What is truly interesting is that research into Alzheimer's disease has changed dramatically in recent years. After listening to a very interesting conversation between Peter Attia and memory neurologist Dr Gayatri Devi, a few insights stand out.
1. We have entered a new era
Just a few years ago, we could essentially only confirm that someone had Alzheimer's disease. Today there are treatments that can actually influence the course of the disease, and diagnostics have become considerably more advanced.
2. Alzheimer's is not one disease, but a spectrum
Two people with the same diagnosis can have completely different symptoms, different rates of disease progression and different treatment needs. That is why individualised diagnostics and treatment are becoming increasingly important.
3. The disease develops over several decades
Memory problems are often the end station, not the beginning. Changes in the brain can start 20 to 30 years before the first symptoms appear. The earlier risks are identified, the greater the possibility of influencing the trajectory through lifestyle and, for some patients, medication.
4. For the first time, there are examples that give real hope
Dr Devi describes how, in recent years, she has seen several patients respond far better to treatment than she previously thought possible. In some cases she has seen both clinical improvements and changes in biomarkers such as amyloid and tau that have given grounds for great optimism. She is careful to stress that these are her own clinical experiences, not a promise of how all patients will respond.
5. "I forgot where I put the car keys... am I getting Alzheimer's?"
It is a question Dr Gayatri Devi hears almost every week. Her first message is perhaps also the most reassuring: our brain is built to forget.
According to Dr Devi, we would not be able to function if the brain stored every name, every conversation and every small detail we encounter in a day. Occasionally forgetting is therefore usually a sign of a normally functioning brain, not of Alzheimer's disease.
Perhaps the most important message is this: Alzheimer's is no longer a disease where we simply wait for the symptoms to arrive. The focus is shifting towards early detection, individualised treatment and prevention.
Source: #399, The evolution of Alzheimer's disease and dementia care: how early detection, personalized treatment, new therapies, and a multimodal approach are changing the landscape, Gayatri Devi, M.D., The Peter Attia Drive.
