Katie Lunnon (Left) is one of the researchers involved 

£1.2 million USA grant to investigate psychosis in Alzheimer’s disease

Funding expected to total £1.2 million ($1,566,874) over four years from the USA’s National Institutes of Health (NIH) will help Exeter academics advance understanding about the underlying biological mechanisms leading to some people with Alzheimer’s disease developing psychosis.

The grant is one of eight awarded by the NIH’s National Institute on Aging (NIA) as part of its Molecular Mechanisms of the Neuropsychiatric Symptoms in Alzheimer’s Disease program, and will fund research that aims to pave the way for new treatments, and better diagnosis and classification of psychosis in dementia. The project, led by Professor Katie Lunnon, is an international collaboration bringing together a cross-disciplinary team of researchers from the United Kingdom, as well as researchers from the University of Pittsburgh and Scripps Research Institute in the United States, the University of Oslo and the Innlandet Hospital Trust, in Norway.

Up to half of people with Alzheimer’s disease experience some form of psychosis, which is linked to a more severe disease course. People who experience psychosis are more likely to be hospitalised, have a faster decline in brain function and everyday abilities, and to die sooner.

Antipsychotic medications that have been developed to treat these symptoms can cause considerable harm in some dementia patients, quadrupling the risk of stroke and death. As a result, doctors have now halved the amount of antipsychotics they are prescribing to people with dementia, yet no new treatments are currently available to reduce psychotic symptoms, which are highly distressing to individuals and carers. This new study at the University of Exeter aims to understand the biological mechanisms underlying psychosis in dementia, which could lead to new treatments.

Dr Byron Creese, Senior Research Fellow at the University of Exeter Medical School, said: “Psychosis is very common in people with Alzheimer’s disease. Many carers and family members will be able to recall an incident of psychosis where, for example, their grandmother may have thought someone was trying to poison her food, or that someone was stealing her money. There is growing evidence that these episodes are linked to a more rapid course of dementia decline, yet there has been very little research on the biological mechanisms that are driving this”

The research will analyse data from more than 500 people to look at how genes are regulated in the brains of people with psychosis in dementia. The study will also look at blood samples to investigate whether there is a biomarker for psychosis, which is a biological signature in the blood, which can help predict which individuals with Alzheimer's disease will have a more rapid decline. This could help with monitoring and treating these patients, as they are more likely to have a worse disease course. 

Prof Katie Lunnon, Professor of Dementia Genomics at the University of Exeter Medical School, said: “We’re really excited that this research could help address an urgent international priority, to develop a better understanding of psychosis in dementia. The project will provide a major step forward in identifying new drug targets for psychosis in Alzheimer’s disease, how we can use existing medications to better treat psychosis in Alzheimer’s disease, and new biomarkers to predict which individuals with mild cognitive impairment will develop psychosis in Alzheimer’s disease and are thus more likely to decline quickly with the disease. This funding has come from the USA government’s research arm, which signifies international recognition of our world-leading work in this area.”

The NIA grant number is R01AG067015.

Date: 4 February 2020