Alzheimer’s dementia (AD) is brutal – it robs patients of memory and turns heartbroken families into stressed caregivers. But there is hope. Researchers are working to prevent memory loss, find early-stage therapies and, one day, a cure for the brain disorder. Top researcher Deborah Yurgelun-Todd, Ph.D., shares the latest AD discoveries…
My aunt, a doctor, couldn’t recognize her loved ones. Then her son, also a doctor, lost his memory. Our family couldn’t understand how their vibrant minds faded so fast.
Then we learned they both suffered from Alzheimer’s dementia.
They’re just two of the millions of people with the degenerative, incurable brain disorder.
About 5.1 million Americans have Alzheimer’s disease, according to the U.S. National Institutes of Health.
With Alzheimer’s disease, a form of dementia, brain cells deteriorate and die, triggering memory loss as well as a decline in social and mental skills. It interferes with everyday chores, like cooking or driving. Eventually, people with Alzheimer’s dementia can’t care for themselves.
But scientists – such as Deborah Yurgelun-Todd, Ph.D., a leading neurobiologist and director of cognitive neuroscience at the University of Utah’s Brain Institute – are making strides in memory loss research and working toward preventive steps, treatments and even a cure for Alzheimer’s dementia.
“I feel very optimistic that we will find even earlier interventions and, potentially, cures,” she says. “I don’t see a cure tomorrow, but I do envision a day when there will be [one].”
In this interview, Yurgelun-Todd explains why memory loss doesn’t always mean Alzheimer’s dementia and shares new treatments, brain-health tips and glimpses into the future of AD research.
How is Alzheimer’s disease different from simple memory loss?
When we talk about simple memory loss, we [mean] what most of us experience during middle age and late adulthood – that tip-of-the-tongue phenomenon when you can think of a word but just can’t get to it. Or when you’ve misplaced your car keys or can’t remember a phone number you had memorized.
I would classify it as a word retrieval [problem] or maybe being a bit confused. Since there’s no real way of addressing this mild memory loss, we usually just cope with it. It’s not something you go to a doctor and get treatment for.
Unlike simple memory loss, Alzheimer’s is a disease state. Patients with Alzheimer’s may not recognize their first-degree relatives or [recall] what they did that morning. It’s diagnosable and usually treated by a neurologist or a psychiatrist.
I know patients with Alzheimer’s dementia often see a neurologist, but why a psychiatrist?
Psychiatry is neurobiological [that is, it deals with the body, not just the mind]. Much of what we know about changes in mood, concentration, brain energy and brain diseases are also ideas in psychiatry.
The already fine line between neurology and psychiatry is blurring even more. That’s because researchers and doctors understand that environmental factors that affect neurology also can [impact our lifestyle. For example,] you’re not eating correctly or are exposed to a neurotoxin, pollution or a head injury.
Pollution and poor diet can affect memory?
Yes, because all these impact our central nervous system and [bodily] functions – like how agile you are [and your] mood. When you’re depressed, your cognitive functioning [isn’t as good].
If you suffer from depression, you can have memory impairment. You can have memory impairment because you have a neurologic disease such as Alzheimer’s. Or you could have some mild memory changes that just come with natural aging.
There's a continuum between emotional and neurological well-being. It’s no longer that you either have a brain disease or an emotional disorder or you’re aging. You could have all three.
Who develops Alzheimer’s dementia?
Anyone can – it’s not discriminating. A person’s socioeconomic status or education doesn’t matter.
Can women develop Alzheimer’s dementia during perimenopause?
In studies, we’ve seen a more rapid change in brain function during perimenopause.
You go through life at a plateau and then you hit perimenopause and start to notice that you’re not thinking as fast, remembering as well or are becoming a little more spacey.
A lot of women have complained to their doctors about this. Patients have tried to understand if that’s related to supplements or estrogen in the brain. It’s usually accompanied by sweats and decreased sleep, which may impact cognitive function.
The typical changes that predate Alzheimer’s disease are mild cognitive impairment – MCI – or aging-related cognitive impairment. The symptoms look a little more severe than just normal aging.
Is Alzheimer’s disease hereditary?
Like other neurological disorders, Alzheimer’s has a genetic component. However, researchers haven’t clearly linked the mild memory loss that occurs during midlife to genetics.
Can memory loss be prevented?
Memory is a complex concept. [It’s] really three abilities: learning new information, excluding irrelevant information and retrieving information.
That means that improving overall memory function involves many different aspects – such as focused attention and inhibitory function [the ability to block irrelevant information]. All may have different treatments.
Do Alzheimer’s dementia patients have trouble with focus and inhibitory function?
This is evident in some Alzheimer’s patients or elderly people. They might use the wrong word; you know what they mean, but the substitution is just so incorrect.
Can we protect our memory?
We think that increasing blood flow to the brain improves function, including memory. That’s the same concept as exercising to improve body’s function.
We also want to increase nutrients for our brain. These natural compounds contribute to brain energy and function.
Are you conducting Alzheimer’s dementia studies on supplements?
Yes. For example, we have four studies completed on the effectiveness of citicoline [a central nervous system stimulant] in improving brain metabolism and energy, and corollary benefits that help the brain focus and recall information. Study participants reported improved attention, mood and sleeping – just an overall sense of well-being.
Now, we’re looking more closely at the relationship between hormonal changes and brain function. This important area will emerge in years ahead.
Editor’s Note: Yurgelun-Todd’s studies are funded by Cognizin, a CDP-choline (or citicoline) supplement. She appears in promotional material for Cognizin.
Are your studies peer-reviewed?
Cognizin provided grants to support the studies. The work is then scientifically peer-reviewed by independent individuals who have nothing to do with the company.
Do other supplements, like omega-3s, protect the brain against Alzheimer’s dementia?
Omega-3s have an enormous impact on membrane permeability and brain function, as well as other parts of the body. It’s a very good brain and mood food.
Cell membranes need to let nutrients flow back and forth between the outsides and insides of cells. With a rigid membrane, it’s very difficult for nutrients to go back and forth.
A permeable membrane is softer, more Jello-like, so it’s easier for nutrients to go through. Omega-3 fatty acids make cell membranes change from rigid to permeable.
How do omega-3’s affect mood?
When nutrients get through to the [brain] cell, it changes the ability to make dopamine, one of the key neurotransmitters associated with mood.
Taking a supplement – one cleared by your doctor – can be an addition to whatever else you do to improve your health, such as exercising or doing mental exercises like crossword puzzles. It gives you the building blocks for brain energy.
Can mental stimulation improve brain function?
If you aren’t exercising regularly as you hit late middle age, you start feeling stiffer and less agile. The same thing happens within the brain. If you don’t use some of the mental abilities you have, you may have trouble using [them] down the road.
For example, people who use a calculator to balance their checkbooks often find it difficult to add and subtract by hand.
You want to keep your brain agile by exercising it.
Does our reliance on computers affect memory?
We’re going into an electronic age where capacities [will] be shifting. The brain [will] process multiple types of information very rapidly.
What are some other medical advances concerning Alzheimer’s dementia?
There have been tremendous strides in the last decade in the treatment of all brain diseases, including Alzheimer’s disease. And that’s partly because of advances in technology.
For example, now we can look at brain function at a cellular level while a person undergoes an MRI [magnetic resonance imaging]. Through imaging and treatment studies, we can diagnose brain diseases earlier and evaluate responses alongside brain function.
That has advanced our knowledge about how the brain changes and what we can do to reverse or improve it.
What would you say to family members who have a loved one with Alzheimer’s dementia?
Though I don’t treat Alzheimer’s disease patients, I recommend that families join a support group. Most hospitals and clinics have [them]. You can also find support groups online.
For more expert advice and information, visit our Alzheimer’s Health Center.
How Much Do You Know About Alzheimer’s?
More than 5 million Americans have Alzheimer’s disease, and that number could climb to 16 million by 2050. Women face a higher risk of developing it than men, and are also more likely to become caregivers.
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