It is a not-so-silent epidemic: The numbers of Americans with Alzheimer’s disease — currently estimated at about 5.4 million — will mushroom in coming years with the aging of the boomer generation.
We haven’t devoted nearly the resources we need to deal with those increasing numbers, according to a new one-hour documentary, Alzheimer’s: Every Minute Counts. Produced by Twin Cities PBS, it will air on PBS stations nationally at 10 p.m. ET on Wednesday, Jan. 25.
Last week, Twin Cities PBS and Next Avenue hosted a Facebook Live event featuring Dr. Rudy Tanzi, an Alzheimer’s researcher with Harvard Medical School and Massachusetts General Hospital who appears in the documentary. If you missed it, you can see it here, or read the edited transcript below:
Next Avenue: What is the current state of Alzheimer’s research?
Dr. Rudy Tanzi: I think that we’ve made some very important realizations over the last several years: (one is) this disease begins long before symptoms. Unlike cancer and diabetes and heart disease, we don’t diagnose Alzheimer’s until there are symptoms.
At that point, the type of treatment you need is very different than if you want to stave off this disease before there’s any cognitive problems. Specifically, we’ve learned that the senile plaques that accumulate in the brain occur 15 or 20 years before symptoms and that’s when you have to hit them, you have to detect them and stop them.
Luckily, we and many others have drugs we’re developing to do this. The idea is to do this in a safe way, take many different shots at hitting the disease early.
Especially over 50, if you’re not getting a total of seven or eight hours of sleep, you’re really hurting your brain.
— Dr. Rudy Tanzi, Alzheimer's researcher
For patients who have the disease right now, just hitting those plaques alone isn’t enough. We’ve seen trials fail for that reason, because you have to do that early on. If the patient has the disease right now, you have to do things like stop neuroinflammation in the brain.
When, if ever, do you believe that genetic testing for these Alzheimer’s-related genes is indicated?
The first genes that we discovered 30 years ago, the early-onset familial genes, are genes that carry mutations that cause the disease (in people) under 60 years old, usually under 50. They guarantee the disease; they’re very bad mutations. Those are the ones we can do very reliable, rigorous genetic testing on now. Only 1 percent of Alzheimer’s (patients) have those mutations.
For the other 99 percent, we know there are about three dozen different genes that are involved in the common late onset form, that’s after 60 years old. But we don’t have reliable genetic testing there. They’re still working out all the different mutations that combine, so that’s actually quite a bit of work to figure out.
In general, do you think we’re doing enough research in the United States right now?
No. If you look at what an epidemic Alzheimer’s is, we say there are 5.4 million people (with Alzheimer’s) in this country. Those are people with symptoms.
If you take the people who have the pathology in their brain and are 15 years away from getting Alzheimer’s symptoms, that 5 million probably goes up to 25 or 30 million.
Imagine if we said you don’t have cancer until you have a big tumor with organ failure. Imagine if we said you don’t have heart disease until you have a heart attack or congestive heart failure. That’s unfortunately what we do with Alzheimer’s — we don’t diagnose it until the brain’s already gone downhill.
So we would never stop cancer or heart disease if we wait for somebody to have symptoms. As soon as you see a little cell gone awry, beginning a tumor, you treat the cancer. As soon as you see high cholesterol with some plaque around the heart you treat heart disease, you don’t wait for a heart attack.
We need the same mindset with Alzheimer’s.
So there’s a lack of recognition of this larger problem that’s coming? And would you argue there’s a lack of money for this research, too?
Yes. Alzheimer’s has been stuck for a long time at about $500 million. Cancer, diabetes, AIDS, heart disease — they all get many billions of dollars. And Alzheimer’s has been like the red-haired stepchild: just ignored.
Now the government has to wake up. As the film says, one in five dollars of Medicare and Medicaid funding goes for Alzheimer’s. You have 71 million baby boomers all together headed into risk age. The average lifespan is already 80. At 85, it’s 40 percent of the population that has symptoms of this disease — we’ve just got a train wreck coming.
We should be absolutely panicked at the government level. When the Medicare and Medicaid bill for Alzheimer’s goes from one in five dollars to one in three dollars — that could happen over the next decade with baby boomers getting older — we could single-handedly collapse Medicare and Medicaid with Alzheimer’s disease.
Now, the government has gone up to about a billion dollars. Which is great, it’s more money. It’s still not the billions of dollars that go to other age-related diseases. I’m glad that cancer and heart disease and AIDS get many billions of dollars, but Alzheimer’s has to get as much or more now given the epidemic and the urgency here with how many cases we’re going to have.
It’s going to crush us. Never mind the social burden on the families. I might add that two-thirds of patients are women. And most caregivers are women. What’s going to happen when so much of our female population is (struck) with this disease? So it’s a huge problem and if we don’t throw a ton of money at it now, it’ll be a disaster.
What do you think are the most important things people can do to minimize their chances of getting Alzheimer’s disease or perhaps stave it off?
There are no guarantees for how to stave off Alzheimer’s. We don’t have therapies to prevent the disease. Current drugs treat the symptoms, modestly and temporarily at best, but we do have recommendations of what we can do in life to at least lower your risk.
We make the point in Super Genes that there are four areas where you can concentrate on your lifestyle to minimize the risk: diet, sleep, exercise and stress management.
For diet, the Mediterranean diet is best: less red meat, more fruits and vegetables, nuts, olive oil, replace red meat with fish if you eat fish. Probiotics, liquid yogurt, kefir, probiotic supplements, that will help keep the gut microbiome healthy and also will help inflammation in the brain.
After diet is sleep. Especially if you’re over 40 or 50, if you get seven or eight hours of sleep it helps you. Especially over 50, if you’re not getting seven or eight hours of sleep — even if it’s interrupted sleep, seven or eight hours total sleep — you’re really hurting your brain. Your brain really cleans itself out during deep sleep.
Exercise: 10,000 steps per day is important for the growth of new stem cells in the short-term memory area of the brain that’s affected by Alzheimer’s. Exercise can also clear the plaque away from the brain.
Finally, stress reduction. Don’t let all this email and social media stress you out. Being so in contact with everything happening in the news, this instant communication that’s expected by email or texting, Instagram — all these things serve to cause anxiety and stress, and stress can also cause inflammation. So take on a meditation practice, go to check your phone a little less often, kind of chill out.