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Like so often in philanthropy, the Rogers Family Foundation’s giving began with the personal and grew into something far-reaching and sustaining. The “personal” was the relationship the late Jacqueline Rogers, who struggled with dementia, developed years ago with her geriatric psychiatrist, Brent P. Forester, MD, MSc, who today is chief of McLean’s Center of Excellence in Geriatric Psychiatry. To honor this relationship, the foundation launched McLean’s Geriatric Mood Disorders Research Program focused on older adults with bipolar disorder, depression and co-occurring cognitive problems that often impair quality of life and daily functioning, and has supported it for more than a decade.
“He was amazing with my mother—so compassionate—she loved him,” says foundation trustee Deborah Rogers Pratt. “We are so pleased with the research that Brent and others have done and how far the program has come.” Pratt’s cousin and fellow foundation trustee Amy Rogers Dittrich adds, “Alzheimer’s disease is the sixth leading cause of death and research is advancing at a gallop. But, the research dollars have not kept pace.”
McLean is home to some of the country’s most exciting research into brain diseases in the elderly, a population that has been largely overlooked. Dr. Forester and his collaborators are pursuing questions ranging from whether a long history of mental illness increases one’s risk of dementia to why depression expresses itself so differently in the elderly and how best to treat it. Research like this fills a longstanding gap that has stymied psychiatrists’ ability to optimally care for their geriatric patients, according to Dr. Forester.
With the Rogers Foundation’s support, Dr. Forester is investigating the use of low frequency magnetic stimulation to treat bipolar depression in older adults. The treatment was discovered serendipitously when a McLean research assistant observed that depressed patients undergoing magnetic resonance imaging felt their moods lift afterward.
Dr. Forester’s research team also is conducting several studies that could yield the first disease modifying treatment for Alzheimer’s disease: amyloid-busting drugs. Although these medications have been deemed ineffective in patients who already exhibit more advanced symptoms of the disease, Dr. Forester believes they hold promise for patients who are not yet symptomatic or are in very early stages of illness. “These medications are like statins for the brain, but instead of lowering cholesterol, they reduce brain amyloid plaques, the hallmark of Alzheimer’s disease,” says Dr. Forester. “If you start a statin to reduce a cholesterol of 300 after having five heart attacks, it won’t help regain lost cardiac function. Similarly, the first studies of amyloid-busting drugs were done on people who already had signs of significant brain degeneration.”
Another important front of Alzheimer’s research is the treatment of agitation, aggression, and other behavioral symptoms that directly reduce independence, increase Alzheimer’s related mortality and stress caregivers. The most widely used treatments—antipsychotic drugs—are only modestly helpful and can have serious side effects, including higher risks of strokes and death. McLean is conducting studies of several novel approaches, including lithium, synthetic THC (the active ingredient in medical marijuana), and electroconvulsive therapy.
Psychologist David G. Harper, PhD, is the Center’s associate director for research and, along with Dr. Forester, is seeking to understand Alzheimer’s patients’ agitation as part of a study examining the interplay between depression, neurocognitive disorders like Alzheimer’s, and inflammation.
“We are interested in the behavioral symptoms of dementia, like agitation, because they are why people are hospitalized, not because they’re a little forgetful,” says Dr. Harper. Inflammation may play a role in these behaviors and “if we can understand the mechanisms that trigger them, it opens the door to novel therapeutics,” he says.
Donors Greg and Kathy Spier, with the Spier Family Foundation, admired the novelty of Harper’s research, one criteria for their family’s philanthropy. “We try to fund studies that the National Institutes of Health won’t fund initially,” says Kathy. “We like research that is a little off the beaten track and we’re hoping our support will deliver preliminary results that will be a bridge to federal support and larger studies.”
Of the top 10 causes of death in the U.S., Alzheimer’s disease is the only one that currently cannot be prevented, slowed or cured. Research conducted in McLean laboratories may one day—in the not too distant future—change that.