Pretty much everybody knows somebody with Alzheimer’s Disease.
A grandparent, an uncle, a friend’s mom.
The disease is distressingly common.
And as the Baby Boomer population continues to age, the number of patients with
Alzheimer’s Disease is only going to continue to go up.
It exceeds cancer, it exceeds heart disease with regard to cost to society.
With 77 million baby boomers and 10 thousand people turning 65 every day,
the statistics looming ahead for the nation are mind-boggling.
Alzheimer's affects almost five and a half million Americans and that number expected
to triple by the year 2050 to as many as 16 million.
There's 35 million people in the world living with dementia.
And that could double in the next generation, so we're talking about a big, big problem.
The cost of forgetting is looming as a national crisis.
But if this devastating disease is so common,
why haven’t scientists come up with effective treatments?
Well, we’ve learned a lot about Alzheimer’s Disease, but it’s still...complicated.
We need to find some sort of sign in the brain that says,
“Hey, this person will likely develop Alzheimer’s”.
But at this point, we haven’t identified a reliable marker
that shows up long before any behavioral changes.
Nor have we found any treatments that are effective at preventing them.
So what’s the solution?
More early clinical research.
With more research and clinical trials, we’ll be able to identify early markers,
better understand disease progression, and develop effective treatments.
Alzheimer’s Disease, or AD, isn’t just an effect of aging.
It’s a neurodegenerative disorder caused by biological changes in the brain that ultimately
cause the dysfunction and death of neurons.
Over time, this leads to memory loss, cognitive dysfunction, and, ultimately, death.
As we talked about in our last video, we do know something about the biology of AD.
Check out that video here if you missed it.
But even though we know biomarkers like amyloid beta plaques and tau tangles are associated
with Alzheimer’s Disease, we’re still not totally sure how, exactly, they lead to
the problems seen in the disorder.
Like, how does the amyloid beta protein get misfolded, and why?
Why do healthy aging brains also have some amyloid beta plaques that
don’t seem to cause any problems?
Are the tau tangles part of what causes the disease, or are they trying to
protect the brain, but doing damage instead?
It’s hard to answer these questions because, in part,
it’s hard to study Alzheimer’s Disease.
In many cases, we use animals like mice and rats to understand how diseases work.
But with AD, animal models don’t cut it.
Animals don’t really get dementia the way we understand it.
And they certainly don’t get the same amyloid beta plaques and tau tangles
that we see in Alzheimer’s Disease in humans.
In order to model the disease in mice, we have to introduce genetic mutations that
lead to the biomarkers we associate with the disease.
But in humans, ordinary AD is almost never caused by single genetic mutations.
These days, most researchers think that Alzheimer’s Disease is caused by an interaction of environmental
and genetic risk factors, and that potential underlying triggers could include inflammation,
infections, and exposure to environmental toxins.
But we’re not exactly sure how those things combine to cause the disease.
So really, we need new research approaches, including new methods to study it in humans,
to fully understand Alzheimer’s Disease.
And we especially need to be able to study people at the very beginning,
when the condition first starts to appear.
The problem is that we still don't know very much about the earliest stages of the disease,
and especially how to recognize it before it has progressed into full-blown dementia.
That’s why there’s a push to develop new ways to study the underlying biology of the
condition using human stem cells, animal models and, most importantly, human research trials.
We’ve seen some promising links come out of this kind of research.
For example, scientists have identified new warning signs of AD, like the genetic variation
APOE4, which seems to be a significant risk factor for developing the condition.
Now people who have that particular genetic variation can let their doctors know that
they have an increased risk of developing Alzheimer’s, and can take preventative measures.
The current most effective way to prevent dementia is by making healthy lifestyle changes.
This includes eating a diet high in leafy green vegetables, whole grains, and lean proteins
and low in saturated fats and refined sugar.
And getting regular, frequent aerobic exercise.
About 30 minutes of moderate exercise five times a week.
Getting plenty of sleep is helpful, too.
These habits seem to be helpful in at least delaying the onset of AD.
Likewise, if a patient knows they are at risk,
they can stay more aware of any warning signs for the disease.
New imaging technologies have allowed researchers to look directly into patients' brains
to see whether or not they have amyloid beta plaques or tau tangles,
which can help with diagnosing the condition earlier.
But imaging technologies are expensive and are pretty much only used in research settings.
As I’ve said before, we still need to work on finding better markers
for the early stages of the disease.
Getting larger groups of patients involved in research trials will allow doctors to compare
patient data, find new risk factors, explore potential biomarkers,
and develop improved treatments.
Dementia is not just a normal part of aging, but it’s no surprise that people think it is
because we don’t understand aging very well to begin with.
That’s why it’s important for people to talk to their doctors early and often
about their brain health
and their risk of dementia.
If you talk to your doctor, they can screen for potential risk factors and early symptoms,
and intervene if needed.
As people start to get older, they can also investigate whether or not they might be eligible
for longitudinal research studies on Alzheimer’s Disease
and possibly get involved in clinical trials.
And that’s really important because remember that once the damage has happened,
there's no going back.
The earlier a patient gets involved in trials, the more time that gives doctors and scientists
to understand how the disease progresses.
We also need more early clinical trials to discover better treatments.
Even when doctors can intervene early, there aren’t a ton of drug options out there for
slowing the progression of AD.
And most of them don’t work very well in patients who
have progressed further in the disease.
New drugs are being developed, but it takes a long time to get any new medication from
the early drug development stages to being an FDA-approved treatment.
And in a disease like Alzheimer’s, which progresses relatively rapidly,
that can make all the difference.
So getting more people into early clinical trials is important for testing new treatments
and gathering enough data to determine if promising therapies are working.
Now, it’s important to note here that there can be some pretty serious barriers that prevent
patients from getting involved in clinical trials or
even getting care for early-stage dementia.
The first is simply the fear or stigma about developing AD.
It is a scary condition, but knowledge will be your best defense.
Getting involved early means that patients may help themselves
and will definitely help others.
Another big barrier is that physicians have limited time, resources, and motivation to
screen patients and refer them to trials.
If you encounter this, push your physician for a referral or seek out a doctor who has
the resources to help you.
Likewise, living in a rural or low-income area can make it difficult to access health
insurance and health care, or may mean there are fewer medical centers, making it nearly
impossible for aging patients to access early intervention treatments.
And when people live alone, it can be hard for them to notice on their own when symptoms
start to show up.
So maintaining a strong social network is important for
helping recognize the early stages of AD.
Check-in on your elderly family members and neighbors.
They might appreciate it.
Another barrier to clinical trials is...people just don’t know about them.
Building awareness is something we can all do by
talking about these kinds of trials with others.
And a lot of other folks, like Bill Gates, are trying to increase awareness and accessibility
of early clinical trial opportunities among doctors and the public so that more patients
can get enrolled.
Some resources for that include the National Institute on Aging’s Clinical Trials finder.
And if you’re in the UK, the Join Dementia Research program.
Check out the links in the description for more info.
While we have not discovered any very effective treatments yet, we do know for certain that
the first time a case of Alzheimer’s Disease is successfully averted,
it will be thanks to a clinical trial.
So I encourage you to learn more about these early intervention clinical trials and think
about whether or not you or a loved one can get involved in helping us
find a way to prevent this terrible disorder.
Talk to your aging family members about the warning signs of dementia, and make sure they
know the basics of Alzheimer’s Disease.
You could even share both of our videos with them, even if they’re completely healthy.
Thank you again to the office of Bill Gates for their help and support making this video.
Bill is on a mission to generate more awareness about Alzheimer’s Disease research and helping
aging adults get involved in clinical trials.
To learn more about clinical trials and enrollment near you, check out the links below.
As someone who lost a family member to dementia, I’m happy to help raise awareness about
clinical research to find treatments so that
others don’t have to experience that same kind of loss.
Thanks for watching this episode of Neuro Transmissions.
I’m Alie Astrocyte, and until our next transmission, over and out!