Supported by the S Family Foundation, the Milken Institute Center for Strategic Philanthropy brought together 30 experts in AD earlier this year to assess the current state of the eld and to identify concrete opportunities where philanthropic capital could make a real difference. The top five listed below.

Support Collaborative Basic Science

Our understanding of the causes of AD and its contributing factors is limited. A historical, intensive focus on one protein, amyloid, may have stifled exploration into other dynamics, causing a lack of diversity in the clinical pipeline. Directed investment into the complex interplay of the full range of biological players promoting neurodegeneration would fill in critical knowledge gaps—gaps that could be turned into new therapeutic targets.

Focus on Biomarkers of the Disease

Currently, the only de native diagnosis of AD is made after death. Current tools to provide interim diagnoses are expensive and invasive, including brain imaging tests or sample collections through a spinal tap. Additionally, cognitive tests used in the clinic are not sensitive enough to detect problems until the disease has progressed significantly. Investment into novel tools that are more sensitive, less invasive, and less expensive to measure AD could help change the disease trajectory for scientists, clinicians, and patients.

Enable Data Science

More data exists than ever before, and are growing exponentially with the expansion of biological techniques examining whole genomes, proteomes, and beyond. Many systems have emerged to fill immediate data needs; however, these systems rarely talk to one another, limiting the ability to share or combine datasets. Philanthropists can help support the crosstalk between big data platforms to unify existing data and can sponsor the integration of data scientists into neuroscience.

Untangle Risk Factors

The AD eld is in the early days of understanding risk factors beyond certain genes. Complicating matters is the lack of diagnostic tools for AD, as well as the co-illnesses that coincide with AD. These issues challenge the ability to untangle AD risk factors from those of other dementias or diseases. Understanding what factors contribute to an individual’s risk of AD is a first step to learning how to mitigate risk. Philanthropists should support long-term efforts to proactively screen patients for disease biomarkers, as well as the studies to follow these individuals over time to assess risk factors.

Reinforce the Clinical Pipeline

No therapeutic has been approved to prevent, slow, or cure AD. The complexity of the disease has made the development of model systems to test novel therapeutics challenging, and the long timescale of disease progression has prompted the industry to shave off time by skipping vital steps in the process. Support by philanthropists to develop and expand model systems would bene t the early clinical pipeline. Additionally, investment into the development and implementation of a “trial ready” cohort would allow for adaptable clinical trials that fully utilize their potential patient population.

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