Norway, the EU, and many other countries/regions are rapidly transforming into ageing societies. Ageing is the largest risk factor for many chronic diseases, including Alzheimer’s disease (AD). There are 46.8 million elderly worldwide affected with AD, with 10.5 million in the EU alone, and this has brought formidable socioeconomic and healthcare challenges to their countries. Over the last 15 years, there were 244 drug candidates for AD tested in clinical trials, most of which targeted tau or Aβ. However, only one, an agent that mitigates symptoms rather than disease progression, received approval from the US FDA and European Medicines Agency. Thus investigating other molecular mechanisms in the etiology and progression of AD is of categorical importance (Fig. 1).

With basic researchers on AD, AD clinicians, national AD networks, drug development companies, local healthcare givers, and municipal institutions, we aim to establish the Norwegian Alzheimer’s disease network (NO-AD, Fig. 2). The aim of this network is to establish synergies among the five major disciplines of AD, including ‘AD mechanisms’, ‘Novel approaches’, ‘AD translational’, ‘AD clinical’, and ‘Society’, with a final aim to dramatically reduce AD incidence, and to maintain healthy brain ageing in the elderly. Through this NO-AD network, we are very focused to target on three challenges: Challenge 1: To discover patient-oriented new mechanisms (the dominant 99% sporadic AD); Challenge 2: To identify novel AD drug targets; and Challenge 3: To initiate early diagnosis through novel early biomarkers and early treatment.

Fig. 1. Ageing brings formidable socioeconomic challenges to Norway, and is the primary driver of AD. (A) Norway is turning to be an ageing society. (B) Predicted pension expenses and fund returns in Norway. It is estimated that the healthcare cost may increase to be unaffordable to the Norwegian economy. (C) Ageing is the primary driver of AD. (D) There are 4 drugs, with the latest Memantine approved in 2002, in the clinic, but none of them could inhibit or reverse AD, with clinical medical benefit scored from ‘major’ to ‘low’. (E) From 2003-2019, there have been over 250 drug candidates for AD tested in clinical trials, and all have so far failed. (Reference: Fang EF).

Fig. 2. Overview of the structure of the NO-AD network. The network hub comprises leading AD researchers from all the major cities in Norway, including Oslo, Stavanger, Bergen, Trondheim, Tromsø, and Kirkenes. This NO-AD network also includes major national/local AD-related hospitals/networks/societies/patient cohorts, including the Norwegian National Advisory Unit on Ageing and Health (Geir Selbæk), Sykehuset Telemark Hospital (Geir Julius Braathen), the Norwegian Centre on Healthy Ageing network (NO-Age), Nansen Neuroscience Network, and the Norwegian Health Association. The NO-AD network can get access to the big ageing/AD cohorts in Norway: the Akershus AD cohort (Tormod Fladby), the Trondheim AD networks, including AD patients in the St. Olav University Hospital cohort, the Hunt4 study (led by Geir Selbæk), two national ageing and dementia cohorts (Trail-Dem and NorCog, by Geir selbæk), the Tromsø Study, and BLSA (the Baltimore Longitudinal Study of Ageing through Vilhelm Bohr). This network will further strength the connections to the foremost brain/AD research institutes worldwide through the established NO-Age network (https://noage100.com/people/). The NO-AD network will have close interactions with the broad national stakeholders, which can provide financial/political/strategic/patient resources to the NO-AD network. Members of the applicants are leaders in the current Nordic AD Consortium which will further strategically and practically strength the NO-AD network.

This network is supported by the nasjonalforeningen (Image from nasjonalforeningen).

Associate Professor Evandro F. Fang (UiO and Akershus University Hospital, right) and Professor Menno P. Witter (NTNU, left) are leading this Norwegian National Alzheimer´s Disease network (NO-AD network). Photo (Asgeir Kobro-Flatmoen)

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