Novartis and the nonprofit Banner Alzheimer’s Institute are working together to see if treating cognitively healthy patients with a genetic disposition for Alzheimer’s could prevent, or at least delay, the onset of the disease, which is now thought to be the third leading cause of death, behind cancer and heart disease.

The disease is an elusive one, in that symptoms typically surface about 20 years after it has kicked in, and researchers are still not sure what causes it. Plaques are associated with Alzheimer’s, as are tangles of Tau proteins, and experimental treatments often seek out these targets.

This experiment will address amyloid build-up. Some patients will receive a Phase-II immunotherapy injection that stimulates the immune response so it attacks amyloid. Others will be given a Phase-I oral BACE inhibitor which is supposed to prevent amyloid from being created in the first place.

The test will include more than 1,300 patients between the ages of 60 and 75 who have two copies of the apolipoprotein E epsilon 4 gene, also known as APOE4.