Katherine Jimenez: Hi, I’m Katherine Jimenez, and I’m with Alzheimer’s Disease Research, a program of the BrightFocus Foundation, a nonprofit organization leading the fight to save sight and mind.
Today, our topic is the state of research on Alzheimer’s disease, with our guest, Dr. Guy Eakin, who has a Ph.D. in Biology and is the Vice President of the Scientific Affairs at the BrightFocus Foundation. He is going to answer some of the most frequently asked questions about the status of research on this deadly disease.
In the last year, there’s been more public attention on Alzheimer’s disease, due in part to a number of celebrities and other newsmakers announcing that they have the disease. Has something changed, in our collective recognition of this devastating condition?
Dr. Guy Eakin: So first of all, thank you for inviting me on air today. An answer to your question—unfortunately, more and more people are learning about Alzheimer’s disease from experience, and this is at a minimum because they know a loved one who has the disease.
Alzheimer’s can strike a wide range of ages, but for most of us, our window of greatest risk is beginning around age 65, and increases for the remainder of our lives.
So, members of the elderly generation that came of age during World War II, and in the so-called Greatest Generation, these people are now in their mid-to-late 80s and even older. And nearly one in three of them have Alzheimer’s disease.
So, the post-war Baby Boomer generation is also confronting Alzheimer’s directly, as caregivers for this Greatest Generation parents, and because the first wave of these Baby Boomers are now reaching age 65 at the rate of about one every eight seconds. So, at that age, one’s risk of having Alzheimer’s disease doubles about every five years.
And finally, the young generation of service members now coming home from wars abroad—these are the veterans who may have survived head trauma, or might have been—these are head traumas that might have been fatal in previous generations—they’re not immune from Alzheimer’s disease, and only time and more research, will tell whether their brain injuries put them at increased risk for Alzheimer’s or other forms of Dementia.
Katherine Jimenez: Guy, isn’t this disease a condition of affluence? Thanks to medical science, persons in developed countries are living longer, and thus more likely to experience age-related diseases like Alzheimer’s disease.
Dr. Guy Eakin: So the demographic threat of Alzheimer’s disease is not limited to developed nations like the U.S. So of course, as countries grow economically and the average lifespan of their citizen’s increases, more people are at risk for this disease and other forms of Dementia. But the steepest increase in Dementia is expected to occur in low and middle income countries, where nearly two-thirds of the people with Dementia now live, and that’s today.
And then as you consider that every country has unique circumstances outside of wealth or average lifespan. If you are thinking about China for instance, decades of the one-child per family policy mean that the burden of care-giving for the elderly falls to fewer family members than it might in other countries. So China has a very unique circumstance in terms of their relationship to Alzheimer’s disease.
I think what I’m trying to say here, is that the fight against Alzheimer’s disease is—by necessity—truly worldwide.
Katherine Jimenez: Okay, so what would you say are the major developments in global research?
Dr. Guy Eakin: The first, and the greatest threat to the research advancements is quite simply the inadequate financial support that’s available for research. There’s just not enough research funding to support the number of promising scientific projects, particularly in this era of U.S. government cut-backs for research funding.
Right now, we have more scientists than ever who are wanting to study Alzheimer’s disease, and many are more proposing very powerful research. Recently, the BrightFocus Foundation, for whom I’m employed, received about 332 proposals for our Alzheimer’s Disease Research funding program, and this is in the year 2012. These proposals involved about 700 scientists at 213 organizations around the world. And it’s about a 33% increase over the last year’s volume of proposals.
So it’s a sign of difficult times. Funding is tough and more researchers are looking to private funding sources like the BrightFocus Foundation than ever before. And, we can’t meet all the need. The U.S. government is cutting back on funding even the most highly rated proposals, and the same is true with other governments around the world.
So, these cut-backs are all the more tragic because the existing public funding for Alzheimer’s has often been inadequate even before the cut backs. So what I’m saying is, when we consider, perhaps, the top 10 deadliest diseases in the U.S., Alzheimer’s is the only one with no disease-modifiying treatment. So, unlike other diseases on that list, if you have Alzheimer’s disease today unfortunately—I’m sad to say—is that you will die with that disease or from that disease. There is no remission, and there is currently no cure for Alzheimer’s.
Last year, for example, the U.S. Congress awarded several billion for two frightening and deadly, but treatable conditions, these are heart disease and cancer. In the same time period, our government awarded only about half a billion relative to the several billion available for these other diseases. So that’s despite this demographic wave of people facing Alzheimer’s disease over the next decade, and these are numbers, when you consider the Alzheimer’s disease, these are numbers that could truly bankrupt our health care system in the U.S.
So, that’s one reason that the BrightFocus Foundation promotes advocacy to increase funding for this disease.
Katherine Jimenez: So, can you tell us. Is there any good news about this disease?
Dr. Guy Eakin: Yes, thanks for asking. I’m happy to say, despite the tough economic times, scientists around the world are making inroads into understanding the disease.
The path to finding treatments for Alzheimer’s disease starts with a significant amount of very early-stage research. Scientists must first ask the very basic questions of how the brain works and what fails in the brain during the course of Alzheimer’s disease.
So at a basic level, scientists have long-known that brains of people with Alzheimer’s disease generally have two major types of abnormalities, and these seem to occur in areas where the communication among the brain’s neurons, and these are nerve cells, has become compromised, and that ultimately disrupts the mental activity.
One abnormality is the amyloid plaques outside of the brain’s neurons. These structures consist, in part, of the protein called beta amyloid as well as some other cellular materials. The other phenomenon is neurofibrillary tangles within the brain’s neurons. So, these so called tangles, among other things, are composed of twisted fibers of protein called tau, as well as other more recently discovered proteins. So whether these abnormalities are the cause or the result of Alzheimer’s disease is not fully understood, but there is a lot of work probing back in search of the first events that begin the progression towards Alzheimer’s disease. And much research is focused on stopping the accumulation of these and other proteins, or preventing them from turning toxic.
Katherine Jimenez: So would you say that researchers are in two warring camps, the plaque versus the tangle theorists?
Dr. Guy Eakin: Not really. I think you can find some things in the internet that suggest that, but it’s mainly historical. I mean, despite the controversies that are out there, most scientists, and actually the BrightFocus Foundation, realize that researchers must challenge these established paradigms with new ideas that can seem counter-intuitive or contradictory at first, or take researchers to seemingly distant territories. But out of many avenues of research, greater knowledge has come. And as research has progressed, the relationship between these proteins and the various structures they form have become more clear. Both, beta amyloid and tau, as well as a host of other proteins, are believed to contribute to this disease, so no, I don’t think that there is a warring camps there or certainly any kind of theorist conspiracy or otherwise.
Katherine Jimenez: Okay, so what are some of the promising areas of research, right now?
Dr. Guy Eakin: Some scientists are exploring possible mechanisms linking diabetes or other diseases to aging to the cognitive impairment that’s seen in Alzheimer’s disease as well as other Dementias.
The others view Alzheimer’s disease like a, perhaps an infectious disease: and this not one that is necessarily passed between people, but in fact it’s not passed between people, but rather, one that is passed between diseased neurons, propagating the effects of the disease throughout the brain and body. If you have questions about how the BrightFocus Foundation is addressing these issues, I certainly invite you to visit our website at www.BrightFocus.org or call our toll free number, which is 1-855-345-6ADR. Or 1-855-345-6237.
So, as I was saying, although Alzheimer’s disease does not appear to be communicable like an infectious disease, there is evidence that different forms of Alzheimer’s disease can be inherited or passed down to future generations. For almost 20 years, some early-onset forms of Alzheimer’s disease have been known to be linked to only a handful of mutations in very specific genes.
So, international teams of genetics researchers are also hoping to speed the rate of discovery for more common later-onset versions of this disorder, so, I should say that these early-onset forms of the disease are quite rare, but most people’s experience with Alzheimer’s disease relates to that later-onset version of the disorder. And so these teams of researchers that are out there, are studying genetic risk factors for the disease across large and varied population groups. And these findings could certainly lead to a better understanding of how to prevent the disease and also on how to treat the disease.
Katherine Jimenez: Are you aware of any progress in the search for treatments?
Dr. Guy Eakin: Well, to date, the few existing treatments for Alzheimer’s disease minimize some of the symptoms and delay the loss of memory in some cases, but this is without slowing the underlying damage to the brain. So, these are symptomatic treatments. And the so-called “disease-modifying” treatments, which would slow cognitive decline by slowing the disease process itself; these are under intense study.
In recent years, there’s been several large clinical trials backed by pharmaceutical companies, that have ended without showing improvements in treated patients. But I think it’s safe to say that scientists widely agree that, like many disorders, Alzheimer’s disease will be most readily treatable if it can be identified early in the disease history, so there’s a lot of focus on pushing these treatments into earlier populations in these trials.
Katherine Jimenez: What about improved detection?
Dr. Guy Eakin: Right! So there is an impetus there for being able to detect the disease earlier in the disease history. So, diagnosis of Alzheimer’s disease has traditionally come after the disease process is well underway. So today’s researchers are looking at new methods of identifying the disease very early in its progression. Again, there are several BrightFocus Foundation grants that are actually looking at exactly this topic.
Alzheimer’s disease researchers, are working to identify new proteins, molecular activities, or other processes in the brain that could become the focus of future clinical trials.
In some cases, there are promising discoveries might lead to the testing of drugs that are already FDA approved for other conditions, but have not yet been tested specifically for Alzheimer’s disease. In such cases, the vast amount of data from the FDA-approval process, that already exist, may be able to put the drug on a fast track for human clinical trials as an Alzheimer’s treatment. This could significantly reduce the time that a drug takes to move from the lab bench to a doctor’s office. I’m proud to say that at the end of the 2012 grant cycle, we have about three projects now that are looking specifically at that question of taking things that are already FDA approved and testing them on whether or not can be used for Alzheimer’s disease.
Katherine Jimenez: Great, this is all great news. Guy, do you have any final thoughts on where we are today with Alzheimer’s disease?
Dr. Guy Eakin: Yeah, I think there are several things people can do to help us find a cure for Alzheimer’s disease, and to help those living with this disorder.
So, if you’ve recently been diagnosed with Alzheimer’s disease or know someone who has, first of all, there are resources to help with healthier living, and these may include some exercises or cognitive training or mind games, which may slow or minimize some of the symptoms. The jury’s still out about that, but they’re certainly not going to harm you and if there’s the potential that they might help, then that’s something you should consider doing. You should learn as much as you can about the available treatments, I think the BrightFocus Foundation.org website is a great place to start. If you are a caregiver, there are resources and support groups to help care for the caregiver.
If you are interested in helping speed the pace of funding for Alzheimer’s research, you can organize fund-raising events; donate to organizations like the BrightFocus Foundation, that focus on increasing research, or you can even leave BrightFocus Foundation in your will, as a bequest for private research funders like the BrightFocus Foundation; you can even become an advocate for change, which is a really a powerful way to help push for increases in research, what I’m saying though, is there is no act too small to move us closer to understanding, preventing, or treating this really devastating disease. And anything you can do is appreciated and important.
Katherine Jimenez: Thanks Guy, for this very helpful information, and thanks everyone for listening. Stay tuned for future podcasts on Alzheimer’s disease. For more information about Alzheimer’s disease or to get involved in advancing research to end this degenerative brain disease, visit brightfocus.org, or call 1-855-345-6ADR. Again that’s 1-855-345-6237. Thanks again everyone.