Alzheimer’s Disease

Alzheimer’s Disease is a progressive and eventually fatal brain disease. It is responsible for 60-80% of all dementia cases. The disease processes begin decades before the onset of symptoms, making early detection and intervention a priority.

Alzheimer's Disease

Cognitive impairment can manifest in different ways including:
  • Memory loss
  • Struggles with language or word retrieval
  • Difficulty naming or recognizing objects or people
  • Significant fluctuation of cognitive function
  • Behavioral changes: disinhibition / apathy-indifference / inappropriate social behavior
  • Trouble completing familiar tasks or activities
  • New onset of paranoia or self-isolation
In 2024, The National Institute on Aging and the Alzheimer’s Association revised the diagnostic criteria of Alzheimer’s Disease to require a biological confirmation of the disease process through various biomarkers.

Early Core 1 biomarkers include amyloid positron emission tomography (PET scan), cerebrospinal fluid (CSF) biomarkers (amyloid Beta 42/40, p-tau 181/ amyloid B42, total tau/amyloid B42) and serum biomarkers (p-tau 217), and are used to establish the diagnosis of the Alzheimer’s Disease process. These markers can be present even before the onset of symptoms.

These tests may or may not be readily available in your region. Presently, CNO uses cerebrospinal fluid (CSF) biomarkers to confirm the presence of Alzheimer’s Disease.

Core 2 biomarkers include CSF or plasma, MTBR-tau243, p-tau 205 and tau-PET. As well as serum or CSF, NFL, GFAP and cerebral MRI. These biomarkers are used for staging, prognosis, and evaluating the treatment effect.

At CNO

The team of neurologists and nurses at CNO will perform a full neurological evaluation, determining if there is evidence of cognitive decline and the possible causes of it.
Presently there is no cure for Alzheimer’s Disease. In Canada, modestly effective symptomatic treatments with cholinesterase inhibitors, donepezil, rivastigmine, galantamine are available. Disease modifying treatments have recently become available in many parts of the world, including the United States, Europe, China and Japan. These treatments include anti-amyloid beta monoclonal antibodies (lecanumab and donanemab) which are administered intravenously every 2 to 4 weeks. They have shown, in controlled trials, a normalization of the amyloid PET scan and a significant reduction in the rate of cognitive decline.

CNO is involved in the administration of a wide variety of intravenous therapies within the clinic, once these treatments are approved by Health Canada, CNO will be administering lecanemab and donanemab in our infusion clinic.

Clinical trials are another therapeutic option for people with chronic neurological conditions. CNO is involved in clinical research for a wide variety of neurological conditions.

rTMS in Alzheimer’s Disease

Repetitive transcranial magnetic stimulation (rTMS) is a form of non-invasive neuromodulation. It involves using an electromagnet to apply repeated, brief magnetic pulses to the central nervous system. This induces a small electrical current in focal areas of the cortex influencing synaptic activity, connectivity, and neuroplasticity in areas of the brain involved in cognition.

rTMS has shown significant effects in cognitive enhancement. Recent reviews have concluded that rTMS appears to be safe and effective in improving cognitive function in people with Alzheimer’s disease. However, further studies are required to confirm, better understand, and improve the intervention.

CNO offers rTMS treatments for those with Alzheimer’s Disease. However, as these treatments are still considered experimental, they are not currently covered by the public health system.

CNO is involved in clinical research for a wide variety of neurological conditions.

rTMS in Alzheimer’s Disease

Repetitive transcranial magnetic stimulation (rTMS) is a form of non-invasive neuromodulation. It involves using an electromagnet to apply repeated, brief magnetic pulses to the central nervous system. This induces a small electrical current in focal areas of the cortex influencing synaptic activity, connectivity, and neuroplasticity in areas of the brain involved in cognition.

rTMS has shown significant effects in cognitive enhancement. Recent reviews have concluded that rTMS appears to be safe and effective in improving cognitive function in people with Alzheimer’s disease. However, further studies are required to confirm, better understand, and improve the intervention.

CNO offers rTMS treatments for those with Alzheimer’s Disease. However, as these treatments are still considered experimental, they are not currently covered by the public health system. To learn more

CNO is involved in clinical research for a wide variety of neurological conditions.
Clinical Trials

RESEARCH AREA

Alzheimer’s Disease

Alzheimer’s Disease is a progressive and eventually fatal brain disease, responsible for 60-80% of all dementia cases. The disease processes begin decades before the onset of symptoms, making early detection and intervention a priority.

We are not currently recruiting for clinical trials related to Alzheimer’s Disease. If you are interested in participating in future studies, please complete our

Research Participation Form.

Completed Trials:

2018: 1346.23 study (Phase II)
2017: CREAD 2 study (Phase III)
2009: EMBRACE study (Phase IV)

Clinical Evaluation

Cognitive impairment can manifest in different ways:

  • Memory loss
  • Struggles with language or word retrieval
  • Difficulty naming or recognizing objects or people
  • Significant fluctuation of cognitive function
  • Behavioral changes: disinhibition / apathy-indifference / inappropriate social behavior
  • Trouble completing familiar tasks or activities
  • New onset of paranoia or self-isolation

By referral, CNO neurologists and nurses will perform a full neurological evaluation, determining if there is evidence of cognitive decline and the possible causes of it.

Biological Diagnosis

In 2024, The National Institute on Aging and the Alzheimer’s Association revised the diagnostic criteria of Alzheimer’s Disease to require a biological confirmation of the disease process through various biomarkers.

Early Core 1 biomarkers include amyloid positron emission tomography (PET scan), cerebrospinal fluid (CSF) biomarkers (amyloid Beta 42/40, p-tau 181/ amyloid B42, total tau/amyloid B42) and serum biomarkers (p-tau 217). Core 1 biomarkers are used to establish the diagnosis of the Alzheimer’s Disease process. These markers can be present even before the onset of symptoms.

The availability of these test may vary depending on your region. Presently, CNO uses cerebrospinal fluid (CSF) biomarkers to confirm the presence of Alzheimer’s Disease.

Core 2 biomarkers include CSF or plasma, MTBR-tau243, p-tau 205 and tau-PET. As well as serum or CSF, NFL, GFAP and cerebral MRI. These biomarkers are used for staging, prognosis and evaluating effectiveness of the treatment.

Treatments

Presently there is no cure for Alzheimer’s Disease. In Canada, modestly effective symptomatic treatments with cholinesterase inhibitors, donepezil, rivastigmine, galantamine are available.

Disease modifying treatments have recently become available in many parts of the world, including the United States, Europe, China and Japan. These treatments include anti-amyloid beta monoclonal antibodies which are administered intravenously every 2 to 4 weeks. They have shown, in controlled trials, a normalization of the amyloid PET scan and a significant reduction in the rate of cognitive decline.

CNO is involved in the administration of a wide variety of intravenous therapies within the clinic (link to Infusion Clinic), once these treatments are approved by Health Canada, CNO will be administering lecanemab and donanemab in our infusion clinic.

Clinical trials are another therapeutic option for people with chronic neurological conditions. CNO is involved in clinical research for a wide variety of neurological conditions.

Learn More

Participate as a Healthy Volunteer

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