WEBVTT - BrainStuff Classics: Why Is Alzheimers's So Difficult to Treat? 0:00:01.800 --> 0:00:04.320 Welcome to brain Stuff, a production of I Heart Radio. 0:00:06.640 --> 0:00:09.959 Hey brain Stuff Lauren vog obam here. Today's episode is 0:00:10.000 --> 0:00:12.760 a classic from the archive that deals with the difficulties 0:00:12.800 --> 0:00:18.040 of diagnosing, treating, and curing Alzheimer's even though it's fairly common. 0:00:20.320 --> 0:00:23.520 Hey brain Stuff, Lauren vog obam Here. People are living 0:00:23.560 --> 0:00:26.760 longer now than ever before. But with this triumph comes 0:00:26.800 --> 0:00:31.760 a truly unfortunate foe, Alzheimer's disease. Symptoms of the progressive 0:00:31.800 --> 0:00:34.760 brain disorder, which is the most common cause of dementia 0:00:34.800 --> 0:00:37.440 for older adults, typically start to show up around the 0:00:37.479 --> 0:00:40.680 age of sixty, just when many people retire and plan 0:00:40.760 --> 0:00:44.440 to start enjoying their golden years. The disease is incurable 0:00:44.560 --> 0:00:47.120 and is listed as the sixth leading cause of death 0:00:47.159 --> 0:00:50.000 for older people in the United States, but the National 0:00:50.040 --> 0:00:52.960 Institutes of Health says more recent estimates indicate it should 0:00:53.000 --> 0:00:56.440 rank third, behind only cancer and heart disease because many 0:00:56.440 --> 0:01:00.680 cases are not reported correctly. Worse, alzheimer is the only 0:01:00.720 --> 0:01:03.480 disease in the top ten causes of death United States 0:01:03.600 --> 0:01:06.000 for which there is neither a cure, nor means of 0:01:06.000 --> 0:01:10.680 prevention nor treatment. To slow down the disease, we spoke 0:01:10.800 --> 0:01:13.880 via email with David Lusk, founder of an issue advocacy 0:01:13.920 --> 0:01:18.559 consulting company called Key Advocacy. Lusk's mother, at age sixty five, 0:01:18.640 --> 0:01:21.880 began exhibiting symptoms like short term memory loss, struggling with 0:01:21.920 --> 0:01:25.360 basic paperwork, and making decisions with difficulty, but she was 0:01:25.400 --> 0:01:29.440 not diagnosed until age seventy. In two thou eight, Lusk said, 0:01:29.760 --> 0:01:32.399 by early twelve, my mother no longer believed I was 0:01:32.440 --> 0:01:34.720 her son. It was crushing to have my own mother 0:01:34.800 --> 0:01:37.119 thinks she wasn't my mother. And she even stopped saying 0:01:37.160 --> 0:01:39.600 I love you. That is the most painful thing to 0:01:39.640 --> 0:01:42.520 ever endure, never hearing your own mother saying she loves 0:01:42.560 --> 0:01:48.200 you ever again. Lusk's mother died after following a pattern 0:01:48.240 --> 0:01:51.600 of cognitive and emotional decline that has become sadly familiar 0:01:51.600 --> 0:01:54.440 for people dealing with Alzheimer's. Lusk wonders if he will 0:01:54.480 --> 0:01:56.760 get the disease himself someday, as it tends to run 0:01:56.760 --> 0:01:59.920 in families. He said that back of your mind concern 0:02:00.000 --> 0:02:01.760 and I try to ignore it, but there's also a 0:02:01.760 --> 0:02:03.920 part of me that wonders if I'm not already walking 0:02:03.920 --> 0:02:06.920 down the dark, fatal path. So many millions have and 0:02:06.960 --> 0:02:11.040 will as the numbers of people with Alzheimer's skyrockets, it's 0:02:11.040 --> 0:02:14.280 troublesome that a cure or effective treatment hasn't been found 0:02:14.280 --> 0:02:16.839 after so many years of research. It's not for lack 0:02:16.840 --> 0:02:19.520 of effort. In fact, more than one hundred drugs have 0:02:19.560 --> 0:02:22.239 been studied in clinical trials since two thousand two, to 0:02:22.360 --> 0:02:24.839 the tune of billions of dollars in funding, but none 0:02:24.840 --> 0:02:28.200 of these have proved effective enough for patient use. So 0:02:28.480 --> 0:02:30.720 what gives? Why is it so hard to find a 0:02:30.720 --> 0:02:35.440 treatment for Alzheimer's. We also spoke with Rebecca edelbay Or, PhD, 0:02:35.639 --> 0:02:40.120 Director of Scientific Engagement for the Alzheimer's Association. She said, 0:02:40.400 --> 0:02:42.680 some of the difficulty has been in being able to 0:02:42.760 --> 0:02:46.200 identify really what the initiation of the diseases in people. 0:02:46.720 --> 0:02:49.040 We've learned that some of the changes are occurring maybe 0:02:49.080 --> 0:02:52.680 ten to twenty years before they're experiencing the cognitive difficulty. 0:02:53.080 --> 0:02:55.720 That's the crux. We need to understand what's happening in 0:02:55.760 --> 0:02:59.320 the brain before you're experiencing symptoms. We're really trying to 0:02:59.360 --> 0:03:02.880 understand the biology underpinnings of the disease. This is where 0:03:02.919 --> 0:03:06.360 researchers are most focused at the moment. Part of the 0:03:06.400 --> 0:03:09.080 problem is figuring out which people to study ten years 0:03:09.120 --> 0:03:12.280 before they're showing any signs of dementia. Edel Mayer said, 0:03:12.600 --> 0:03:14.680 we're trying to I D people we believe to be 0:03:14.720 --> 0:03:17.720 at risk, and maybe the candidates have a primary relative 0:03:17.720 --> 0:03:20.840 that had full blown Alzheimer's. Maybe they have risk factors 0:03:20.880 --> 0:03:24.360 poor cardiovascular health or difficulties with their sleep. All of 0:03:24.400 --> 0:03:26.280 these things put you at risk for being someone to 0:03:26.360 --> 0:03:30.639 develop Alzheimer's. Of course, not everyone with poor heart health 0:03:30.720 --> 0:03:33.440 gets Alzheimer's. Edel Mayor notes that one of the ways 0:03:33.480 --> 0:03:36.280 to try to find people at risk is through bio markers, 0:03:36.320 --> 0:03:38.960 which are measurable substances that show up in a living 0:03:39.000 --> 0:03:42.440 thing when a particular event is occurring. Checking people who 0:03:42.440 --> 0:03:45.560 aren't yet symptomatic over a period of years and comparing 0:03:45.600 --> 0:03:48.840 them against people with Alzheimer's and varying stages can shine 0:03:48.920 --> 0:03:52.560 light on which biomarkers to look out for. Some potential 0:03:52.600 --> 0:03:55.240 biomarkers which could eventually help to pinpoint those at risk 0:03:55.280 --> 0:03:59.440 of Alzheimer's include blood and urine tests, genetic profiles, brain imaging, 0:03:59.640 --> 0:04:03.520 and pre teens in cerebral spinal fluid. Identifying some of 0:04:03.560 --> 0:04:06.760 these biomarkers might even lead to the development of preventative measures. 0:04:07.280 --> 0:04:09.560 New evidence from one of the largest clinical trials of 0:04:09.600 --> 0:04:13.640 its kind revealed in July the people who aggressively lower 0:04:13.680 --> 0:04:16.960 their systolic blood pressure to below one twenty may reduce 0:04:17.120 --> 0:04:21.039 risk of cognitive impairment. Edel Mayer said, we can modify 0:04:21.080 --> 0:04:25.000 some of our risk factors by very significantly controlling cardiovascular health. 0:04:25.279 --> 0:04:27.120 What's good for your heart is going to be good 0:04:27.120 --> 0:04:30.919 for your brain. Other modifiable risk factors could be related 0:04:30.960 --> 0:04:33.839 to diet, exercise, drugs that harm the brain, and even 0:04:33.880 --> 0:04:37.800 sleep quality, but those require more study before definitive recommendations 0:04:37.800 --> 0:04:41.640 can be made. In the meantime, continuing efforts are underway 0:04:41.680 --> 0:04:44.680 to find a treatment. Edel Mayer says that it's crucial 0:04:44.720 --> 0:04:47.440 to figure out how to quote remove those built up 0:04:47.440 --> 0:04:50.400 proteins in the brain that we believe are inhibiting neuronal 0:04:50.440 --> 0:04:54.640 communication in the brain. An additional area of study focuses 0:04:54.640 --> 0:04:57.800 on better managing the behavioral systems of Alzheimer's that can 0:04:57.839 --> 0:05:01.440 be so disruptive in day to day life, like sleep problems, agitation, 0:05:01.720 --> 0:05:04.839 or even bouts of aggression. Better management of these symptoms 0:05:04.880 --> 0:05:07.359 would mean a better quality of life for patients and 0:05:07.440 --> 0:05:12.080 their families. To improve detection, the Alzheimer's Association is planning 0:05:12.080 --> 0:05:15.800 to release twenty recommendations to help doctors make timely diagnoses 0:05:16.040 --> 0:05:19.880 and establish best practice protocols for how Alzheimer's should be handled. 0:05:20.240 --> 0:05:24.359 These guidelines are expected to be published in late For 0:05:24.440 --> 0:05:26.840 Lusk's part, he says that if a treatment or cure 0:05:26.880 --> 0:05:30.240 for this disease was discovered, he'd feel amazingly relieved to 0:05:30.400 --> 0:05:33.920 not have to dread a diagnosis of Alzheimer's, he said, 0:05:34.240 --> 0:05:36.400 to no longer have to worry about that and have 0:05:36.520 --> 0:05:39.280 that concern. That would be a huge weight lifted off 0:05:39.279 --> 0:05:50.760 my shoulders. Today's episode is based on the article why 0:05:50.839 --> 0:05:53.120 is it so Hard to find a Cure for Alzheimer's 0:05:53.120 --> 0:05:55.479 on how Stuff Works dot Com, written by Aliyah Hoyt. 0:05:56.000 --> 0:05:58.320 Brain Stuff is production of I Heart Radio in partnership 0:05:58.320 --> 0:06:00.200 with how stuff Works dot Com, and this produced by 0:06:00.200 --> 0:06:03.279 Tyler Clang and Ramsay Yut. Four more podcasts from my 0:06:03.320 --> 0:06:06.480 heart Radio visit the heart Radio app, Apple Podcasts, or 0:06:06.520 --> 0:06:08.320 wherever you listen to your favorite shows.