A free teleconference series offered by UsAgainstAlzheimer's Network covering a wide range of topics with leaders in the Alzheimer's community.
Dr. Jeffrey Iliff spoke with George Vradenburg for the August Alzheimer’s Talks. Dr. Iliff is an Assistant Professor in the Department of Anesthesiology and Perioperative Medicine at Oregon Health & Science University and he was part of a team that discovered a critical brain-cleansing system. During this discussion he outlined his research on how sleep helps clear waste from the brain and how sleep and neurodegenerative diseases like Alzheimer’s might be connected. We also discussed useful tips that we can all use to improve our sleep and brain health.
A few key highlights:
We need good sleep to clean out our brains.
While you’re sleeping, your brain is very active, cycling through REM sleep and slow-wave sleep. One of the critical activities during sleep is processing memories – converting short-term memories to long-term memory storage. During slow-wave sleep, the glymphatic system in the brain is also sweeping out the debris that accumulates through the course of the day.
Poor sleeping appears to be linked to Alzheimer’s.
Dr. Iliff says there is a clear association between sleep disruption and the development of Alzheimer’s pathology. Also, this glymphatic system appears to slow with age. In the future, imaging techniques may help scientists measure the cleaning function to better understand how it works and see if it can be modified.
It could be a vicious cycle.
Having Alzheimer’s could disrupt the parts of the brain that control sleep, and lead to poor sleeping cycles. But, poor sleep could prevent brain cleaning and contribute to the development of Alzheimer’s. Scientists need more research to determine which way the association runs, or if it runs both ways.
Tips for better sleep!
Sleep, like cardiovascular health, may be one of the things you can control, to possibly reduce your risk of developing Alzheimer’s. Dr. Iliff shared some recommendations to get quality sleep. Go to bed and wake up at the same time every day, maintain a quiet sleep environment, and “unplug” from screens at least an hour before bed.
Thank you to Dr. Iliff for describing his research and answering questions. If you missed the talk – or if you’d like to hear it again – you can listen to an audio playback or read the transcript of our conversation. Dr. Iliff answered a lot of interesting questions during the discussion, including whether naps count, and the impact of sleep medication.
And if you missed the live tweets, check out the discussion of this call on Storify!
Dr. Robert Rissman was our guest for the July Alzheimer’s Talks where he spoke about his research on the relationship between chronic stress and Alzheimer’s disease and his work to develop a biomarker for Alzheimer’s and prevent cognitive decline.
Dr. Rissman is Associate Professor of Neurosciences at the University of California San Diego School of Medicine, Biomarker Core Director for the Alzheimer’s Disease Cooperative Study at UCSD, and neuropathology core director for the Shiley-Marcos Alzheimer’s disease research center.
A few key highlights:
Animal models show stress plays an important role in development of Alzheimer’s.
Dr. Rissman’s work looks at how the brains of mice change during stress and how there could be changes in Alzheimer’s related pathways after stress.
They found that emotional stressors relate directly to changes in a protein in the brain, called tau that is central to the development of Alzheimer’s disease. His team also identified a peptide in the brain, called corticotropin releasing factor (CRF), which plays an important role in regulating those tau changes. Specifically, there is one type of a CRF receptor that regulates a stress-induced increase in tau.
Research leads to development of potential drugs to stop Alzheimer’s
Dr. Rissman’s work in mice shows that drugs that impact the CRF system could be used to prevent or delay the onset of Alzheimer’s disease by preventing neurofibrillary tangles. By giving the drug for five months, before the mice developed full-blown pathology, he was able to prevent the cognitive decline and greatly reduce the levels of beta amyloid plaque, though more research is needed.
Stress comes in many forms
Stress can be from external or internal sources. Having Alzheimer’s disease is an example of an internal, physiological condition that puts stress on the brain and leads to cellular change. External stress, especially chronic, long-term stress, can also induce changes in the brain and may make you more susceptible to developing Alzheimer’s.
Biomarkers in our future
In a just released separate study Dr. Rissman is looking for novel biomarkers of Alzheimer’s disease. He identified microvesicles, which could predict what individuals transitioned from mild cognitive impairment to Alzheimer’s disease - which could lead to the development of a blood test for Alzheimer’s disease.
Thank you to Dr. Rissman for describing his research and answering questions. If you missed the talk – or if you’d like to hear it again – you can listen to an audio playback or read the transcript for all the details of our conversation on stress and Alzheimer’s disease.
And check out the discussion Storified!
I hope that you can join us next month on Tuesday, August 16th from 4 – 5pm Eastern with Dr. Jeffrey Iliff who will discuss his groundbreaking research on the connection between sleep and Alzheimer’s disease. Click here to register.
Dr. Eric Reiman, the Executive Director at Banner Alzheimer’s Institute, joined this Alzheimer’s Talks to discuss his research to prevent Alzheimer’s disease, including two clinical trials that the Alzheimer’s Prevention Initiative has underway and the need to recruit more people into clinical trials to speed these efforts.
Key highlights from the call:
Exciting research to prevent Alzheimer’s
The Alzheimer’s Prevention Initiative has begun two five-year trials in individuals who are cognitively well but are at the highest risk for developing Alzheimer’s symptoms.
One, in Colombia they are tracking the world’s largest extended family with early onset autosomal dominant Alzheimer’s disease, with a rare “misspelling” of a gene that makes it a certainty that they will develop Alzheimer’s at an average age of 44. The other trial involves older adults between 60 and 75 years old who have two copies of APOE-4 that put them at very high risk of developing Alzheimer’s disease.
Speeding the search for a treatment
One of the field’s greatest challenges, according to Dr. Reiman, is getting prevention therapies tested, approved, and to market in a timely fashion, given the slow progression of the disease. By studying people who are at extremely high risk, or are destined to develop Alzheimer’s disease based on their genetic history trials may provide results more rapidly and also teach us how biomarkers behave. He is now suggesting doing 2-year prevention studies in a wider population while waiting for data from the longer studies.
Collaboration and data sharing with other scientists is pushing research forward at new rates. Dr. Reiman is hopeful that one of the therapies being studied today will result in an effective prevention treatment by 2025.
What can you do?
Dr. Reiman recommended adopting a heart healthy lifestyle, including diet and exercise, that might help delay the onset of symptoms. Other recommendations to reduce risk include control diabetes, treat high blood pressure and high cholesterol, stop smoking, and engage in socially and intellectually stimulating activities.
One of the most important things you can do is to register with the Alzheimer’s Prevention Registry for the latest information in prevention research and for more information on Alzheimer’s studies. Please sign up today, it will take less than a minute.
Thank you to Dr. Reiman for describing his research and answering questions. If you missed the talk – or if you’d like to hear it again – you can listen to an audio playback or read the transcript of our conversation.
The API Generation Study that Dr. Reiman discussed is now recruiting individuals at high risk for Alzheimer’s disease. The study is looking for participants between the ages of 60 and 75, with no cognitive impairment, who may be at particularly high risk for developing Alzheimer’s disease because of their genetic background. The study is investigating whether two investigational anti-amyloid compounds can prevent or delay the emergence of symptoms of Alzheimer’s in these high-risk individuals.
Journalist, radio talk show host, and author Diane Rehm spoke with George Vradenburg on this Alzheimer’s Talks about her new book, On My Own, which is a deeply personal, profoundly moving, and incredibly honest book about her life before and after her husband’s death with Parkinson’s disease.
Key highlights from the call:
It is important to discuss end-of-life wishes.
Diane had discussed end of life wishes with her husband, John, throughout their marriage. John Rehm’s parents both took their own lives after dealing with pain and illness. Death was “simply part of the conversation,” she said, and the whole family knew that death with dignity was what John Rehm had always wanted for himself.
She was frustrated when John decided he could no longer care for himself and was ready to die, that the only thing he could do was to stop eating, drinking, and taking medication, which lasted ten days.
She believes that choice at the end of life is perhaps the most important.
“I believe in choice,” said Rehm, “and choice at the end of life is equally as important to me as any other choice in my life, perhaps the most important choice.” She would like people to be supported in whatever choice a person makes, whether it is palliative care, medical treatment, or ending your life, as long as a person has the right to make his or her own choice. We also discussed the challenges with choice when someone has Alzheimer’s.
Diane Rehm will be leaving NPR at the end of the year. She believes that John’s death has given her a final gift – the impetus to carry on life in a new and vital way. She talked about her commitment to speaking out about her own experiences, her belief in the importance of choice at the end of life, and also her desire to continuing her work with UsAgainstAlzheimer’s – including appearing in readings of Trish Vradenburg’s play, Surviving Grace.
Thank you to Diane Rehm for sharing her story and speaking candidly about her experiences. Make sure to pick up a copy of her new book, and if you missed the talk – or if you’d like to hear it again – you can listen to an audio playback or read the transcript of our conversation.
We look forward to having you join the next Alzheimer’s Talks on Monday, June 13, 2016, at 4 p.m. Eastern with Dr. Eric Reiman, the Executive Director at Banner Alzheimer’s Institute, who will discuss two important trials currently underway. Click here to register.
A new analysis released by ResearchersAgainstAlzheimer’s shows that 17 new Alzheimer’s drugs could be on the market within the next five years. Drew Holzapfel, Director of ResearchersAgainstAlzheimer’s, and Dr. David Morgan, CEO of the Byrd Alzheimer’s Institute and founding member of ResearchersAgainstAlzheimer’s joined us for this month’s Alzheimer’s Talks to discuss the study, ‘Will the Next Five Years Witness an Innovation Wave in Medicines for Alzheimer’s?”
Key highlights from the call:
Hope is on the horizon.
A first-of-its-kind analysis of Phase 3 clinical trials (the final stage of drug development) shows that 17 Alzheimer’s drugs could be on the market within the next five years. No new Alzheimer’s drug has been introduced since 2003, so we are cautiously optimistic for the future.
Our health care system needs to be prepared.
With new drugs will come new requirements: doctors need to better recognize and diagnose Alzheimer’s. We’ll need more trained physicians and the infrastructure to diagnose the disease and to administer new medicines.
Access and advocacy are crucial.
Ensuring broad access to new medications will require making them affordable through innovation as well as changes to Medicare and other health payment systems. It is also important to continue to advocate for increased research funding to accelerate the search for a cure.
Thank you to Dr. David Morgan and Drew Holzapfel for summarizing this analysis and answering questions. If you missed the talk – or if you’d like to hear it again – you can listen to an audio playback or read the transcript of our conversation.