Normal cognition (primary prevention)

  1. Generations 1 (https://www.generationprogram.com/#Main): Sponsored by Novartis in collaboration with Banner Alzheimer’s Research Institute. Inclusion: APO Ɛ4/Ɛ4, age 60-74, MMSE ≥24, RBANS memory index ≥85 and CDR=0 or RBANS 70-84 and CDR=0.5, GDS<6, generally good health. RPCT with either placebo, amyloid vaccine or β-secretase inhibitor to reduce brain amyloid burden. Twice yearly visits for 8 years for safety and cognitive assessment. Amyloid and FDG-PET scans plus volumetric MRIs at baseline, years 2,5 & 8. Study partner needed for this and all studies. 

  2. Generation 2: Similar to above but for heterozygous APO Ɛ4 and only randomized to placebo or β-secretase inhibitor.