Alzheimer’s is a disease that affects more than 5 million Americans. Dr. Jessica Langbaum, the principal scientist at Banner Alzheimer’s Institute in Phoenix, and Dr. William Burke of the Stead Family Memory Center will discuss what the disease does, how it can be diagnosed and the latest research and treatment news.
Ted Simons: Over five million Americans currently have Alzheimer's disease and that number could triple by 2050. New drugs and treatments targeting Alzheimer's are in the works. Here to update us on the fight against the disease are Dr. Jessica Langbaum at Banner Alzheimer's Institute in Phoenix. And Dr. William Burke of the Stead Family Memory Center also I believe with Banner, correct?
Dr. William Burke: That's correct.
Ted Simons: Good have you both here, thanks for joining us.
Dr. Jessica Langbaum: Thank you.
Ted Simons: As far as what is new in Alzheimer's research what's out there?
Dr. Jessica Langbaum: I think there are a lot of exciting developments going on in Alzheimer's research. For the first time we're starting to do trials of investigational drug in people who are cognitively normal. They don't have signs or symptoms of Alzheimer's disease but they are at high risk for developing Alzheimer's based on things like genetics or the biology starting to be present, the underlying biology is starting to be present in their brains. It's a really exciting thing going on in research right now.
Ted Simons: That underlying condition, is that the plaque buildup, those things?
Dr. William Burke: The underlying biology of Alzheimer's disease, the two things we focus the most on are the accumulation of a protein called amyloid and another protein called tau, they cause deposits called plaques and tangles. That's what we look for in the brain.
Ted Simons: When people ask what causes Alzheimer's, can we safely say that those proteins, that plaque causes Alzheimer's?
Dr. William Burke: At this point really it's an association. We know it's there in people who have Alzheimer's disease but we're still not 100% sure, particularly in the later onset version of the disease, whether either protein is necessarily causative. But it's certainly there, and it's what we use to diagnose the condition.
Ted Simons: I know there's a big concern about what prevents Alzheimer's. Anything new on that front?
Dr. Jessica Langbaum: We're still exploring a unusual of different things. There are some what we say in general is what's heart-healthy is brain-healthy but there is nothing definitive with that. We do encourage that. Then again, like I was mentioning, we have some very exciting clinical trials going on using anti-amyloid therapies to see if that slows down the cognitive decline.
Ted Simons: What would some of those therapies be?
Dr. Jessica Langbaum: There are a few studies going on at the Banner Alzheimer's Institute. There's a study of an anti-amyloid therapy, these are passive therapy drugs that try to remove the amyloid from the brain and seeing if that slows the progression of Alzheimer's disease. We have many studies going on, a program at the Banner Alzheimer's Institute is looking at a range of anti-amyloid therapies and seeing that that may slow down cognitive decline.
Ted Simons: I read ultrasound was being used as perhaps a way to get rid of that plaque. That is viable?
Dr. William Burke: It's a very early single report he and it is an interesting study. It's never been done to a human. It's not even possible to do it to a human right now as I understand the technology. It certainly is an interesting approach.
Ted Simons: As far as we talk about prevention as far as diet. Anything good for the heart will be good for the brain. The diet, lifestyle, preexisting conditions, genetics, I think genetics is out there and everyone kind of understands that. But things like diet and lifestyles: Factors?
Dr. William Burke: Incredibly important factors. There was just a nice study down in Europe where they did a multicomponent intervention that looked at diet, physical exercise, social interaction, and found a really impressive preventative effect from people who participated in that intervention. Of the things that we can do as far as prevention, physical exercise is the thing we have by far the best evidence, that it can help put off the onset of dementia.
Ted Simons: We know that because we've seen evidence of that or we understand how it puts off? That understanding part is tough, isn't it?
Dr. Jessica Langbaum: I would say we're seeing evidence in studies where we assign people to a physical activity a group that do physical exercise compared to those who aren't. We see a difference in rates of dementia between those two. But it's probably again relating to the what's heart healthy is brain healthy. Truly understanding the mechanism, I don't think we're there yet. But we certainly encourage people to, as Dr. Burke said, engage in physical exercise, monitor their diet, things like that.
Ted Simons: The Banner Alzheimer's Institute prevention initiative, tell us what you're talking about here.
Dr. Jessica Langbaum: This is a collaborative program we have a privilege of leading out of the Banner Alzheimer's Institute. It's sort of an umbrella term we use to say, these are studies we're doing in people at highest risk of developing memory, thinking problems due to Alzheimer's based on age and genetics. We have one we're doing in Colombia, South America, with an extraordinarily large cadre of family members with a genetic mutation that causes them to develop Alzheimer's in their 40s.
Ted Simons: My goodness.
Dr. Jessica Langbaum: That's ongoing, we receive federal funding from the National Institute of health. We're doing this in collaboration with a drug company, and of course support from the Banner Alzheimer's Institute. We have another study starting later this year in 2015. People at highest known risk for developing Alzheimer's disease later in life because of a genetic susceptibility factor because they carry two copies of a dream.
Ted Simons: So there is a difference between those who develop Alzheimer's symptoms earlier in life and those later in life? Do we know what that difference is?
Dr. William Burke: Certainly age is the strongest risk factor to develop Alzheimer's disease overall. It's very unusual to develop Alzheimer's disease early in life. A sizeable number of those people who develop the disease in their 30s and 40s are a known genetic cause of the disease. There are other people who develop it at that age. We still don't really understand why they get the disease at that age. That's fortunately a small number. The number of people who have a dementia at age 60 is about 1% of the population. And that roughly doubles ever five years after that. So age he is overwhelmingly a factor with the baby boomers about to hit those ages. That's where we're at, we so strongly believe in prevention, it's an incredibly important strategy.
Ted Simons: As far as treatment and care, how has it changed over the years?
Dr. William Burke: I think to me the biggest revelation as far as care is that we don't have any drugs that can cure of illness. Most of the drugs have symptomatic treatments that we can use. We have learned if we work with patients and their families, educate them, give them the tools to understand the disease process, how to best care for their loved ones, people do much better if they have that education and support through the process of the illness. We believe very strongly in a care model that involves not only a physician but a group of people that can work with the patient and their family to kind of work through the process as the disease unfolds.
Ted Simons: And that family situation is very important, isn't it? This is a disease that hits one person but the entire family is affected.
Dr. Jessica Langbaum: Families raleying when one member is affected, they come together to support the care he and the caregiver themselves.
Ted Simons: Is there optimism? We keep waiting for the magic bullet. Obviously we're learning more and more. As the doctor mentioned we've got to find out something quick because that baby boom generation, we're catching up there is there optimism out there?
Dr. Jessica Langbaum: I am optimistic. The reason is that we keep each year, we learn more and more about the disease. We know know that the disease starts in a person's brain about 10 to 20 years before the first signs of memory and thinking problems emerge. Now that we know that we are starting to be able to starting target the disease at the very earliest stage. I am optimistic.
Ted Simons: Good to have you both here, thank you very much.
Ted Simons: Thursday on "Arizona Horizon" we'll learn about a new way to offer input to state lawmakers. And in light of an upcoming Ken Burns series on cancer, we'll lube at a local cancer treatment center. That's at 4:30 and 10:00 on the next "Arizona Horizon." That is it for now. I'm Ted Simons, thank you so much for joining us. You have a great evening.
Dr. Jessica Langbaum:Principal Scientist, Banner Alzheimer's Institute; Dr. William Burke:Stead Family Memory Center;