Half a century ago, a neurologist in St. Louis refused to dismiss his elderly patients' failing memories as the ordinary surrender of old age, and asked instead what was unfolding inside their brains. That question has become a study that now carries forward on federal renewal into 2031, its long memory built from volunteers who returned year after year across generations. Its present effort is to learn whether the disease can be halted before it takes hold, and to ensure that the knowledge belongs to every community it touches, not only to those who have historically been able to step forward
$32 Million Renewal Extends Landmark Alzheimer's Study at WashU Medicine Through 2031
Alzheimer's has affected multiple generations of one participant's family, including her grandfather's death from the disease and her father's and uncles' diagnoses.
"Alzheimer's disease may run in my family, but this is where it runs out."
Mark
Why does a study that started in the 1970s still matter this much?
Mimi
Because it's followed people for decades. That long view is how researchers learned the disease begins silently in the brain, long before memory fails.
Mark
And the renewal is $32 million over five years?
Mimi
Yes, from the National Institute on Aging, running through 2031, the study's 45th year.
Luke
Worth noting the funding is confirmed, but nothing here says what the new work will find. The racial biomarker question is something they'll examine, not a result.
Mark
Fair. What's the enrollment piece?
Mimi
Black participation in the center's research went from 3% to 17% since 1998. Now they want to grow a north St. Louis pilot from about 40 people to 300, using a mobile clinic.
Luke
That 17% is the researchers' own figure, and it's one center's. The source doesn't say how it compares with the city's population.
Mark
What about the new treatments?
Mimi
They'll track patients receiving them in ordinary care. They've slowed progression in some people in trials, so the question is what happens outside trials.
Luke
Right, "some people" matters. Nothing here says how much, or for whom, in real-world settings. That's unknown.
Mark
And Nicole Garrison?
Mimi
Her grandfather died of Alzheimer's, and her father and his siblings were all diagnosed. She joined in 2025 and does it for her daughters.
El Pulso
- A $32 million federal renewal keeps one of the longest-running Alzheimer's studies alive through 2031, its 45th year.
- The study's enrollment has long leaned toward white, highly educated volunteers, and that imbalance now sits at the center of the work.
- A mobile clinic pilot in north St. Louis aims to grow from about 40 participants to 300, carrying research into neighborhoods that distrust institutions and lack transportation.
- Researchers must confirm whether key biomarkers behave differently across racial groups, since a tool that fails some populations fails them all.
- Newly approved treatments are being tracked in everyday clinical care, where their promise to slow decline will be tested beyond controlled trials.
Half a century ago, a neurologist in St. Louis refused to dismiss his elderly patients' failing memories as the ordinary surrender of old age, and asked instead what was unfolding inside their brains. That question has become a study that now carries forward on federal renewal into 2031, its long memory built from volunteers who returned year after year across generations. Its present effort is to learn whether the disease can be halted before it takes hold, and to ensure that the knowledge belongs to every community it touches, not only to those who have historically been able to step forward.
In the 1970s, Leonard Berg, a neurologist at Washington University in St. Louis, kept meeting older patients whose memories were slipping. He refused to call it simply aging, and set out to understand what was happening in their brains. More than forty years later, that work continues, now renewed with $32 million from the National Institute on Aging through 2031.
The study has enrolled more than 1,877 people, and its greatest lesson comes from patience. Because volunteers returned year after year, researchers learned that Alzheimer's begins silently, long before memory fails. John C. Morris, who has led the program since 1998, says the aim now is to stop the disease before brain cells die, and to do it for every community, since the illness crosses all races and backgrounds.
The study's reach has been limited, however. Its volunteers have been mostly white, highly educated and healthy. Morris has raised Black participation from 3% to 17%, but the team now plans a north St. Louis pilot expanded to 300 residents, using a mobile clinic that brings testing to neighborhoods where mistrust and transportation barriers have kept people away. Those who contribute, Morris insists, should receive something in return.
For Nicole Garrison, a Lake St. Louis pharmacist, the work is deeply personal. Her grandfather died of Alzheimer's, and her father and his siblings were later diagnosed. She has joined the study since 2025, undergoing testing, scans and spinal taps, knowing it may not help her directly. She does it for her daughters and for families like hers. "Alzheimer's disease may run in my family," she said, "but this is where it runs out."
In the 1970s, Leonard Berg, a neurologist at Washington University School of Medicine in St. Louis, kept seeing older patients with memory problems. He declined to write those problems off as normal aging or senility, and he set out to learn what was happening inside their brains. More than four decades later, the research project he started is still running.
The project is the Healthy Aging and Senile Dementia program, one of the longest-running longitudinal studies of Alzheimer's disease. It has enrolled more than 1,877 people. This month it received a renewal of $32 million over five years from the National Institute on Aging, part of the National Institutes of Health. The money carries the study through 2031, its 45th year, and lets investigators put more weight on preventing Alzheimer's and on enrolling a wider range of participants.
John C. Morris, MD, has led the program since 1998, when Berg retired. He holds the Harvey A. and Dorismae Hacker Friedman Distinguished Professorship of Neurology. He points to how much has changed: forty years ago, Alzheimer's could only be confirmed after death, by examining the brain under a microscope. Because volunteers have returned year after year, across generations, researchers learned that the disease starts silently in the brain long before memory fails. Morris says the goal now is to stop the process before brain cells die, and to do so for every group, since Alzheimer's occurs across all races and ethnicities.
The program's early funding let Berg and his colleagues establish the Alzheimer Disease Research Center at WashU Medicine in 1985, one of the first 10 such centers in the country. Charles F. and Joanne Knight later endowed it. The Knight ADRC is now the university's hub for Alzheimer's and related dementia research, supporting long-term participant studies along with work on biomarkers, brain imaging and genetics. Berg and colleagues developed the Clinical Dementia Rating, which Morris later refined. It is now the worldwide standard for judging whether dementia is present and how severe it is. Morris and colleagues also found that Alzheimer's-related brain changes can exist in people with no memory symptoms. That led in 2005 to the Adult Children Study, led by Morris, which follows middle-aged people who have a parent with Alzheimer's, to learn who is likely to develop the disease and what triggers symptoms.
With the renewal, the program will examine whether some Alzheimer's biomarkers differ between Black and white participants. If they do, diagnostic tools may not work equally well across racial groups. The team will first broaden who takes part. Like most clinical research, the study has drawn mostly white, highly educated, generally healthy volunteers. Since 1998, Morris has raised the share of Black participants in the Knight ADRC's research from 3% to 17%, bringing it closer to the makeup of St. Louis. The team now plans to expand a pilot in north St. Louis that enrolled about 40 people to 300, with varied education, income and health histories. A mobile clinic will go into neighborhoods to collect data, blood and other tissue samples, and volunteers can be connected to health services if they need them. Morris says mistrust of medical institutions and practical barriers such as transportation have kept many community members away, so the research is going to them, and he says those who give time, blood and trust must be given something back.
The second goal is to track patients in ordinary clinical care, outside trials, who are receiving newly available Alzheimer's treatments. Those therapies have been shown to slow progression in some people, and the aim is to see how they perform in the real world.
For Nicole Garrison, a pharmacist from Lake St. Louis, the work is personal. Her grandfather died of Alzheimer's. Her father, a Navy veteran, and each of his siblings were eventually diagnosed. A Knight ADRC participant since 2025, she has undergone cognitive tests, brain imaging, blood draws and spinal taps. She participates partly because Black Americans are disproportionately affected by Alzheimer's yet underrepresented in research, and she urges policy leaders to widen access to blood-based tests, which are far less invasive than scans or spinal taps. She says none of it guarantees she will benefit, and that was never the point. She does it for her daughters and for families like hers. "Alzheimer's disease may run in my family," she said, "but this is where it runs out."
What to watch through 2031: whether biomarker tools prove equally reliable across racial groups, and whether the new treatments slow the disease in routine care as they have in controlled settings.
Citas Notables
Because people have volunteered to come to us year after year and across multiple generations, we have learned the disease starts silently in the brain long before memory fails.— John C. Morris, MD, principal investigator
None of it guarantees I'll personally benefit. That was never the point.— Nicole Garrison, study participant
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