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What can you do to reduce your risk of Alzheimer’s disease?

How can I prevent Alzheimer’s disease? Is there a cure for those who already have it?

P. Murali Doraiswamy, director of the Neurocognitive Disorders Program at Duke University School of Medicine and co-author of The Alzheimer’s Action Plan, said:

Alzheimer’s disease, the most common form of dementia, affects 6.2 million Americans over the age of 65. It is one of the most feared illnesses and one of the most elusive illnesses in terms of treatment and cure.

on Monday, The Food and Drug Administration has approved biogen’s aducanumab, the first treatment for Alzheimer’s disease in almost 20 years. Sold under the Aduhelm brand name. Approval of this drug came after years of research and doubts about its effectiveness.

Approval is “a positive step in the right direction,” says Dr. Doraiswamy. However, he said it is important for clinicians and patients to hold back expectations, not all people with Alzheimer’s disease are targeted, and the benefits and benefits are not “dramatic.”

P. Murali Doraiswamy of Duke University School of Medicine is a leading researcher in Alzheimer’s disease.


Photo:

Sean Rocco / Duke Health

Although difficult to combat progressive brain disease, Dr. Doraiswamy is optimistic about progress in various areas. Blood tests have been developed in the clinic to detect Alzheimer’s disease, and home digital cognitive tools for tracking and possibly treating Alzheimer’s disease have cleared the FDA. Researchers are finding ways to detect Alzheimer’s disease-related proteins using advanced brain scans, and identify how seemingly unrelated deafness is associated with an increased risk of Alzheimer’s disease. Did.

“I think it’s a hopeful time,” says Dr. Doraiswamy.

In this edited interview, he discusses promising tools for detecting Alzheimer’s disease, steps that can be taken to mitigate risk, misunderstandings about the disease, and the impact of Covid-19 on dementia.

How do you tell the difference between memory problems in normal aging, as opposed to Alzheimer’s disease and other dementias?

Dr. Dry Swami: If you can’t remember what you forgot, you have a problem. We all forget things, but usually come back after a few hours or when there is no stress or effort. The second is that it gets worse over time. Normal age-related memory loss does not worsen significantly over time. Also, clues are rarely useful in Alzheimer’s disease. If you cue others, they will either remember or give you the correct answer.

And while we all struggle to remember new information and take some time to understand smart TVs, people with Alzheimer’s disease find it impossible to use new microwave ovens and remote controls. I feel.

What are the most promising developments in the detection of Alzheimer’s disease and the treatment of mild memory deficits?

A simple blood test that appears to be of reasonable diagnostic and predictive value. Instead of performing a series of two-hour tests or ordering a complex brain scan that costs thousands of dollars, your GP can do a simple blood test. These are not approved by the FDA for routine clinical practice, but we have a very close relationship and expect to have some tests that can do that within the next two years. ..

There are also many digital-based cognitive tests. Some are free memory tests and self-tests that anyone can take at home and provide memory scores, but interpretation requires some expertise. 1, Self-managed jero cognitive examIncludes simple math problems, questionnaires, and drawing tests. Several other digital-based cognitive tests that have been cleared by the FDA require a prescription and are used for memory assessment. One FDA approved test It contains a series of brain games to evaluate five cognitive areas such as attention, work, and episodic memory.

In the future, it can be combined with digital treatment. Therefore, if you find that you have weak memory, reaction time, or concentration, play certain computerized cognitive games to enhance those skills. These digital therapies have been approved for symptoms such as ADHD, and there is no reason why they will not be available next year or so for the treatment of mild memory loss.

What are some advances in brain research?

One of the major developments is called “Alzheimer’s in a Dish”. They were able to use the patient’s neurons to form a small Alzheimer’s disease brain with spots and neurofibrillary tangles in a Petri dish. This study, conducted at Massachusetts General Hospital, is a huge step forward as it allows us to see if the drug works immediately. They can screen hundreds of thousands of drugs in months, compared to the more costly and time-consuming process of using mice.

What are some precautions that one can take on his own?

diet. Vegetarians and people on a Mediterranean diet have a cleaner brain in terms of the pathology of Alzheimer’s disease than those who eat a diet rich in saturated fat. The vegetarian diet is associated with a reduction in amyloid lesions in the brain. Reducing the risk of blood vessels and controlling blood pressure, cholesterol, diabetes, and weight have been shown to reduce the risk of developing dementia. Being active both mentally and socially.

Deafness can be one of the most reversible factors in the risk of Alzheimer’s disease. Studies have shown that long-term deafness causes the brain region, which is very close to the memory center, to shrink. Therefore, hearing aids and regular hearing tests are very important.

How about sleep?

Sleep is when the brain boosts immunity and saves memory. We know that sleep is important for clearing toxic proteins from the brain. They are all important. Yes, a good rest is important for a healthy memory.

Many treatments and treatments appear to be aimed at early-stage patients. How about those after the middle stage?

Drugs to treat mid-term symptoms are on the market, but no drug has been found to repair a brain injury once it has occurred. Therefore, there is a very urgent need to develop preventive strategies.

Share your thoughts

How has Alzheimer’s disease affected your life? Join the conversation below.

How did the pandemic affect people with Alzheimer’s disease?

For the past 12 to 15 months, patients with Alzheimer’s disease have not received appropriate treatment. More Alzheimer’s disease patients died during the pandemic than any other illness. There are several studies suggesting an increased incidence of dementia among Covid survivors. We may end up with the new term Covid dementia.

Research on Covid vaccine technology has really helped this area in terms of rapid resource mobilization and collaboration with regulators. I hope it will spread to other areas like us.

What prevents people from being tested?

fear. Alzheimer’s disease is more feared than cancer. People are afraid to lose their independence and identity and have to give up everything from driving to managing their accounts. However, many patients who are diagnosed and in the early stages can still drive and manage. To determine what you can and cannot do, you need to adjust your family plan.

Others don’t think it’s worth the evaluation because they can’t do anything about it. However, without evaluation, we do not know if it is Alzheimer’s disease or another disease. There was a patient who thought he had Alzheimer’s disease, but it turned out to be a serious vitamin deficiency. We corrected it and his perception returned to normal.

It is also important that people take the test. That way, you can plan, including financially.

What do you personally do to keep your brain healthy?

I am a scholar It’s helpful to have a rewarding job every day from morning till night. I play tennis and exercise. I spend a lot of time socializing. I like chess and bridges. 2-3 days a week, sometimes a glass of wine. I’m a vegetarian, so I don’t have to worry about plaque buildup associated with saturated fat.

What do you want to see in 10 years?

I think technology and brain science will be tightly integrated. I think a drop of blood can be a great tool for imaging the brain and detecting the early stages of the pathology of the disease.

Perhaps there will be highly sophisticated smartphone-based sensors and wearables that can predict the onset of Alzheimer’s disease.

I hope to have a vaccine to prevent Alzheimer’s disease within 10 years, but I don’t know yet.

Write to Claire Ansbury clare.ansberry@wsj.com

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What can you do to reduce your risk of Alzheimer’s disease?

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