The news about Alzheimer's is dismal. A new Eli Lilly drug to treat Alzheimer's has failed big-time. After investing hundreds of millions of dollars in the drug, Semagacestat, the company announced it made patients worse.
And the latest idea from an elite circle of Alzheimer's researchers is to torture us with diagnostic spinal taps and brain scans, so we can know ten years in advance if we are heading lickety split into Alzheimer's even though specialists admit they have no treatment to stop it and are even losing faith in their long-held theories of what causes it. "This is a time of major soul-searching in the field," lamented Duke University researcher, Dr. P. Murali Doraiswamy, in the New York Times.
As a person who carries the major gene, ApoE4 for Alzheimer's, I am intensely tuned into and disturbed by this public conversation. The gene triples my risk of ending up with Alzheimer's. Some 77 million other Americans also carry ApoE4 (25 percent of the population), but few know it, and doctors are reluctant to test and tell, supposedly because they don't want to scare us. I accidentally discovered my gene via a blood test for cholesterol factors several years ago, and I'm glad I did, because it energized me to search for answers other than those from Big Pharma and its philosophical collaborators.
I have discovered a large contingent of Alzheimer's researchers who are extremely positive about prevention and not counting on an elusive drug to stymie the growing Alzheimer's epidemic of aging baby boomers. Investigators Gregory Cole and Sally Frautschy at UCLA's Center for Alzheimer's Research and Gary W.Arendash, PhD, at the Florida Alzheimer's Research Center, for example, are all focusing on prevention. There is a plethora of upbeat dialogue in the scientific community that does not grab headlines because it's not about big money and a magic cure. It's primarily about what people can do to change their own trajectory toward Alzheimer's.
Contrast the recent disturbing headlines in the New York Times about Alzheimer's drugs and diagnosis with the June, 2010 issue of the Journal of Alzheimer's Disease. It is a special issue devoted to finding ways to prevent Alzheimer's. Editors in chief George Perry, University of Texas at San Antonio and Mark A. Smith, Case Western Reserve, (who predicted the failure of Lilly's drug and others like it,) and guest editor, Jack de la Torre at the Center for Alzheimer's Research, Banner Sun Health Research Institute in Arizona all endorse the science showing how this disease can be cut off at the pass earlier in life.
Dr. de la Torre boldly asserts that finding a cure for Alzheimer's is a delusionary quest unlikely to happen in a hundred years and most probably, never. He argues that even if you could replace dead neuronal networks, bringing a shrunken Alzheimer's brain back to life, the persona and intellect of the individual would be so altered as to create a different personality. "Alzheimer's is incurable, but it is preventable," he says. "We need to identify and lower Alzheimer's risk factors in people when they are still cognitively normal and long before irreversible symptoms appear."
While the search for a pharmaceutical cure plays front and center, quietly in the background countless neuroscientists worldwide have concluded that Alzheimer's, as well as memory decline and other age-related dementias are actually slow-developing chronic diseases, like heart disease and cancer, partly dependent on lifestyle and other treatable diseases.
De la Torre, for example, is convinced that Alzheimer's and dementia are particularly tied to cardiovascular factors, notably, constricted blood flow to brain cells, and that midlife screening to detect and correct such heart-related deficits would help prevent much brain degeneration during aging. The special journal issue produced by de la Torre, called "Basics of Alzheimer's Disease Prevention," also included new research on the relationship between Alzheimer's and diabetes, high blood pressure, triglycerides, cholesterol and cholesterol- lowering drugs, (statins), a Mediterranean diet, exercise, fish oil, B vitamins and antioxidants.
This special issue of JAD is but the latest example of a shifting paradigm toward prevention. Other leading medical journals are full of studies, often funded by your tax dollars, filtered through the National Institutes of Health, revealing the dangers of alcohol, smoking, toxic chemicals, head injuries, infections, certain forms of anesthesia, excess copper, low vitamin B, excess calories, obesity, diabetes, thyroid problems, sleep deprivation, and depression in raising your risk of dementia and Alzheimer's.
The wisdom of Alzheimer's prevention, derived from the famous Nun Study at the University of Minnesota, and the Religious Orders Study, at Rush University in Chicago, has been piling up for a decade or two, but is rarely put into practice. Comparing brains at autopsy with lifestyle and cognitive status allows investigators to proclaim the value of mental, social and physical stimulation in building a brain more resistant to Alzheimer's. Best time to start: when you are young, but even activity in old age can make a huge difference.
Prolific research from the U.S. Department of Agriculture, UCLA, Tufts University and Columbia University College of Physicians and Surgeons, as well as dozens of other institutions, reveals a reduced Alzheimer's risk from consuming berries, nuts, curry powder, fruits and vegetables, fatty fish, olive oil and the Mediterranean diet, and various supplements, including folic acid, alpha lipoic acid, Vitamin B12, multivitamins and vitamin D.
We are missing the boat when we allow a small fragment of the scientific conversation about Alzheimer's, centered on ineffective pharmaceuticals and frightening diagnostic methods, drown out the momentous message coming from another research perspective: that we can take action right now to delay the progression and onset of Alzheimer's which happens over decades. The good news is that we know now how to detect and lessen many midlife lifestyle problems that may otherwise lead to irreversible dementia. The approach is much the same, Dr. De la Torre points out, as we now use extensively to prevent heart disease, cancer, diabetes and other chronic diseases of aging.
Obviously, this doesn't mean we should stop searching for treatments for the underlying causes and symptoms of Alzheimer's and other dementias or spare funding to relieve those already suffering.
But it is urgent that we have a vigorous dialogue about how to rescue the multitudes now racing at breakneck speed toward Alzheimer's. Unless we intervene, Alzheimer's cases in the United States will nearly triple. A May Alzheimer's Association report, "Changing the Trajectory of Alzheimer's Disease," predicts that cases will jump from 5.1 million to 13.5 million by 2050 with costs during that period exceeding $20 trillion in today's dollars.
If we could delay the onset of Alzheimer's by only five years, according to the report, some 1.6 million Americans expected to get Alzheimer's by 2015 and nearly 6 million scheduled to get it by 2050 would remain free of it while Medicare savings would be $33 billion in 2020 and $283 billion by mid century.
The only way to make that happen is to start talking as loudly about preventing Alzheimer's -- and listening to the researchers who can tell us how to do that -- as we do about trying to cure it.
Jean Carper is the author of 100 Simple Things You Can Do to Prevent Alzheimer's and Age-Related Memory Loss (Little, Brown & Company, September 2010).
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