By: McKenna Gazzier

A person’s ability to think, act, or speak is altered by Alzheimer’s disease, which causes loss of memory and other brain functions, leading to a steady decrease in a person’s ability to function in their daily life. While researchers across the world are working to better understand this disease, and, someday, develop a cure, it is important for people to recognize the early warning signs and know that there are treatment options. To share the latest information on Alzheimer’s disease, Memorial Hermann spoke to leading experts Dr. Paul E. Schulz, director of the UTHealth Neurosciences Neurocognitive Disorders Center and professor in the Department of Neurology at McGovern Medical School at UTHealth, as well as the director of the Dementia Program at the Mischer Neuroscience Institute at Memorial Hermann, and Dr. Nahid J. Rianon, MBBS, DrPH, assistant professor of geriatric medicine at McGovern Medical School at UTHealth.

Rianon, who has been a geriatric physician since 2010, said that patients struggling with this kind of dementia typically begin to see symptoms in people ranging from ages 55 to 80. In Alzheimer’s, when the brain ages, it begins to adopt self-harming tactics.

“There are genetic materials that make up the pathology in the brain,” said Rianon. “Alzheimer’s and other dementia-related illnesses are not a normal part of aging. In some patients, longtime high blood pressure and cholesterol can contribute to this kind of damage.”

Rianon explained that there are steps people can take if they are concerned that a loved one is showing early signs of the disease.

“There is no cure,” Rianon said.  “What we do to slow potential Alzheimer’s is early diagnosis, making sure patients can be seen by specialists, and keeping the patients active mentally and physically. Interaction with people is important for Alzheimer’s patients; when people are depressed and isolated, memory loss might worsen faster.”

Rianon suggested that loved ones try to be aware of family or friends who might experience symptoms of Alzheimer’s disease or dementia. To somebody who might not be able to take care of themselves, be an ally. Take older members of your family to the doctor, call them more often, and get involved.

“I think it is important to pay attention to patients’ hearing abilities, especially those with dementia or memory loss,” Rianon said.  “Make sure a hearing aid is available for those who need it, as it helps them to remain active with communication and with meaningful interaction that helps with brain health.”

 It is equally important to be aware of the toll the disease takes on caregivers.

“Caregivers often are known as the second patient or victim and they may become sick from caregivers’ stress,” Rianon said.

Dr. Paul E. Schulz, a physician for 37 years, has seen patients as early as their 40s who are beginning to display symptoms of Alzheimer’s disease. He said that the occurrence of the disease doubles every five years the longer one lives.

“At age 60, 1% of patients experience symptoms of Alzheimer’s,” said Schulz. “That is 1 out of 100 people. At 65, 2%; at 70, 4%, and so on.”

Physicians still are not sure what causes the disease.

“We have developed PET imaging tools to evaluate patients coming in with symptoms that can see plaques in the brain. We now know that we can see them up to 20 years before they come to see us,” said Schulz. “Only 1% of patients with Alzheimer’s involve their direct genetics; in the majority of cases, there is no specific etiologic factor to which we can point. However, we do know some risk factors, including high cholesterol, high blood pressure, diabetes, smoking, traumatic brain injury, and geography.”

Current research is also looking at a link to gut health. When looking at a person’s gastrointestinal system, more bacteria are found in the gut than in the entire body. Schulz said one theory is that specific bacteria could be having a direct effect on brain health by direct infection or releasing factors that cause brain inflammation.

“In addition, other risk factors may include things to which we are exposed during life, which cause ‘epigenetic’ alterations. These do not change our DNA directly, but instead, chemically modify it in ways that affect whether DNA is made into proteins. We hypothesize that these may be important for the majority of patients who develop Alzheimer’s disease,” said Schulz.

Schulz added that there are certain things people can do to reduce the risk of Alzheimer’s.

“Memory naturally gets worse with age,” Shulz said.  “However, studies of risk factors for dementia have revealed that you can reduce the risk of getting Alzheimer’s by about 20% to 80% by stopping smoking, wearing your seatbelt to prevent traumatic brain injury, and treating increased levels of cholesterol, triglycerides [blood fats], sugar, and blood pressure. Physical and mental exercise also lower the risk for developing Alzheimer’s disease.”

Offering some hope, Schulz said one medication has just been approved by the U.S. Food and Drug Administration (FDA) called aducanumab. Another drug, donanemab was given a fast-track approval by the FDA. While they do not cure Alzheimer’s, they appear to have a positive effect and are offering experts hope that we are getting closer to controlling this terrible disease.

“Memorial Hermann bought this drug and donated it to our dementia program so that we could give it to an Alzheimer’s patient recently,” Schulz said. “We are very hopeful that it will help the course of his disease. We are chipping away at Alzheimer’s disease one step at a time. Although it may not be the cure, we are absolutely on the right track to having significant treatments for this disease in our lifetime.”