively unimpaired individuals with a low burden of Abeta pathology have a distinct CSF biomarker profile. Alzheimers Res Ther. 2021 Jul 27;13(1):134. doi: 10.1186/s13195-021-00863-y.
citation: Grau-Rivera O, Navalpotro-Gomez I, Sanchez-Benavides G, Suarez-Calvet M, Mila-Aloma M, Arenaza-Urquijo EM, Salvado G, Sala-Vila A, Shekari M, Gonzalez-de-Echavarri JM, Minguillon C, Ninerola-Baizan A, Perissinotti A, Simon M, Kollmorgen G, Zetterberg H, Blennow K, Gispert JD, Molinuevo JL; ALFA Study. Association of weight change with cerebrospinal fluid biomarkers and amyloid positron emission tomography in preclinical Alzheimer's disease. Alzheimers Res Ther. 2021 Feb 17;13(1):46. doi: 10.1186/s13195-021-00781-z.
citation: Arenaza-Urquijo EM, Salvado G, Operto G, Minguillon C, Sanchez-Benavides G, Crous-Bou M, Grau-Rivera O, Sala-Vila A, Falcon C, Suarez-Calvet M, Zetterberg H, Blennow K, Gispert JD, Molinuevo JL; ALFA Study. Association of years to parent's sporadic onset and risk factors with neural integrity and Alzheimer biomarkers. Neurology. 2020 Oct 13;95(15):e2065-e2074. doi: 10.1212/WNL.0000000000010527. Epub 2020 Jul 31.
citation: Salvado G, Molinuevo JL, Brugulat-Serrat A, Falcon C, Grau-Rivera O, Suarez-Calvet M, Pavia J, Ninerola-Baizan A, Perissinotti A, Lomena F, Minguillon C, Fauria K, Zetterberg H, Blennow K, Gispert JD; Alzheimer's Disease Neuroimaging Initiative, for the ALFA Study. Centiloid cut-off values for optimal agreement between PET and CSF core AD biomarkers. Alzheimers Res Ther. 2019 Mar 21;11(1):27. doi: 10.1186/s13195-019-0478-z.