On a Mission to Prevent Alzheimer's Disease

Life expectancy rates have been rising for decades. But living longer also means an increased risk of developing Alzheimer's disease. From 1999 to 2014, the age-adjusted death rate from Alzheimer's in the U.S. jumped 54.5 percent, according to the Centers for Disease Control and Prevention.

Neuroscientist James Galvin, M.D., associate dean for clinical research in the College of Medicine and an expert in degenerative brain disorders, says that 42 percent of people who live until age 85 will develop Alzheimer's disease.

And unlike cancer or heart disease, no one survives Alzheimer's.

"Diseases like Alzheimer's or Parkinson's lead to degeneration of the brain. When the brain stops working, the body stops working," Galvin said, since the brain controls every bodily function.

"However, the opposite may also be true. If your body's health is not optimal, then your brain doesn't work," he said.

For that reason, Alzheimer's disease may be preventable. "Over 30% of the risk of Alzheimer's disease may be explained by reversable or treatable conditions such as obesity, physical activity, social engagement, disturbed sleep, diabetes, high blood pressure and lipid profiles," Galvin said.

A $1 million grant from The Harry T. Mangurian, Jr. Foundation has helped Galvin launch the Dementia Prevention Initiative in the Comprehensive Center for Brain Health at the college.

The initiative's goal is to create a tailored, personalized prevention plan based on a patient's specific risk factor for Alzheimer's disease and related disorders.

Galvin says this type of precision medicine has been widely successful in cancer research, and "we now want to extend these principles to attacking Alzheimer's disease."

The grant will fund extensive clinical assessments for 75 participants, including blood work, strength testing, an EEG, memory tests, MRIs, spinal taps and PET scans.

"If there are multiple ways to get Alzheimer's disease, there may be multiple ways to treat Alzheimer's disease."
— James Galvin, M.D., M.P.H.

Participants must agree to follow the individual protocol developed by a team of experts which includes: a neurologist, gerontologist, social worker, physical therapist, nurses, public health specialists and researchers.

The team will evaluate both common known risk factors — tobacco use, diabetes, obesity, sleep apnea and physical inactivity, for example — as well as genetics and biomarkers.

A thorough eye exam is key, since retina tissue is identical, developmentally, to brain tissue, and the blood vessels that penetrate the retina are same ones that penetrate brain, according to Galvin.

"We can't look directly at the brain, but we can look directly at the retina," he said.

But while an eye doctor may do the same tests, how the data is analyzed is quite different.

"An ophthalmologist will look for the risk of glaucoma, but we're looking for a progressive decline in retinal thickness that may also represent a change in the brain in terms of loss of neurons," said Galvin, who notes that thinning of retinal nerve fibers, a sign of glaucoma, may also indicate an increased risk for Alzheimer's.

"People with sensory deficits — hearing or vision loss — seem to have a higher risk of developing the disease," he said.

Galvin's team will follow patients to see if the intervention plans reduce the risk.

"We know a lot about (Alzheimer's) once it's already there, but we don't know how it got there," he said. "People develop pathology (brain changes) decades before clinical symptoms, but not everybody will develop symptoms. Our research hopes to develop a personalized plan to build a better brain as we age."