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Microdialysis of the Brain

Paving the Way for Improved Alzheimer's Treatments

SINNAIS™ microdialysis of brain technology allows cerebrospinal fluid (CSF) to be siphoned, filtered, and analyzed for beta-amyloid concentration, with results reported to a physician’s tablet, while the clean CSF is returned to the spinal canal.

Alzheimer Treatments - People walking in nature
  • Measures CSF Abeta levels in real-time
  • Can be charged inductively
  • Siphons CSF
  • Can be refilled
  • Measures CSF p-Tau and total Tau levels in real-time
  • Provides real-time feedback on rates of Abeta clearance from the brain
  • Uses a proprietary biological filter to run CSF through a filter and remove Abeta, p-Tau, and other protein debris
  • Customizes and optimizes dosage to patients’ specific pharmacokinetic and pharmacodynamic needs—Personalized Medicine
  • SMART Shunt and Smart Optical Sensor (SOS) can monitor drug toxicity and concentration in real-time, with a wireless connection to the cloud

Alzheimer's Disease

To understand the benefits of microdialysis of the brain, one must first consider the causes and consequences of Alzheimer's disease, particularly as they relate to the brain, neurons, and cerebrospinal fluid (CSF).

Although the exact cause of Alzheimer's remains unknown, researchers believe it results from a complex interplay of genetic, lifestyle, and environmental factors. This interplay leads to the buildup of amyloid plaques, tau tangles, brain cell death, and brain shrinkage. The APOE-e4 gene is the strongest known genetic risk factor for late-onset Alzheimer's, increasing the likelihood of developing the disease after age 65.

Other, rarer genetic mutations, such as those found in the APP, PSEN1, and PSEN2 genes, are directly linked to early-onset Alzheimer's, although they account for only a small percentage of cases.

Inflammation plays a significant role in Alzheimer's; the brain's immune response can become overactive, leading to chronic inflammation that further damages brain cells. Vascular problems and lifestyle factors—such as poor diet, lack of physical activity, smoking, and other contributors to cardiovascular disease—are also believed to increase Alzheimer's risk. Additionally, chronic stress and poor sleep may negatively affect brain health over time. Aging brings natural changes to the brain, including shrinkage, inflammation, and oxidative stress, which may contribute to Alzheimer's, though they do not directly cause the disease.

In recent years, new findings have shed light on the causes of Alzheimer's disease, highlighting factors such as the gut microbiome, the link between sugar and Alzheimer's, and early symptoms like unusual vision problems. Conversely, boosting brain protein levels may help slow the decline associated with Alzheimer's.

Prevalence of Alzheimer's Disease

The most prevalent risk factors for Alzheimer’s include:

01

Age

Most people with Alzheimer's are 65 or older, and the risk doubles about every five years after that.

02

Family History & Genetics

Having a close family member with Alzheimer's increases the risk, and certain genes like APOE-e4, are associated with this increased risk, though they do not guarantee the disease will develop.

03

Gender

Women are more likely to develop Alzheimer's than men, partly due to their longer life expectancy.

04

Lifestyle & Heart Health

Risk factors for heart disease, including obesity, high blood pressure, high cholesterol, and diabetes elevate Alzheimer's risk. Poor diet, lack of exercise, and smoking may also contribute.

05

Head Injuries

A history of traumatic brain injury, particularly repetitive injuries, may increase Alzheimer's risk, with some studies suggesting that even a single severe injury could elevate risk.

06

Cognitive Engagement & Education Level

Lower levels of formal education and reduced cognitive engagement throughout life are linked to a higher Alzheimer’s risk. Reading, learning, and social activities may lower it.

07

Sleep Issues

Sleep disorders, like sleep apnea and chronic sleep deprivation, are linked to increased Alzheimer’s risk, potentially due to higher amyloid plaque buildup in the brain.

08

Ethnicity

Research indicates that African Americans and Hispanics are at a higher risk of developing Alzheimer's than Caucasians, possibly due to higher rates of cardiovascular issues, diabetes, and other health disparities.

While these factors increase the likelihood of developing Alzheimer’s, they do not guarantee it, and many individuals with risk factors never develop the disease.

What causes Alzheimer's

The most prevalent risk factors for Alzheimer’s include:

01

Amyloid Plaques

Alzheimer’s brains exhibit abnormal clumps of a protein called beta-amyloid that build up outside nerve cells. These clumps, known as plaques, are toxic to brain cells and disrupt communication between neurons, ultimately leading to cell death.

02

Tau Tangles

Inside brain cells, abnormal accumulations of a protein called tau form twisted tangles. In healthy neurons, tau helps stabilize the internal structure, but in Alzheimer’s, these tau proteins become abnormal, leading to cell dysfunction and death.

03

Brain Cell Death and Shrinkage

As neurons die, the brain shrinks, leading to memory loss and cognitive decline, starting in memory-related areas like the hippocampus, before spreading to other regions.

04

Genetics

Certain genes can increase Alzheimer’s risk, with the APOE-e4 gene being the strongest factor for late-onset Alzheimer’s. Rarer mutations in the APP, PSEN1, and PSEN2 genes are directly linked to early-onset Alzheimer's, but they represent a small percentage of cases.

05

Inflammation

In Alzheimer’s, the brain’s immune response becomes overactive, leading to chronic inflammation that may further damage brain cells.

06

Vascular Problems

Alzheimer’s disease is closely linked with heart and blood vessel health, with conditions like high blood pressure, heart disease, stroke, and diabetes increasing the risk due to their impact on brain blood flow.

07

Lifestyle & Environmental Factors

Poor diet, physical inactivity, smoking, chronic stress, and inadequate sleep—factors contributing to cardiovascular disease—are believed to increase Alzheimer's risk.

08

Aging

As we age, natural changes such as shrinkage, inflammation, and oxidative stress may contribute to Alzheimer's without directly causing it.

Alzheimer’s disease is likely caused by a combination of factors, varying in influence among individuals. Although it cannot be prevented, a healthy lifestyle—including a balanced diet, regular exercise, and cognitive engagement may help reduce the risk.

Costs of Alzheimer's

The costs of Alzheimer’s disease to the American healthcare system are significant and multifaceted. In 2023, the total costs of caring for individuals with Alzheimer’s and other dementias in the U.S. were estimated to exceed $345 billion. This figure encompasses both direct and indirect costs, reflecting the complexity of the burden on individuals, families, and the national economy.

Direct Medical Costs

This includes hospitalizations, outpatient care, medications, and long-term care services, with Medicare and Medicaid covering a significant portion of these costs.

Informal Caregiving

Many individuals with Alzheimer’s are cared for by family or friends, creating a substantial economic burden, with the estimated value of unpaid caregiving at around $272 billion annually.

Impact on Productivity

The loss of productivity among patients and caregivers also contributes to the economic impact, as caregivers often reduce work hours or leave the workforce entirely to provide care.

Future Projections

If trends continue, Alzheimer’s care costs could exceed $1 trillion by 2050, primarily driven by the aging population.

In-Home Care

The monthly cost of Alzheimer's care varies by type of care required and geographic location. Here's an overview:

Home Health Aide

The national median rate is $33 per hour, totaling $1,320 per week for 40 hours, or $5,280 monthly, with an overall median cost of approximately $6,200 per month.

Semi-Private Room

The national median cost is approximately $7,908 per month.

These costs underscore the need to address Alzheimer’s disease from both a healthcare and broader societal perspective.

Target indications

Serving Unmet Needs

$15.8B

Combined Treatment Market Size

As of 2024, nearly 7 million Americans aged 65 and older are living with Alzheimer’s disease, a number expected to reach 13 million by 2050.

180K

Total Addressable Market (TAM)

Alzheimer’s is among the most expensive conditions for the U.S. healthcare system, with care costs projected at $360 billion in 2024, including direct medical expenses and unpaid caregiving valued at nearly $350 billion in 2023. These figures underscore the significant impact on individuals and the healthcare system.

Recent treatment developments include FDA-approved monoclonal antibodies lecanemab (Leqembi) and donanemab (Kisunla) for mild Alzheimer’s, which target and clear amyloid plaques in the brain. Unlike symptom-focused treatments, these therapies aim to modify the disease process.

Future research is exploring strategies like managing beta-amyloid buildup, preventing tau protein tangles, reducing brain inflammation, and developing oral medications. While promising, Alzheimer’s remains complex, and a cure is still elusive. However, Cognos is making strides toward more effective treatment options, offering new hope to patients and caregivers.

Read more on clinical relevance

$15.8B

Combined Treatment Market Size

180K

Total Addressable Market (TAM)