Everyone commented what a great talk it was. Not a single boring moment, tho some of it was definitely over my head.
People asked very intelligent questions. I was really curious to know how Dave got into the study of Alzheimer's.
"I just sort of stumbled on it," he said.
His undergrad degree at Franklin and Marshall in biology pretty much meant you were going to study medicine, which he did. He knew from Day One he wanted to be a neurologist as he really liked the brain.
You're really beaten down as a resident, he said, seeing all these horrific cases at the VA.... stroke, Parkinson's, and Alzheimers, which he said is a disease worth fighting for.
One reason it's tough to study is bc it's so slow-moving. Takes many years to develop and alter your thinking and behavior.
Newt Gingrich, former Congressman from GA, ramped up funding for Alz. Dave also had a couple of mentors who deepened his understanding of the disease.
Dementia is a broad term for many different memory loss conditions. Alzheimer's is under this umbrella.
Dave has been researching monoclonal antibodies for 12 years. He's had wonderful mentors, he said, one of whom should have won a "Nobel Prize" for his research.
In 1997, a Nobel was given to Stanley Prosiner for his work in categorizing various neurological diseases.
There are TWO types of drugs that are being developed.
Aricept has been on the market since 2010.
It improves the function of
nerve cells in the brain. It works by preventing the breakdown of a
chemical called acetylcholine (ah SEET il KOE leen). People with
dementia usually have lower levels of this chemical, which is important
for the processes of memory, thinking, and reasoning.
Aricept is used to mild to moderate dementia caused by Alzheimer's disease.
No drug has been found to reverse Alz though the audience clamored to know when one might be expected.
He talked about the HIV epidemic starting around 1985. People felt hopeless about finding a treatment for it. And then, about 10 years later, smart people with PhDs who worked for drug companies began to "bend the curve" - find effective treatments - at first taking huge cocktails of drugs, but now not so many.
After all, he said, "Magic Johnson" is still alive.
I was glad to hear him talk about quackery. Jellyfish which is sposed to help is useless. One well-known product was just found useless by the FDA and will have to pay huge sums for fooling the public..
He mentioned the many "quack" commercials on late nite television. Dr Oz, he said, ought to be locked up. I asked about Dr Amen. Another quack, he said. Dave agreed that all those medical claimers of miracles on PBS were useless.
I mentioned that when my dad was dying of cancer when he was 58 laetrile or apricot pits were popular for cancer patients. Dave had never heard of laetrile. "A person is desperate," I said "and would do anything to save their loved one."
Dave mentioned the fad quack drug Gingko Biloba everyone was taking years ago.
1864-1915 (dead at age 51 of heart failure)
The neurologist / pathologist Alois Alzheimer was the first person to document Alz disease. He studied a German woman named Auguste Deter, who, at 51, suffered from progressive short-term memory loss.
He was eventually able to isolate
the pathological causes of severe dementia, work so extensive that the
condition became known as Alzheimer's disease.
He wrote up an extensive case history of her. She became totally "amnestic."
You are not born with Alz disease, said Dr Dave, but you have the genes to acquire it. Just bc you have the genes does not mean you'll get it.
It depends on PROTEINS in the brain.
Dr Alzheimer - who also worked with the famous Emil Kraepelin, an early pioneer in psychiatry - thoroughly documented the "big puffy collections of ameloids - proteins."
Amazingly, the disease was then totally FORGOTTEN, until it resurfaced among older people in their 80s or 90s.
Neurocells are responsible for language skills, visual, consciousness, memory. Proteins "gum up" the works. They are all over the brain and are transported around, altho there are also antibodies against them.
Nature is so cruel, he said. Auguste Dieter got the diz at 54, but Dr Dave has seen a 42-yo patient, so befuddled they didn't know who they were any more.
In Iceland, Alz disease is unknown. Why?
The [bad] ameloid proteins increase as we age. This begins around age 40. Everyone who has this "pathologic protein" will get Alz disease. The amount doubles every five years.
At age 60, it's one percent.
At age 70, it's two percent.
After age 85, half of everyone with the protein gets the disease.
Aaron Copland, American composer.
Says Dr Dave, It's as costly and horrific as fighting The Iraq War.
In Japan, he said, there's a "gray tsunami of Alzheimers."
When the brain cells start dying they release a neurotoxin. Again, we think we can get rid of it when we can duplicate the Icelandic protein that inhibits the disease.
Parkinson's diz, he said, releases a different toxic protein.
This sculpture on the Penn campus was done by Robinson Fredenthal, who died from complications of Parkinson's diz at age 69.
"He had lived since 2003 at Inglis House, the West Philadelphia home for people with severe disabilities."
This brings up the point of Where does a person with Alz disease live? This question was brought up by audience members.
Every family must decide. At a good facility, said a fam member, the cost may be as much as $6,000 per month.
About twice a month, I mail a postcard to my friend Lillian, age 106, who lives in a beautiful facility.
She reads the postcard easily, but doesn't understand the meaning. As her daughter told me, her body is shutting down.
Some cultures keep their loved ones "home forever," said Dave.
The behavior of the Alz patient changes so they might be socially inappropriate, childishly upset, throw tantrums, engage in nocturnal behavior, make racist statements.
This is NOT because of underlying or unconscious beliefs. It's just how the disease manifests itself.
This was a very important point he made.
An audience member asked if it's a good idea to 'correct' the person.
Why? said Dave. It will do no good. You want to have as easy a relationship as possible.
There's no particular order of what parts of the mind will go first. A person may not be able to talk but they can play golf.
Famous story of Phineas Gage, a normal guy at a construction site, crippled for life after an accident.
In the country of Colombia, in a small rural village, Alz disease is rampant. Drug trials are under way.
Human beings, said Dave, are endlessly clever, so there is indeed hope for better treatments.
Prevention - A heart-healthy diet, do not develop diabetes, exercise.
See the cheese? Dave said he takes a cholesterol medication, as do I. If you take meds, that means you visit your doctor. There's a bit of controversy about statins increasing the chance of getting Alz, but the risk is worth it.
Indian doctors - and there are many of them - prescribe turmeric as a preventive measure against Alz.
He also discussed football and what it does to your brain. It's not just the concussions, it's the continual ramming of your head. Once isn't too bad but during a game it happens dozens of times, exposing your brain to a different type of memory loss and the condition of CTE.
An 18-yo shot himself in the chest so his brain could be studied.
There is so much more to talk about, but I've discussed the main points here.
Afterward I met downstairs with my friends
Again, one of the best talks. I told him this and said he's performing a wonderful service for us all.
As always, I wanted to buy myself a treat. All the booths were closed except the deli which would close in two minutes.