Speaking on Health
with David Borenstein, MD
It is sad to lose a family member or a close friend to a disease, and it may even be worse when you lose them when they’re still alive. They’re living, but their mind is gone: this is the reality of dementia. The toll it takes on the individual is devastating, but it is also disheartening for the people who care for that person.
Alzheimer’s disease has the potential to become an epidemic. We need to find ways to prevent this disease. Luckily, clinical trials are under way to find ways to stop this illness in its earliest phases. Here, Laurie Ryan, PhD, provides background about the disease and answers questions about Alzheimer’s disease risk, lifestyle factors, and clinical trials.
Q&A with Laurie Ryan, PhD
Chief of the Dementias of Aging Branch in the Division of Neuroscience
National Institute on Aging
What is Alzheimer’s disease?
Alzheimer’s disease is the most common form of dementia, which is a progressive loss of cognitive motor function that occurs as the brain—the central nervous system— deteriorates. Alzheimer’s disease predominantly affects adults over 65 years of age.
What causes Alzheimer’s disease?
Alzheimer’s is a complex disease, and there are genetic, cardiovascular, and many other risks factors that can put a person on the pathway to potentially developing the disease. Though we have come to understand a lot more about what those risk factors are, and we can pinpoint some of the changes that occur over a decade or more in the brain before the dementia starts, we don’t know absolutely what the cause is at this point. We have a much better understanding now, but we don’t have a specific cause.
Can you provide an example of a current topic of research sponsored by the National Institute on Aging related to Alzheimer’s prevention?
One focus of current research is amyloid, which is a protein that builds up in the brain and causes plaques to develop. The development of these amyloid plaques is an early indication of Alzheimer’s—it builds up as much as a decade before dementia sets in. It has become a target of prevention trials, to see if we can stop the buildup of this protein before it progresses to cause dementia. Prior research has shown us that targeting amyloid later in disease progression has not been effective in slowing Alzheimer’s, but current studies are aiming to discover if early intervention might be able to stop the buildup of the protein and slow progression. Several prevention trials are ongoing related to anti-amyloid therapies.
The media often reports on research into how lifestyle factors may affect brain health—and Alzheimer’s, in particular. What do we know about the impact that lifestyle factors might have on the development of dementia?
The impact of lifestyle factors on brain health is an ongoing area of research; there have been observational and animal studies related to the role these factors may play in prevention, and other, larger trials are also under way. Some of these results are encouraging. For instance, studies have shown that exercise and maintaining physical activity as we age is good for brain health; information is also emerging about the role that sleep plays in cognitive function; diet can also be a factor, as can remaining mentally active as we age. Although there is also some information available about the potential benefit of specific foods—caffeine and chocolate, for example—we don’t yet have enough information to know the extent of the impact. As with all lifestyle recommendations, moderation is key; a healthy lifestyle is certainly a benefit in many ways.
What should we know about the role that clinical trials play in Alzheimer’s research?
We cannot make these important discoveries into the causes and potential treatments without clinical trials, wherein volunteers—individuals and families—commit to participating in research studies. There are great resources to learn more about clinical trials, which offer opportunities to contribute to research for both healthy people and those already diagnosed with Alzheimer’s. Two good places to learn more about clinical trials are the National Institute on Aging website (nia.nih. gov/alzheimers) and the Alzheimer’s Association website (alz.org).
David Borenstein, MD, is the author or co-author of more than 100 journal articles and books, including Heal Your Back: Your Complete Prescription for Preventing, Treating, and Eliminating Back Pain (2011) and Back in Control: Your Complete Prescription for Preventing, Treating, and Eliminating Back Pain from Your Life (2003), and three medical textbooks: Low Back and Neck Pain: Comprehensive Diagnosis and Management, third edition; Low Back Pain: Medical Diagnosis and Comprehensive Management, second edition; and Neck Pain: Medical Diagnosis and Comprehensive Management. The low back pain text has been recognized by the American Association of Medical Libraries as one of the 200 essential books for a medical library.