Cognitive health is shaped by genetics, medication exposure, activity, sleep, nutrition, chronic conditions, social engagement and more. ISF’s work brings those pieces together with longitudinal information from real senior living environments to build a more complete picture of cognitive aging.
// THE OPPORTUNITY
The missing piece may be what happens between clinical visits.
With appropriate consent and governance, information about medication exposure, activity, sleep, nutrition, cognition, vitals and other aspects of daily life can be studied together rather than as isolated snapshots. ISF’s communities generate approximately 100,000 data points per resident per month, creating dense longitudinal information that laboratory or episodic clinical data alone cannot reproduce.
// UNDERSTANDING RISK
Risk is one data point. Context gives it meaning.
ISF's genetic research currently focuses on APOE, a gene associated with brain health. The APOE ε4 variant is the strongest known genetic risk factor for late-onset Alzheimer's disease—but carrying the variant does not mean an individual will develop Alzheimer's. That distinction matters. ISF treats genetic information as one signal within a much larger picture, not as a diagnosis or prediction.
Through voluntary cheek-swab screening, participating residents contribute genetic information that can be considered alongside other longitudinal health and lifestyle information. As more residents voluntarily participate, the research cohort becomes more useful—creating an opportunity to explore why people with similar genetic risk may experience very different aging trajectories.
Risk is one data point. Context gives it meaning.
// RETHINKING MEDICATIONS
What if part of the next Alzheimer's therapy already exists?
Developing entirely new drugs for Alzheimer's disease is difficult, expensive, and frequently unsuccessful. Another research pathway asks a different question: could medications already approved for other conditions have therapeutic potential for Alzheimer's disease and related dementias? ISF and Cedars-Sinai have submitted an NIH R01 application focused on developing a translational framework to accelerate that search.
The proposed research combines artificial intelligence, cell-based studies, organ-on-chip models, and real-world senior living data to identify and validate promising repurposed therapies. It also looks beyond medication alone—examining how medication exposures may interact with non-pharmacologic factors such as activity, sleep, nutrition, and cognitive engagement.
The goal is to move away from studying one variable at a time toward understanding the combinations that shape real outcomes.
01 — APOE4 STUDY
Voluntary genetic screening introduced in senior living.
02 — EXPANDED GENETIC STUDY
Connect genetic risk with longitudinal aging information.
03 — REAL-WORLD EVIDENCE
Study genetics alongside medication, activity, sleep, nutrition and cognition.
// CLOSING THE LOOP
One resident creates a story. Many measurements over time create evidence.
A genetic result becomes more meaningful when considered alongside what happens next. A medication record becomes more meaningful when examined alongside cognition, activity, sleep, nutrition and other measures. ISF’s role is to bridge biomedical research and the everyday experience of aging through longitudinal, consented and governed real-world evidence.
The objective is a continuous research loop in which information collected in the real world helps generate questions, test hypotheses and inform more personalized approaches to healthy aging.
ISF's longer-term opportunity is to bring genetic, medication, health, behavioral, and lifestyle information together within a longitudinal data infrastructure.
That allows research questions to become increasingly connected.
Why do two people with similar genetic risk age differently?
How do medication exposures relate to cognitive outcomes over time?
How might sleep, nutrition, physical activity, or engagement change those relationships?
And can patterns found in real-world senior living data help researchers identify interventions worth investigating further?
The objective is a continuous research loop in which information collected in the real world helps generate questions, test hypotheses, and ultimately inform more personalized approaches to healthy aging.
Together, ISF's genetic and polypharmacy work approaches ADRD from different directions: understanding individual risk while investigating how medications, lifestyle factors, and real-world experience interact over time.
