If you want a glimpse at medicine’s track record against Alzheimer’s, look no further than the numbers: Pharmaceutical companies have recorded a 99 percent failure rate against the disease, spending billions of dollars on each failed drug candidate.
A new effort backed by genomics pioneer Dr. Lee Hood wants to fight Alzheimer’s without developing any drugs at all. Instead, Hood and his collaborators are employing wellness techniques and boatloads of data in the latest example of how leading minds are looking elsewhere for answers to the enigmatic illness.
“People really have had the wrong idea about Alzheimer’s and what’s causing it,” said Hood, who is launching a new institute in September that is led by Dr. Mary Kay Ross. The Brain Health and Research Institute (BHRI), as the Seattle-based program is known, aims to stabilize or improve cognitive function in people with Alzheimer’s by implementing a range of lifestyle changes.
The effort is built on the idea that Alzheimer’s is not a single disease in need of a single drug. “Monotherapy doesn’t work. We’ve had over 400 failed drug trials — that’s crazy,” said Ross, who serves as BHRI’s CEO and president. “We have to go in other directions and we have to look at other options.”
In many ways, the institute reflects the expertise of its founders. Hood brings research connections and analytical know-how from the Institute for Systems Biology (ISB), which he co-founded. Ross brings a functional and holistic approach to treating Alzheimer’s that she has developed over the years in her own practice. Ross uprooted that business from Savannah, Ga. in order to set up shop in Seattle, even bringing her patients with her.
BHRI will collect extensive data on individual patients, creating a profile that Hood calls “deep phenotyping.” The institute will create this quantitative view of health from a smorgasbord of 21st-century tools, including gut microbiome checks, streaming data from sleep and activity monitors, and tests for blood analytes, among others.
Hood has tried a similar approach before. He co-founded Arivale, a Seattle startup that aimed to improve people’s health through insights gained from extensive biological testing. Arivale teamed up with ISB and other medical groups on a trial called Coaching for Cognition in Alzheimer’s (COCOA).
But this past April, Arivale closed abruptly after the startup failed to find a market for its comprehensive and costly approach to what the company called “scientific wellness.”
Despite its financial struggles, Hood argued that Arivale was a “spectacular success” in showing the novel approach can improve health.
“We found that when you integrate these data types together, they led for each individual to actionable possibilities that, if acted upon, could improve your wellness or let you avoid disease. We want to apply this to Alzheimer’s,” Hood said.
Related: Why Arivale failed: Inside the surprise closure of an ambitious ‘scientific wellness’ startup
The institute will also benefit from Arivale’s investment in technology that aims to make sense of large, personalized health datasets. “We’ve brought the three computational platforms that Arivale probably spent $20 to $25 million creating into ISB, along with seven of the key personnel that can man these computational tools,” said Hood, who has co-founded more than a dozen companies, including biotech giant Amgen.
The methodology used at BHRI is derived from a plan created by Dr. Dale Bredesen, a neurologist and Alzheimer’s researcher. The institute’s holistic approach to treatment includes supplements, mindfulness and exercise. Patients will also follow a plant-based version of the ketogenic diet, which some studies indicate may be beneficial for people with neurodegenerative diseases. Another focus will be to root out environmental toxins such as mold, which may worsen cognitive problems, and the institute will use video games to improve basic brain functions.
“The thing that separates us is the marriage of science and medicine,” said Ross, adding that the clinicians and scientists at BHRI plan to meet every two weeks.
Hood and Ross have a daunting task ahead of them. Alzheimer’s disease costs the U.S. an estimated $290 billion each year, and around a third of all seniors will die with dementia, according to the Alzheimer’s Association. In March, yet another drug effort failed when Biogen and Eisai abandoned two late-stage trials.
The string of pharmaceutical defeats has prompted companies to look beyond amyloids, the protein fragments thought to cause the disease that have long been the target of Alzheimer’s drugs. San Francisco-based biotech startup Cortexyme is going after enzymes produced by bacteria found in gum disease. In Seattle, Athira Pharma, formerly M3 Biotechnology, is in early-stage trials for a therapy that aims to slow, halt or re-establish brain function by promoting cellular regeneration.
There are signs that digital health and wellness are catching on elsewhere in Alzheimer’s research. UC Berkeley received a $47 million grant from the National Institute on Aging to study the effect of lifestyle changes on cognitive function. Drugmaker Eli Lilly released early results from a study that showed devices like the iPhone could identify people with dementia.
The vast majority of healthcare spending for the disease goes toward end-of-life care rather than prevention, Ross said. In the future, she hopes that “brain check-ups” will become part of a regular doctor’s visit.
The group has already initiated two research studies and plans to pursue others. ISB is funding some of the center’s initial research, and BHRI is applying for National Institute of Health grants.
Other BHRI staff include Dr. Kristine Lokken, Dr. Jeremy Whiting, brain health coach Kerry Mills, and chief operating officer Stephen Ross. The institute expects to see more than 300 patients in its first year of operations.
“We’re incredibly optimistic about our ability over the next few years to demonstrate reversal in early Alzheimer’s disease,” said Hood. “I think it’s absolutely going to change the face of Alzheimer’s.”
Editor’s note: Hood will speak on the health tech stage at the 2019 GeekWire Summit in Seattle. More information about the Summit, taking place Oct. 7-9, here.