Dr. Nazneen Dewji is an Associate Professor of Medicine and a researcher at the University of California, San Diego working on a cure for Alzheimer's. She talks with us here about the progress her team has made towards finding a cure, as well as some of the issues that those with Alzheimer's - and those caring for them - currently face.
Why have you focused your research on Alzheimer’s?
My post-doctoral work was on neurological disorders in children. In 1986, when I joined the faculty at UCSD, people were just starting to think about aging. Alzheimer’s really interested me – it is a neurological disorder, which was my background, but one of aging – and it is a huge problem. One in 10 people over the age of 65 gets Alzheimer’s, and the incidence increases logarithmically with age. If you live to be 90, the incidence is one in two. By 2050, 75 million people in this country alone will be over the age of 65, and half of those, over 85. You can do the math.
Are there any promising leads for finding a cure?
Currently, there are no disease-modifying drugs available. The drugs available offer very mild symptomatic relief for a short time. But since I started researching Alzheimer’s, there’s been tremendous progress in finding out what the toxic species is – and the mechanism that produces it. ß-amyloid, or “Aß,” is widely accepted to be the major toxic species that causes Alzheimer’s disease.
In my own lab, we’ve spent at least a dozen years trying to find out what the mechanism is that produces Aß. Once we did that, we wanted to find out how we could interfere with this mechanism so that we could inhibit the production of Aß. So at this point, we have a couple of potential drug candidates that can stop the very production of the toxic species in an animal model of Alzheimer’s disease. These are now being developed as disease-modifying drugs for Alzheimer’s, and will hopefully fill this terrible unmet need.
How can we know if someone we love is experiencing the initial stages of Alzheimer’s?
There isn’t a definitive diagnostic test – that can only be done post-mortem – but neurologists can do a battery of tests whereby they can tell you – pretty conclusively -- whether you have Alzheimer’s or not.
The early signs of Alzheimer’s include personality changes and/or rapidly worsening short-term memory -- not just normal forgetfulness. This is rapidly worsening memory. The hippocampus, which is involved in memory, is one of the first regions in the brain to be affected, hence the memory loss. Another cue is disorientation, as is decreased comprehension. All of these symptoms together certainly warrant a visit to the neurologist.
What’s most important to caring for someone with Alzheimer’s?
It is important to get professional help, both for the patient and the caregiver – this disease is just as hard on the caregiver as it is on the patient.
There is actually a lot of help available – and a lot of information out there. I’d suggest visiting the Alzheimer’s Association website to find resources and ideas. There are also a number of Alzheimer’s daycare centers now available. They offer activities that Alzheimer’s patients can enjoy, often centered around music or art. Alzheimer’s patients retain their ability to enjoy music and art for quite some time after the onset of the disease, while those areas of the brain involved in such activities are still not affected.
Early in the disease, there is a time when the patient knows there’s something wrong – at which point the patients may experience depression because they know something’s not right – but after a while, they pretty much live in the moment – so with such activities, it isn’t impossible to keep those with Alzheimer’s relatively happy.
Do you have any prevention tips?
The biggest tip is to keep moving. Exercise is good both for the body and the brain. It increases neurogenesis [the process by which neurons are created] and oxygenation. Don’t smoke, and only consume small amounts of alcohol. Follow a low-cholesterol, balanced diet. And use your brain. As they say, Use it or lose it. Keep your brain functional. They’ve shown people with more education keep Alzheimer’s at bay longer. But exercise is definitely most important because it effects so many different reactions in the brain.
Anything else we should know?
Once you know that someone has Alzheimer’s, it’s a good idea to take care of their legal issues. What they need, would like, want -- while they can still make those decisions. Until we have something – like the drug my lab is exploring – that will hopefully arrest the disease where it is – we need to think ahead, because Alzheimer’s disease is progressive, and with time the patient will decline.
Dr. Nazneen Dewji is an Associate Professor of Medicine at the University of California, San Diego. Dr. Dewji was born in Tanzania and raised in England. She was educated at the University of London, where she earned her B.Sc. (Hons.) in Biochemistry and her Ph.D. in Protein Chemistry and Enzymology. In 1986 Dr. Dewji accepted a faculty position in the department of Medicine at UCSD. She has worked on the molecular and cellular mechanisms in Alzheimer's disease since 1986.
For more on Alzheimer's and The Shriver Report: A Woman's Nation Takes on Alzheimer's, visit, www.shriverreport.com