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������ psychology professor John Gunstad, Ph.D., has received agrant of nearly $2.6 million from the National Institutes of Health to expand his Alzheimer’s disease research into a national study.

Gunstad is studying how speech patterns in older adults can be used as an early detector of Alzheimer’s, the progressive neurological disorder that is the leading cause of dementia in the elderly. Alzheimer’s causes changes in the brain before symptoms appear.

Gunstad’s research began last year, through ������’s Brain Health Research Institute and its partnership with the Cleveland Brain Health Institute, which provided a $40,000 grant for the initial study of 60 individuals.

With the new NIH grant, Gunstad will partner with researchers at Columbia University in New York, to collect the same speech pattern data from a pool of nearly 3,000 people, whose health already is being studied by Columbia.

“Essentially, our study will piggyback on their ongoing research which will give us a much larger data set,” he explained.

The idea for Gunstad’s research blossomed from existing work by IBM using new technology to study changes in speech patterns in patients with psychosis or schizophrenia, to determine who were at the highest risk for future hospitalization. 

Gunstad contacted IBM researchers to see if he could use the company’s technology to collect and examine speech from older adults to determine who is at greatest risk of dementia, based on how their speech patterns were changing. That resulted in a collaboration with IBM researcher Rachel Ostrand, Ph.D., for the initial study, who Gunstad said was enthusiastic about expanding the use of the technology.

Such changes include patients having trouble coming up with words or substituting vague terms or pronouns when they can’t find the proper word. For example, Gunstad said patients may start referring to an item such as a chair as a “thing” rather than using the exact noun.

The technology records the test subjects in conversation, then assigns codes to different words and parts of speech, which are then analyzed for speech patterns that can predict problems in the future.

The tests are ongoing in patients ages 55 to 90.

“We wanted to cast a wide net to catch people across a wide continuum,” Gunstad said. “Changes in speech patterns can be detected very early on.”

The new NIH-funded research is expected to take four years, during which time the local study will continue.

“We’ll be adding a new piece to a giant project,” Gunstad said. “The sample is very diverse.”

The Columbia study is called the WHICAP Offspring project. Beginning in 1989, Columbia researchers studied thousands of adults from the Washington Heights, Hamilton Heights, and Inwood neighborhoods of Manhattan as part of a community-based study of aging and dementia among elderly urban dwellers called WHICAP (Washington Heights-Hamilton Heights-Inwood Community Aging Project.)

WHICAP researchers collected detailed information about the onset of dementia and how symptoms develop over time. The study has yielded comprehensive data on the rates of, and risk factors for, Alzheimer's disease and other dementias among African Americans, Caribbean Hispanics and Caucasians living in the three New York communities, including how the rates of disease and frequency of disease risk factors vary across ethnic groups.

Gunstad will be working with the WHICAP Offspring project in which the study subjects are the children of those in the original WHICAP study. He said one of the points he hopes to discover through the study is whether the speech pattern analysis is as accurate predictor for those people for whom English isn’t a first language.

Michael N. Lehman, director of ������’s Brain Health Research Institute, praised Gunstad’s work as innovative.

“He is pursuing the possibility of an exciting, new approach to the diagnosis and early detection of Alzheimer’s disease. The use of automated speech analysis as a ‘digital biomarker’ for the disease is truly innovative. Since early detection is key in developing new treatments and interventions for this devastating disease, the project has tremendous potential to improve brain health,” Lehman said.

Lehman noted how the project focuses on the African American and Hispanic populations, which are two- to four-times more likely to develop Alzheimer’s disease than Caucasians.

“We are exceptionally proud of Dr. Gunstad. His work is a great example of the cutting-edge, collaborative research that the Brain Health Research Institute is fostering,” he said.

Paul DiCorleto, ������’s vice president of research and sponsored programs, said Gunstad’s grant will be a service to the elderly, as well as boon for the university.

“A large federal award like this one is wonderful to receive not just because of the dollars that will come to ������ and the people who will be employed, but because of how it speaks to the excellence of the project and its great significance to the brain health of the elderly,” he said. “This is one of many examples of outstanding research emanating from ������’s Brain Health Research Institute.”

Work on Gunstad’s initial study of 60 subjects from northeast Ohio will continue as the national study gets underway.

Gunstad worked with Lindsay Miller Scott, Ph.D., a clinical neuropsychologist from University Hospital’s Foley ElderHealth Center in Beachwood, Ohio, to help recruit research subjects for the local portion of the study.

Miller Scott, who received her Ph.D. in clinical psychology from ������ in 2014, previously worked in Gunstad’s laboratory as a graduate student. She said she was excited for the opportunity to help recruit research subjects for the local study because her work with the elderly has shown her firsthand how devastating Alzheimer’s disease is for patients and their families.

“It’s a horrible disease,” Miller Scott said. “It slowly robs people of their identities. It’s really hard for caregivers and family members, who are slowly losing the person they have known and loved for so long.”

Early detection means that Alzheimer’s patients have the best chance of benefitting from the medications that are available, but also means they can plan better for their futures and that of their family members.

“If they knew earlier that this was in their future, they maybe would have gone on that vacation or planned that trip,” Miller Scott said.

Recruiting from the UH clinic is new for ������, and would not have been possible without the wide-reaching connections of the Brain Health Research Institute.

“The Brain Health Research Institute is really the mortar between the bricks that helps connect us to partnering institutions,” Gunstad said.

Gunstad, who serves as associate director of the Brain Health Research Institute, said its mission is to make these types of connections to support a wide array of research activities.

Miller Scott said collaboration is an excellent way to ensure that researchers stay connected. “There are so many great institutions doing a lot of important work both clinically and in research. It makes sense to all work together and connect,” she said.

Researchers at ������ are conducting a variety of Alzheimer’s studies, looking at its causes and possible treatments through psychology and biology. Previous research by Gunstad has examined the use of probiotics as a way of protecting the brain from Alzheimer’s by promoting a healthy gut, which is viewed as a key to overall health.

As the Baby Boom generation ages, the prevalence of Alzheimer’s disease is expected to triple in the next 30 years and result in an estimated $1.1 billion in health care costs in the U.S. There is no cure for Alzheimer’s and no new medications to treat the disease have been produced in the last 15 years.

Gunstad said the growing prevalence of Alzheimer’s can be attributed to increased life expectancies.

“With modern medical care, people are living long enough to get Alzheimer’s disease,” he said. “We age into Alzheimer’s disease.”

While there are variants of the disease which can strike the young, most Alzheimer’s begins after age 65, Gunstad explained. If changes in speech patterns can help to determine the onset of Alzheimer’s at an early age, treatment can start earlier when it is more effective.

“That’s one of the reasons I am excited about this line of research,” he said. “Individuals often come in very late in the process. Their condition is more advanced by the time they come in for treatment.”

If speech pattern monitoring proves to be an effective diagnostic tool, Gunstad said he would anticipate a time when technology would make the testing so simple it could be done by with an app on a cell phone.

“It could be made portable, and could be done at home,” he said.

To learn more about ������’s Brain Health Research Institute, visit /brainhealth.

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