WEBVTT - Why Is Alzheimers's So Difficult to Treat?

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<v Speaker 1>Welcome to brain Stuff from how Stuff Works, Hey, brain Stuff,

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<v Speaker 1>Lauren vocal bomb. Here. People are living longer now than

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<v Speaker 1>ever before. But with this triumph comes a truly unfortunate foe,

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<v Speaker 1>Alzheimer's disease. Symptoms of the progressive brain disorder, which is

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<v Speaker 1>the most common cause of dementia for older adults, typically

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<v Speaker 1>start to show up around the age of sixty five,

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<v Speaker 1>just when many people retire and plan to start enjoying

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<v Speaker 1>their golden years. The disease is incurable and is listed

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<v Speaker 1>as the sixth leading cause of death for older people

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<v Speaker 1>in the United States, but the National Institutes of Health

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<v Speaker 1>says more recent estimates indicate it should rank third, behind

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<v Speaker 1>only cancer and heart disease, because many cases are not

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<v Speaker 1>reported correctly. Worse, Alzheimer's is the only disease in the

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<v Speaker 1>top ten causes of death United States for which there

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<v Speaker 1>is neither a cure, nor means of prevention nor treatment

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<v Speaker 1>to slow down the disease. We spoke via email with

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<v Speaker 1>David Lusk, founder of an issue advocacy can salting company

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<v Speaker 1>called Key Advocacy. Lusk's mother, at age sixty five, began

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<v Speaker 1>exhibiting symptoms like short term memory loss, struggling with basic

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<v Speaker 1>paperwork and making decisions with difficulty, but she was not

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<v Speaker 1>diagnosed until age seventy. In two thou eight, Lusk said,

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<v Speaker 1>by early twelve, my mother no longer believed I was

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<v Speaker 1>her son. It was crushing to have my own mother

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<v Speaker 1>thinks she wasn't my mother, and she even stopped saying

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<v Speaker 1>I love you. That is the most painful thing to

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<v Speaker 1>ever endure, never hearing your own mother saying she loves

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<v Speaker 1>you ever again. Lusk's mother died in after following a

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<v Speaker 1>pattern of cognitive and emotional decline that has become sadly

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<v Speaker 1>familiar for people dealing with Alzheimer's. Lusk wonders if he

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<v Speaker 1>will get the disease himself someday, as it tends to

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<v Speaker 1>run in families. He said that back of your mind concern.

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<v Speaker 1>I try to ignore it, but there's also a part

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<v Speaker 1>of me that wonders if I'm not already walking down

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<v Speaker 1>the dark fatal path. So many millions have and will

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<v Speaker 1>as the numbers of people with Alzheimer's skyrockets, it's troublesome

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<v Speaker 1>that a cure or effective treatment hasn't been ound after

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<v Speaker 1>so many years of research. It's not for lack of effort.

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<v Speaker 1>In fact, more than one hundred drugs have been studied

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<v Speaker 1>in clinical trials since two thousand two, to the tune

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<v Speaker 1>of billions of dollars in funding, but none of these

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<v Speaker 1>have proved effective enough for patient use. So what gives?

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<v Speaker 1>Why is it so hard to find treatment for Alzheimer's.

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<v Speaker 1>We also spoke with Rebecca edelbay Or, PhD, Director of

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<v Speaker 1>Scientific Engagement for the Alzheimer's Association. She said, some of

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<v Speaker 1>the difficulty has been in being able to identify really

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<v Speaker 1>what the initiation of the disease is in people. We've

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<v Speaker 1>learned that some of the changes are occurring maybe ten

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<v Speaker 1>to twenty years before they're experiencing the cognitive difficulty. That's

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<v Speaker 1>the crux. We need to understand what's happening in the

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<v Speaker 1>brain before you're experiencing symptoms. We're really trying to understand

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<v Speaker 1>the biology underpinnings of the disease. This is where researchers

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<v Speaker 1>are most focused at the moment. Part of the problem

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<v Speaker 1>is figuring out which people to study ten years before

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<v Speaker 1>they're showing any signs of dementia. Edelmayer said, we're trying

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<v Speaker 1>to i d people believed to be at risk, and

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<v Speaker 1>maybe the candidates have a primary relative that had full

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<v Speaker 1>blown Alzheimer's. Maybe they have risk factors poor cardiovascular health,

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<v Speaker 1>or difficulties with their sleep. All of these things put

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<v Speaker 1>you at risk for being someone to develop Alzheimer's. Of course,

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<v Speaker 1>not everyone with poor heart health gets Alzheimer's, and al

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<v Speaker 1>Mayor notes that one of the ways to try to

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<v Speaker 1>find people at risk is through biomarkers, which are measurable

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<v Speaker 1>substances that show up in a living thing when a

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<v Speaker 1>particular event is occurring. Checking people who aren't yet symptomatic

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<v Speaker 1>over a period of years and comparing them against people

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<v Speaker 1>with Alzheimer's and varying stages can shine light on which

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<v Speaker 1>biomarkers to look out for. Some potential biomarkers which could

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<v Speaker 1>eventually help to pinpoint those at risk of Alzheimer's include

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<v Speaker 1>blood and urine tests, genetic profiles, brain imaging, and proteins

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<v Speaker 1>in cerebral spinal fluid. Identifying some of these biomarkers might

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<v Speaker 1>even lead to the development of preventative measures. New evidence

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<v Speaker 1>from one of the largest clinical trials of its kind

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<v Speaker 1>revealed in July the people who aggressively lower their stolic

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<v Speaker 1>blood pressure to below one twenty may reduce risk of

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<v Speaker 1>cognitive impairment. Edel Mayer said, we can modify some of

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<v Speaker 1>our risk factors by very significantly controlling cardiovascular health. What's

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<v Speaker 1>good for your heart is going to be good for

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<v Speaker 1>your brain. Other modifiable risk factors could be related to diet, exercise,

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<v Speaker 1>drugs that harm the brain, and even sleep quality, but

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<v Speaker 1>those require more study before definitive recommendations can be made.

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<v Speaker 1>In the meantime, continuing efforts are underway to find a treatment.

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<v Speaker 1>Edel Mayer says that it's crucial to figure out how

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<v Speaker 1>to quote remove those built up proteins in the brain

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<v Speaker 1>that we believe are inhibiting neuronal communication in the brain.

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<v Speaker 1>An additional area of study focuses on better managing the

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<v Speaker 1>behavioral systems of Alzheimer's that can be so disruptive in

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<v Speaker 1>day to day life, like sleep problems, agitation, or even

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<v Speaker 1>bouts of aggression. Better management of these symptoms would mean

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<v Speaker 1>a better quality of life for patients and their families.

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<v Speaker 1>To improve detection, the Alzheimer's Association is planning to release

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<v Speaker 1>twenty recommendations to help doctors make timely diagnoses and establish

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<v Speaker 1>best practice protocols for how Alzheimer's should be handled. These

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<v Speaker 1>guidelines are expected to be published in late For Lusk's part,

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<v Speaker 1>he says that if a treatment or cure for this

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<v Speaker 1>disease was discovered, he'd feel amazingly relieved to not have

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<v Speaker 1>to dread a diagnosis of Alzheimer's, he said, to no

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<v Speaker 1>longer have to worry about that and have that concern.

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<v Speaker 1>That would be a huge weight lifted off my shoulders.

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<v Speaker 1>Today's episode was written by Aliya Hoyt and produced by

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<v Speaker 1>Tyler Clang. If you enjoy our show and want to

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<v Speaker 1>support us directly, visit our online shop at te public

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<v Speaker 1>dot com slash brain stuff, and of course, for more

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<v Speaker 1>on this and lots of other hopeful topics, visit our

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