WEBVTT - How Close are we to Curing Alzheimer's? 0:00:00.080 --> 0:00:03.160 Guess what, Mango? What's that? Well, you remember a few 0:00:03.240 --> 0:00:05.960 years ago when the social media sites and apps, and 0:00:06.040 --> 0:00:10.480 I'm thinking Facebook especially, they started using this facial recognition 0:00:10.520 --> 0:00:13.360 programming and that was used to recognize all of us 0:00:13.360 --> 0:00:16.160 and these photos that we were posting. And I remember 0:00:16.200 --> 0:00:19.400 when it first started happening. I think this is honestly 0:00:19.440 --> 0:00:21.720 just a little bit creepy, Like, how did you know 0:00:21.880 --> 0:00:24.119 that was my friend Steve? I mean, the guy was 0:00:24.160 --> 0:00:26.440 wearing a hat, he had on glasses, then he had 0:00:26.520 --> 0:00:28.880 longer hair than he might have weighed five or six 0:00:28.920 --> 0:00:31.600 more pounds, Like, how did you know that was Steve? 0:00:31.800 --> 0:00:35.320 I know, it was so impressive, but also so creepy. 0:00:35.640 --> 0:00:37.760 I felt the same way. I kind of had mixed 0:00:37.760 --> 0:00:40.040 emotions about it. But you know, as much as the 0:00:40.080 --> 0:00:43.680 world of artificial intelligence can sometimes weird us out and 0:00:44.040 --> 0:00:46.720 leave us feeling a little bit violated, even you know, 0:00:46.760 --> 0:00:49.400 the more I've read about its potential applications in the 0:00:49.400 --> 0:00:52.879 world of medicine, the more I'm actually fascinated, you know, 0:00:52.920 --> 0:00:55.480 by what it might be capable of in the decades ahead. 0:00:56.120 --> 0:00:58.640 So how do you mean exactly, Well, I've been reading 0:00:58.760 --> 0:01:02.480 some about how so many conditions and genetic ones in particular, 0:01:02.960 --> 0:01:05.000 have what some in the medical field would call a 0:01:05.120 --> 0:01:08.360 certain face, and that is a set of similar features 0:01:08.400 --> 0:01:12.600 that might indicate whether someone might have a certain genetic syndrome. Now, 0:01:12.640 --> 0:01:15.360 the advantage of technology is obviously that these machines can 0:01:15.400 --> 0:01:18.839 process so many millions of pieces of data at one time, 0:01:19.280 --> 0:01:22.360 and they'd be looking for these common features, even very 0:01:22.440 --> 0:01:25.400 subtle ones. So some of those same programmers who were 0:01:25.400 --> 0:01:28.319 helping places like Facebook, they're getting involved to help with 0:01:28.360 --> 0:01:32.319 the diagnosis of Alzheimer's, something that's often incredibly difficult to 0:01:32.319 --> 0:01:35.320 diagnose before significant damage has been done in the brain, 0:01:35.920 --> 0:01:38.720 and they're often looking for these subtle speech delays or 0:01:38.760 --> 0:01:41.720 slight hiccups as you might describe them, that a doctor 0:01:41.840 --> 0:01:44.440 might not be able to see it first. And it's 0:01:44.440 --> 0:01:47.400 still very early, but of course we all hope this 0:01:47.520 --> 0:01:51.240 leads to better diagnosis and better treatment, and the progress 0:01:51.280 --> 0:01:54.080 to date does give us some real hope. I feel 0:01:54.120 --> 0:01:56.680 like most of us have been affected by Alzheimer's in 0:01:56.720 --> 0:01:59.240 some way, knowing a loved one who's suffered from it. 0:01:59.480 --> 0:02:01.960 I know both of us have. So you know, today 0:02:02.000 --> 0:02:04.160 we wanted to talk a little bit about that, Like 0:02:04.200 --> 0:02:07.160 what we know about Alzheimer's, what kind of progress we're 0:02:07.200 --> 0:02:09.919 making and fighting it, and who seems to be doing 0:02:09.960 --> 0:02:13.160 the best job of caring for those with Alzheimer's. So 0:02:13.280 --> 0:02:36.919 let's get started, right hey, their podcast listeners, Welcome to 0:02:36.960 --> 0:02:39.440 Part Time Genius. I'm Will Pearson and as always I'm 0:02:39.480 --> 0:02:41.760 joined by my good friend man guest shot Ticketer and 0:02:41.800 --> 0:02:43.799 on the other side of the soundproof glass, hunched over 0:02:43.880 --> 0:02:46.880 his brand new copy of Mandarin for Dummies. It's been 0:02:46.919 --> 0:02:49.880 a while since I've seen a dummies book, but anyway, 0:02:49.880 --> 0:02:52.880 that that's our friend and producer Tristan McNeil, and of 0:02:52.919 --> 0:02:55.640 course he's on theme as usual. You know, I was 0:02:55.639 --> 0:02:57.840 reading just this week about how learning a new language 0:02:57.840 --> 0:03:01.079 can help stave off Alzheimer's in some cases. And this 0:03:01.120 --> 0:03:03.640 was from a study out of York University in Toronto 0:03:03.960 --> 0:03:07.280 where they actually examined over a hundred long time bilingual 0:03:07.320 --> 0:03:10.919 Alzheimer's patients along with over a hundred monolingual patients, and 0:03:11.000 --> 0:03:13.960 it turned out that on average, the bilingual patients have 0:03:14.000 --> 0:03:16.880 been diagnosed with Alzheimer's about four years later than the 0:03:16.919 --> 0:03:19.919 monolingual patients. So the idea is that because learning a 0:03:19.960 --> 0:03:22.919 second language gives the brains such a strong workout, it 0:03:22.960 --> 0:03:25.320 can actually help keep the full effects of the disease 0:03:25.400 --> 0:03:29.200 at bay longer, which is really interesting. But you know, 0:03:29.400 --> 0:03:33.160 it's honestly sometimes tough to say for certain, because they're 0:03:33.160 --> 0:03:36.440 all kinds of genetic and environmental factors that can increase 0:03:36.520 --> 0:03:40.520 or decrease a person's chances of contracting Alzheimer's, and we'll 0:03:40.560 --> 0:03:43.600 be talking about a few of those later on. But ultimately, 0:03:43.680 --> 0:03:46.760 no one is immune to the disease, and the greatest 0:03:46.840 --> 0:03:49.520 risk factor associated with it, of course, is is just 0:03:49.720 --> 0:03:53.040 age itself. In fact, studies have clearly shown that the 0:03:53.120 --> 0:03:57.040 number of people with Alzheimer's disease increases with age, so 0:03:57.200 --> 0:03:59.920 much so that roughly one in five people now suffer 0:04:00.040 --> 0:04:02.560 from it by the age of eight five. And I 0:04:02.600 --> 0:04:04.760 know all of this is upsetting to think about, and 0:04:05.120 --> 0:04:07.680 people who have Alzheimer's disease and their family are already 0:04:07.680 --> 0:04:10.160 dealing with it on a daily basis, and those of 0:04:10.200 --> 0:04:12.040 us who have been lucky enough not to have to 0:04:12.080 --> 0:04:15.120 face it in some big way would probably rather focus 0:04:15.120 --> 0:04:17.760 on just about anything else. But the truth is this 0:04:17.839 --> 0:04:20.840 is something everybody needs to stay informed about, particularly if 0:04:20.880 --> 0:04:23.920 you plan to live past the age of sixty. Another 0:04:23.960 --> 0:04:26.400 good news is that scientists are already hard at work 0:04:26.440 --> 0:04:29.920 on new research and new treatments, and that's what we'll 0:04:29.960 --> 0:04:32.800 be focused on today. You know, all those promising approaches 0:04:32.839 --> 0:04:36.520 to Alzheimer's disease that could hopefully lead to earlier detection 0:04:36.680 --> 0:04:39.839 and improve symptom management and hopefully one day of course 0:04:39.839 --> 0:04:42.560 secure that's right, But before we get to the more 0:04:42.600 --> 0:04:44.680 hopeful side of the topic, we should probably do a 0:04:44.720 --> 0:04:47.599 quick crash course on what the disease is exactly. So 0:04:48.000 --> 0:04:52.600 for starters, Alzheimer's disease is a chronic, progressive neurodegenerative disease, 0:04:52.960 --> 0:04:55.120 which means it's a form of dementia that leads to 0:04:55.200 --> 0:04:58.800 severe cognitive loss and eventual death. And while there are 0:04:58.880 --> 0:05:02.120 several different kinds of dementia, Alzheimer's is the most common, 0:05:02.120 --> 0:05:06.440 accounting for somewhere between sixty eight percent of all dementia cases. 0:05:06.800 --> 0:05:09.640 So really, dementia is something of an epidemic at this point, 0:05:09.680 --> 0:05:11.359 I would think, because you know, some of the stats 0:05:11.400 --> 0:05:15.800 I found all researching, we're pretty jaw dropping. Apparently, Alzheimer's 0:05:15.880 --> 0:05:18.080 is now the sixth leading cause of death in the 0:05:18.160 --> 0:05:21.680 US and the seventh worldwide. And that really wasn't the 0:05:21.720 --> 0:05:26.280 case even fifty years ago. Yeah, So Alzheimer's was formally 0:05:26.320 --> 0:05:29.240 recognized as an epidemic back in the seventies, and sadly 0:05:29.320 --> 0:05:32.479 that designation still stands today. In fact, that the world 0:05:32.560 --> 0:05:35.760 has a larger aging population than ever before, which inevitably 0:05:35.800 --> 0:05:37.960 means that the number of people who developed the disease 0:05:38.080 --> 0:05:41.360 is only set to grow. For example, this organization called 0:05:41.400 --> 0:05:45.520 Alzheimer's Disease International, they estimated that about five million people 0:05:45.520 --> 0:05:48.799 in the US and nearly fifty million people worldwide currently 0:05:48.839 --> 0:05:52.160 suffer from dimension one form or another, but by twenty 0:05:52.200 --> 0:05:55.279 fifty the number is projected actually to reach one hundred 0:05:55.400 --> 0:05:59.400 thirty one million. Wow. So it's obvious in light of 0:05:59.440 --> 0:06:01.359 that why they such a big push to find a 0:06:01.400 --> 0:06:04.320 cure as soon as possible. But you know, I'm curious 0:06:04.360 --> 0:06:06.920 how long have we known about the problem, Like, is 0:06:06.960 --> 0:06:09.320 Alzheimer's something we've been trying to get a grip on 0:06:09.360 --> 0:06:14.480 for centuries or this a relatively new threat. Well, dementia 0:06:14.520 --> 0:06:16.840 as a broad concept is popped up in medical text 0:06:16.920 --> 0:06:19.359 going all the way back to ancient Greece, but the 0:06:19.520 --> 0:06:22.560 first case study for Alzheimer's in particular was in nineteen 0:06:22.600 --> 0:06:26.640 o one, and that's when this German neuropathologist named A. 0:06:26.760 --> 0:06:29.599 Louis Alzheimer, you know who the disease is named after, 0:06:30.040 --> 0:06:33.240 began treating a woman at an asylum in Frankfurt, and 0:06:33.360 --> 0:06:35.440 the fifty one year old patients seemed to suffer from 0:06:35.520 --> 0:06:38.479 some kind of psychosis. In addition to rapid memory loss, 0:06:38.520 --> 0:06:41.920 she reported I guess uh, strange feelings of jealousy towards 0:06:41.960 --> 0:06:44.680 her husband. She also had these odd behaviors, like she'd 0:06:44.720 --> 0:06:48.360 dragged furniture to and fro She'd hied uh. Sometimes she'd 0:06:48.360 --> 0:06:50.520 think people were out to kill her, so then she 0:06:50.560 --> 0:06:54.000 would scream out loudly. It was pretty sad, and so 0:06:54.200 --> 0:06:57.320 was Dr Alzheimer able to help her in anyway? No, 0:06:57.400 --> 0:06:59.960 not really. But when the patient died five years later, 0:07:00.520 --> 0:07:03.919 Alzheimer was able to dissect or brain, and his findings 0:07:03.920 --> 0:07:06.440 formed the basis for the first formal description of pre 0:07:06.560 --> 0:07:11.600 senile dementia. So what did he find when he looked? So? 0:07:11.760 --> 0:07:14.240 Today we know that the main effects of Alzheimer's, like 0:07:14.360 --> 0:07:18.840 memory laws, decreased thinking ability, Personality changes like these are 0:07:18.920 --> 0:07:21.680 all the result of dyeing brain cells and the atrophy 0:07:21.680 --> 0:07:24.960 of certain key regions of the brain. And the reason 0:07:25.080 --> 0:07:27.560 these brain cells start to die off is because something 0:07:27.600 --> 0:07:30.360 has disrupted the communication between the neurons and the brain. 0:07:30.960 --> 0:07:35.640 So Alzheimer's biggest contribution was really identifying what that something was, 0:07:36.200 --> 0:07:39.480 or at least most likely what it is, because when 0:07:39.480 --> 0:07:43.080 he dissected that patient's brain and examined it under a microscope, 0:07:43.360 --> 0:07:47.120 he identified these tiny tangles and plaques dotting the gray tissues. 0:07:48.200 --> 0:07:50.200 And and these are the masses that that are some 0:07:50.280 --> 0:07:53.360 kind of protein build up, right, yeah, there are. There 0:07:53.360 --> 0:07:55.240 are these two types of proteins at work. It's the 0:07:55.280 --> 0:07:58.000 amyloid and the tao. And while we don't know what 0:07:58.040 --> 0:08:01.520 prompts the accumulation of these proteins are how exactly they interact, 0:08:01.760 --> 0:08:05.000 their presence is usually a telltale sign of Alzheimer's. So 0:08:05.280 --> 0:08:08.920 the amaloid is recognizable because it bunches together into sticky 0:08:08.960 --> 0:08:12.520 clumps through these beta amaloid plaques. And the tow is 0:08:12.560 --> 0:08:15.000 easy to spot because it accumulates as tangles of these 0:08:15.040 --> 0:08:18.480 watered up protein strands. You know, even before we started 0:08:18.480 --> 0:08:21.440 doing our research for today's episode, I'd always heard that 0:08:21.480 --> 0:08:24.840 one of the biggest obstacles for treating Alzheimer's is that it's, 0:08:24.840 --> 0:08:28.280 you know, notoriously difficult to diagnose. By the time the 0:08:28.360 --> 0:08:31.520 symptoms manifest enough to be caught, much of that damage 0:08:31.560 --> 0:08:34.240 has already been done. But why is that, like, if 0:08:34.280 --> 0:08:37.480 these plaques and tangles are so noticeable. Yeah, it's a 0:08:37.480 --> 0:08:40.120 good question, and the answer is that we actually haven't 0:08:40.160 --> 0:08:43.280 found a reliable or accurate way to measure these protein 0:08:43.320 --> 0:08:46.120 build ups, especially in living patients. So more than a 0:08:46.240 --> 0:08:49.120 hundred years after that initial case in Germany, there's still 0:08:49.200 --> 0:08:52.880 no definitive way to diagnose Alzheimer's without dissecting the brain 0:08:53.000 --> 0:08:56.000 post mortem to look for these hallmark plaques and tangles. 0:08:56.040 --> 0:08:59.000 And in recent years, some postmortems have given a reason 0:08:59.040 --> 0:09:01.200 to question whether the presence of these build ups is 0:09:01.280 --> 0:09:04.679 really telling the whole story anyway. Oh, so what do 0:09:04.760 --> 0:09:07.319 you mean by that? Well, there have actually been some 0:09:07.360 --> 0:09:10.000 cases where patients who were said to have Alzheimer's were 0:09:10.040 --> 0:09:13.040 revealed to not have plaques and tangles in their brains. 0:09:13.080 --> 0:09:15.800 And maybe even weirder, there are also cases where post 0:09:15.800 --> 0:09:18.160 mortem exams show massive build ups in the brains of 0:09:18.200 --> 0:09:21.960 people who had excellent memories. So while these plaques and 0:09:22.000 --> 0:09:24.240 these tangles appear to have some part in the onset 0:09:24.240 --> 0:09:27.600 of Alzheimer's, it isn't true in all cases, and as 0:09:27.600 --> 0:09:30.000 a result, a growing number of researchers are starting to 0:09:30.040 --> 0:09:33.079 think that chronic inflammation might actually play the larger role 0:09:33.120 --> 0:09:35.520 in the disease than they initially thought. So here's how 0:09:35.559 --> 0:09:38.720 Scientific American broke down the new hypothesis and article from 0:09:38.840 --> 0:09:43.719 last November. In the brain tissue damaging long term inflammation 0:09:43.760 --> 0:09:45.880 can also be caused by a build up of cells 0:09:45.920 --> 0:09:49.560 known as microglia. In a healthy brain, these cells engulf 0:09:49.600 --> 0:09:52.959 and destroy waste and toxins, but in Alzheimer's patients, the 0:09:53.000 --> 0:09:56.360 microglia failed to clear away this debris, which can include 0:09:56.360 --> 0:10:00.480 toxic tow tangles or amyloid plaques. The body then activates 0:10:00.520 --> 0:10:03.400 more microglia to try to clear the waste, but this 0:10:03.480 --> 0:10:07.360 in turn causes inflammation. Long term or chronic inflammation is 0:10:07.400 --> 0:10:10.680 particularly damaging to brain cells and ultimately leads to brain 0:10:10.720 --> 0:10:15.559 cell death. Okay, so in this case, the inflammation, which 0:10:15.600 --> 0:10:18.080 could be worsened by the plaques and the tangles would 0:10:18.400 --> 0:10:21.680 would actually be the real culprit behind the dying brain cell. 0:10:21.800 --> 0:10:24.800 So how would just been thinking about this? How would 0:10:24.800 --> 0:10:27.560 that impact the search for for treatments, though, I mean, 0:10:27.760 --> 0:10:30.120 from everything I've read, it seems like most researchers have 0:10:30.160 --> 0:10:33.080 been focusing on the other ways to prevent or destroy 0:10:33.200 --> 0:10:35.959 these protein build ups. So I mean, I hate to 0:10:35.960 --> 0:10:37.600 ask this, but have we been heading in the wrong 0:10:37.640 --> 0:10:41.200 direction this whole time? Well it's too early to say 0:10:41.240 --> 0:10:43.680 for sure, but I really hope not. It would be 0:10:43.720 --> 0:10:46.240 devastating to see such a colossal amount of effort and 0:10:46.280 --> 0:10:48.880 money lead to a dead end. I mean, we hear 0:10:48.920 --> 0:10:52.200 about new promising treatments all the time, but all too 0:10:52.280 --> 0:10:54.520 many of them disappear from headlines a few months later 0:10:54.600 --> 0:10:58.360 because they were later proven ineffective during trials. And in fact, 0:10:58.679 --> 0:11:01.480 at this point, none of the hot twenty three experimental 0:11:01.640 --> 0:11:06.200 Alzheimer's drugs developed between two thousand and fourteen have made 0:11:06.280 --> 0:11:09.760 it past the later stages of clinical testing. And that's 0:11:09.800 --> 0:11:12.600 obviously a concern for all sorts of reasons, you know, 0:11:12.679 --> 0:11:14.600 not the least of which is just how much it 0:11:14.679 --> 0:11:17.800 costs to develop even one new form of treatment. For example, 0:11:17.840 --> 0:11:20.640 that there was this two thousand sixteen study from the 0:11:20.760 --> 0:11:24.640 Journal of Health Economics, and it found the average research 0:11:24.679 --> 0:11:27.040 and development cost for a new medicine are about two 0:11:27.040 --> 0:11:31.080 point six billion dollars. Good lord, it's hard to even 0:11:31.200 --> 0:11:33.679 wrap your head around that kind of money for something 0:11:33.760 --> 0:11:35.840 like that. But you know the truth is that, you know, 0:11:35.880 --> 0:11:38.520 we as a country still aren't spending as much on 0:11:38.559 --> 0:11:42.520 Alzheimer's researches we likely should be. I mean, stimulate spending 0:11:42.520 --> 0:11:45.120 for Alzheimer's research was increased to around I think it 0:11:45.160 --> 0:11:47.719 was around one point eight billion dollars this year, and 0:11:48.120 --> 0:11:50.680 that does get it pretty close to that two billion 0:11:50.679 --> 0:11:54.200 dollar mark that the Alzheimer's Association has has long been 0:11:54.240 --> 0:11:58.120 saying that researchers needed in order to treat the disease effectively. 0:11:58.760 --> 0:12:01.360 But this funding has to be every year, so there's 0:12:01.400 --> 0:12:04.520 no guarantee that that upper trend will continue long term. 0:12:04.600 --> 0:12:07.520 And not to mention that's just funding for new research, 0:12:07.559 --> 0:12:09.880 I mean that the actual cost of health care for 0:12:09.920 --> 0:12:13.920 dementia already exceeds two hundred billion dollars each year in 0:12:13.960 --> 0:12:18.640 the US. Yeah. But despite the uncertainties that still surround Alzheimer's, 0:12:18.679 --> 0:12:21.960 like all that plaques and tangles, research we've been spending 0:12:21.960 --> 0:12:24.120 so much money on will still be super useful no 0:12:24.240 --> 0:12:27.640 matter what. And that's partly because many researchers are now 0:12:27.679 --> 0:12:30.880 pushing for a more personalized approach to Alzheimer's treatment. It's 0:12:30.920 --> 0:12:33.160 similar to the way we're dealing with cancer, like there's 0:12:33.160 --> 0:12:36.200 no one treatment that's effective for every kind of cancer, 0:12:36.480 --> 0:12:38.560 or even for every case of the same kind, and 0:12:38.720 --> 0:12:41.160 it's the same way with Alzheimer's. So the idea you 0:12:41.200 --> 0:12:43.280 had the new approach is to use multiple drugs to 0:12:43.320 --> 0:12:45.480 target the many different changes in the brain that can 0:12:45.480 --> 0:12:49.079 occur with Alzheimer's. Okay, I see. So for instance, you 0:12:49.160 --> 0:12:52.120 might start a patient off with one drug if you're 0:12:52.120 --> 0:12:55.040 trying to reduce that build up of amyloid plaques or 0:12:55.080 --> 0:12:57.560 something like that, and then you might switch to another 0:12:57.720 --> 0:13:01.000 if inflammation is the bigger issue, or or change it 0:13:01.040 --> 0:13:04.599 up if it's different for another patient exactly. So, Alzheimer's 0:13:04.600 --> 0:13:07.240 is obviously this complex disease and it doesn't manifest the 0:13:07.280 --> 0:13:09.840 same across the board, so it's helpful to have as 0:13:09.880 --> 0:13:12.360 many tools at our disposal as possible to treat it, 0:13:12.480 --> 0:13:15.000 and that way we can mix and match medications to 0:13:15.160 --> 0:13:18.920 create treatment plants tailor made for each patient's pelecular profile. 0:13:20.320 --> 0:13:22.599 Al Right, well, that does sound like a more promising 0:13:22.600 --> 0:13:24.840 approaches as well. As a nice reminder that it's worth 0:13:24.880 --> 0:13:28.000 tackling this problem from as many different angles as we can. 0:13:28.200 --> 0:13:30.280 I mean, you never know which one might lead to 0:13:30.920 --> 0:13:34.959 that game changing solution that we're always looking for. Absolutely, 0:13:35.000 --> 0:13:37.160 And in the meantime, there's still some effective ways to 0:13:37.200 --> 0:13:40.160 reduce your chances of contracting Alzheimer's, and even a few 0:13:40.200 --> 0:13:43.920 new ideas for how to detect and diagnose Alzheimer's without 0:13:43.960 --> 0:13:46.640 having to wait for a postmortem. Yeah, well, I definitely 0:13:46.640 --> 0:13:48.360 want to talk about those, but before we do, let's 0:13:48.400 --> 0:14:09.600 take a quick break. You're listening to Part Time Genius 0:14:09.600 --> 0:14:11.920 and we're talking about the most promising efforts to treat 0:14:11.960 --> 0:14:14.920 Alzheimer's disease. All right, mango, So we talked about how, 0:14:14.960 --> 0:14:18.400 for decades now, the prevailing theory has been that Alzheimer's 0:14:18.400 --> 0:14:20.960 is caused by these cell killing protein build ups in 0:14:20.960 --> 0:14:24.240 the brain. And you noted how chronic inflammation is also 0:14:24.280 --> 0:14:27.160 thought to have some role in that degeneration. And what 0:14:27.320 --> 0:14:29.360 strikes me about all this is it it seems like 0:14:29.400 --> 0:14:32.840 we know where the accumulations and inflammation may come from, 0:14:32.840 --> 0:14:36.760 but we don't really know why they occur. Yeah, that's true, 0:14:36.800 --> 0:14:39.720 but but a person's genetics do provided least some clues 0:14:39.720 --> 0:14:41.840 as to what's going on. For for example, we know 0:14:41.920 --> 0:14:44.240 that the trigger for most cases of Alzheimer's is a 0:14:44.320 --> 0:14:48.120 single mutated gene and it's on one of our chromosomes. 0:14:48.120 --> 0:14:50.920 Then remember that we all have two copies of every gene, 0:14:51.120 --> 0:14:53.320 one from each of our parents, so potentially someone could 0:14:53.360 --> 0:14:55.920 have two copies of this mutated gene. Al right, So 0:14:55.960 --> 0:14:58.320 how big a factor is this mutation on whether a 0:14:58.400 --> 0:15:02.000 person develops Alzheimer's or not? I mean, it really depends 0:15:02.040 --> 0:15:04.080 on how many copies of the muta genes someone has. 0:15:04.160 --> 0:15:06.880 So if a person has one copy, then there's up 0:15:06.920 --> 0:15:10.200 to chance of them developing the disease, And if they 0:15:10.240 --> 0:15:13.520 have two copies, then the likelihood jumps to as high 0:15:13.520 --> 0:15:17.680 as eight seven m alright, And so how common is 0:15:17.680 --> 0:15:21.400 it to have one or two of these genes? So 0:15:21.640 --> 0:15:26.200 apparently about of the population has one copy, but it's 0:15:26.200 --> 0:15:28.680 only two percent that have two copies. And testing for 0:15:28.720 --> 0:15:31.120 the genes is actually something you can do through something 0:15:31.120 --> 0:15:33.200 like twenty three and ME or one of those other 0:15:33.280 --> 0:15:36.160 personal genetics tests. You know, though, you know, whether you 0:15:36.200 --> 0:15:38.000 want to stress yourself out with something like that is 0:15:38.000 --> 0:15:41.120 another question entirely. Yeah, I can see. I'm you know, 0:15:41.160 --> 0:15:42.880 a lot of people might feel like that level of 0:15:42.880 --> 0:15:46.200 self knowledge is is something they're not quite prepared to handle, 0:15:46.240 --> 0:15:49.400 and especially considering that many researchers say there's more to 0:15:49.480 --> 0:15:52.720 the disease than just genetics. For example, I was reading 0:15:52.720 --> 0:15:55.560 how some scientists think that the true causes of Alzheimer's 0:15:55.600 --> 0:15:59.000 can be traced back to more environmental factors. That includes 0:15:59.000 --> 0:16:02.000 everything from your diet to how many times you've been 0:16:02.040 --> 0:16:04.800 you know, hitting the head in your lifetime too. Of course, yes, 0:16:04.880 --> 0:16:07.800 you know how many languages you speak? Yeah, definitely, so 0:16:08.040 --> 0:16:10.000 that language one is actually rooted in the fact that 0:16:10.040 --> 0:16:14.000 people who stay mentally active experienced less cognitive decline as 0:16:14.000 --> 0:16:16.960 they age, and amazingly, that remains the case even for 0:16:17.000 --> 0:16:19.200 people whose brains were later found to be riddled with 0:16:19.320 --> 0:16:22.280 familiar signs of Alzheimer's, like those plaques or tangles we've 0:16:22.280 --> 0:16:25.360 been talking about. So even when the disease is already 0:16:25.360 --> 0:16:27.880 set in, elderly patients who make it a habit to 0:16:27.960 --> 0:16:30.880 read or write or play thinking games like chess can 0:16:31.000 --> 0:16:34.040 sometimes stave off its symptoms for a lot longer. In fact, 0:16:34.120 --> 0:16:38.000 one two thirteen study found that people who didn't routinely exercise, 0:16:38.040 --> 0:16:42.440 their brains experienced cognitive decline full forty eight percent faster 0:16:42.680 --> 0:16:47.800 than those dident Yeah, that's pretty pretty good endorsement for reading. 0:16:47.880 --> 0:16:49.800 But you know, you know, for those times when your 0:16:49.840 --> 0:16:53.320 brain just needs a break or you know, it does 0:16:53.400 --> 0:16:56.040 look like there's some other ways, and and one of 0:16:56.080 --> 0:16:58.640 these that many people might find of interest is by 0:16:58.680 --> 0:17:01.560 knocking back a couple of of drinks. Or at least 0:17:01.600 --> 0:17:03.440 that's the word from a study that came out earlier 0:17:03.480 --> 0:17:07.080 this year in Scientific Reports. Honestly, that kind of sounds 0:17:07.119 --> 0:17:09.400 like a made up name for a dun over like this. 0:17:09.400 --> 0:17:11.680 This was in Scientific Reports, So I should have a 0:17:11.760 --> 0:17:15.520 drink a lot, that's right. But the researchers found that 0:17:15.600 --> 0:17:18.480 drinking just two glasses of wine daily is enough to 0:17:18.560 --> 0:17:21.680 net you a positive effect, which it works due to 0:17:21.720 --> 0:17:25.160 the way the alcohol interacts with the brain. So apparently 0:17:25.160 --> 0:17:28.040 the wine enhances the brain's ability to remove those damaging 0:17:28.080 --> 0:17:31.200 toxins that build up in the brain, which of course 0:17:31.240 --> 0:17:34.199 includes those TAO and beta amyloid proteins that we've been 0:17:34.200 --> 0:17:37.520 talking about. The brain typically does this by pumping in 0:17:37.640 --> 0:17:41.639 some cerebral fluid to flush away those troublesome plaques and tangles. 0:17:41.640 --> 0:17:45.160 But there's something about alcohol that gets the old cerebral 0:17:45.240 --> 0:17:48.919 fluid flowing more efficiently. And in case you're not a 0:17:48.920 --> 0:17:51.240 wine drinker, there is some evidence that other forms of 0:17:51.280 --> 0:17:54.479 alcohol work too. For instance, there was another study from 0:17:54.480 --> 0:17:56.800 a couple of years ago that found that beer drinkers 0:17:56.840 --> 0:18:00.880 tend to have fewer ammoloid build ups than non beer drinkers. Now, 0:18:00.960 --> 0:18:03.440 as always, I do need to pause here and say 0:18:03.760 --> 0:18:07.560 the key part here is moderation. Excessive alcohol consumption is 0:18:07.600 --> 0:18:10.919 obviously not a good thing for anybody. Yeah, I mean, 0:18:11.080 --> 0:18:13.560 it's really wild to lay out all the environmental factors 0:18:13.600 --> 0:18:17.200 potentially connected with Alzheimer's, Like I saw this one report 0:18:17.280 --> 0:18:20.199 in the Journal of Neuroscience about how even something like 0:18:20.240 --> 0:18:23.000 sleeping on your side can help delay the development of 0:18:23.040 --> 0:18:26.879 both Alzheimer's and Parkinson's. And apparently it goes back to 0:18:26.920 --> 0:18:30.080 the fluid flush routine our brains used to clear out waste. Like, 0:18:30.119 --> 0:18:33.160 it turns out the fluid flows most effectively when we're 0:18:33.160 --> 0:18:35.720 asleep and on our sides. All right, so it sounds 0:18:35.760 --> 0:18:38.680 like we've got the solution here. We just need to 0:18:38.760 --> 0:18:41.440 do some Sudoku puzzles all day long. Line on our 0:18:41.480 --> 0:18:44.440 side and then drink ourselves into a wine comas that 0:18:44.440 --> 0:18:47.520 that's the solution here, Yeah, and pick up cantonese. I 0:18:47.520 --> 0:18:49.600 think it's not the part of right, right, Okay, that's right. 0:18:49.600 --> 0:18:52.600 I forgot, But I mean, you know it's it's there's 0:18:52.640 --> 0:18:56.040 no surefire way to hold back Alzheimer's either, you know that. 0:18:56.040 --> 0:18:58.320 That's the thing about all these environmental risks we're talking about, 0:18:58.359 --> 0:19:01.480 like they can only suggest probable connections between things that 0:19:01.520 --> 0:19:05.120 have already happened. Like I've even seen studies that link 0:19:05.200 --> 0:19:09.080 drinking soda, both regular and diet, to the onset of Alzheimer's. 0:19:09.080 --> 0:19:11.560 And and while there might be a correlation between getting 0:19:11.560 --> 0:19:14.880 Alzheimer's and drinking soda, that doesn't mean that one necessarily 0:19:14.960 --> 0:19:17.800 caused the other to happen. Well, that's a good point, 0:19:17.840 --> 0:19:21.520 And I mean these kinds of lifestyle considerations can be 0:19:21.640 --> 0:19:24.040 kind of reassuring for us to think about. But the 0:19:24.080 --> 0:19:27.040 research I do find most exciting is this stuff aimed 0:19:27.040 --> 0:19:30.680 at finding new detection methods for Alzheimer's. After all, it's 0:19:30.680 --> 0:19:33.159 two thousand and eighteen, and it feels like we need 0:19:33.200 --> 0:19:37.000 a better system than having to dissect these brains post mortem. Yeah, 0:19:37.240 --> 0:19:39.240 I agree, and that's why I was excited when I 0:19:39.280 --> 0:19:41.320 first found out that we actually do have tests that 0:19:41.359 --> 0:19:44.440 can identify those gene mutations I mentioned earlier, the ones 0:19:44.480 --> 0:19:47.720 that make a person more likely to develop Alzheimer's. But 0:19:47.800 --> 0:19:50.160 as it turns out, many people who develop Alzheimer's don't 0:19:50.160 --> 0:19:53.040 actually carry that genetic marker. Well, many who do never 0:19:53.119 --> 0:19:56.400 end up exhibiting Alzhemer's symptoms. Well, so this is kind 0:19:56.400 --> 0:19:58.800 of like the plaques and tangles then, right, like that, 0:19:59.000 --> 0:20:03.080 they're reliable markers that maybe point the way to Alzheimer's, 0:20:03.160 --> 0:20:05.639 except for all of these cases where for some reason 0:20:05.720 --> 0:20:08.480 they don't, yeah, exactly, And and that means that even 0:20:08.520 --> 0:20:11.720 genetic testing can't provide any real degree of certainty one 0:20:11.720 --> 0:20:14.920 way or another. And that's what makes it all so confusing, Like, 0:20:15.080 --> 0:20:17.600 even if you don't have the genetic markers, you could 0:20:17.600 --> 0:20:22.080 still develop the disease. Well, thankfully, some researchers have begun 0:20:22.119 --> 0:20:26.080 branching out from genetic and environmental factors and they're concentrating 0:20:26.080 --> 0:20:29.840 on these so called biomarkers instead. Now, the idea here 0:20:29.920 --> 0:20:32.840 is that the body exhibits tell tale biological signs of 0:20:32.880 --> 0:20:35.720 Alzheimer's that we don't necessarily have to look at the 0:20:35.760 --> 0:20:38.360 brain to find so that we can look for these 0:20:38.359 --> 0:20:41.320 clues in all kinds of places that might be in 0:20:41.359 --> 0:20:44.600 the blood or in the cerebro spinal fluid we mentioned earlier, 0:20:45.000 --> 0:20:48.119 or even in the eyes of all places, And honestly, 0:20:48.160 --> 0:20:50.720 that last one is probably my favorite because all it 0:20:50.800 --> 0:20:54.199 involves is administering these fancy eye drops, and that's just 0:20:54.280 --> 0:20:58.280 so much less obtrusive than digging around in somebody's brain. Yeah, 0:20:58.280 --> 0:21:00.320 I mean that that obviously sounds way better there to me, 0:21:00.600 --> 0:21:04.120 But walk me through what makes these eye drops so fancy. Well, 0:21:04.160 --> 0:21:06.440 even though we have things like pets cans to help 0:21:06.520 --> 0:21:08.840 us take a closer look at living brains, it can 0:21:08.880 --> 0:21:12.240 still be incredibly tough to identify those beta em aloid 0:21:12.320 --> 0:21:15.800