As a biologist, choosing a career in healthcare was an easy decision for me. However, I haven’t always worked in the field of memory loss or Alzheimer’s disease. In fact, I spent 5 years of my healthcare career working on diabetes, before I switched my focus to brain health. It may seem like quite a leap from the pancreas to the brain, but the longer I work on cognitive health, the more I see the same story emerge that we’ve seen in the last ten years with diabetes.
Type 2 diabetes in 2009
In 2009, 79 million people in the US were at risk of diabetes. Employers’ healthcare costs were skyrocketing, and diabetes was either the number one or number two cost driver for most employers. There were no drugs approved to prevent the disease, the American Diabetes Association didn’t support prevention, and physicians did not want to tell their patients they were prediabetic because they believed there was nothing they could do. This was despite the publication of a large landmark study called the Diabetes Prevention Program, which showed the world that people’s risk of getting diabetes can be reduced by 58% through diet and exercise changes.
I joined a diabetes company in 2009 whose mission was to prevent the disease. They had developed an innovative blood test that could detect a patient’s risk of developing diabetes within the next five years. But because most people didn’t believe diabetes could be prevented, they didn’t want to know they were at risk. The exceptions were a few early adopters who challenged perceived wisdom. One of my favorites was a doctor named Dr. Abouassaly. He created his own diabetes prevention program that included a text at lunch to ensure you weren’t eating french fries! He would meet his patients at the gym every day, and he had “Dr. A” approved meals at the local restaurants so people would know which of the healthy options to choose. He was ahead of his time, but he could only serve a small community in Iowa. Our challenge was getting our test and programs like his to the masses.
Where are we now?
Fast forward eight years and I see diabetes prevention ads sponsored by pharma on the sides of buses. Last year the first national public service campaign was launched to tell the nation that diabetes is preventable, and in the USA diabetes prevention programs are reimbursed by Medicare. Writing in 2017, it’s hard to remember a world where people didn’t believe that diabetes was preventable. Doctors now identify those who are prediabetic because they know that lifestyle changes can effectively be implemented and delay or prevent diabetes altogether.
What does this have to do with Alzheimer’s disease?
A “silver tsunami” is coming: there are now 100 million people in the US over the age of 50 and we know that cognitive decline and the future of Medicare are their top two concerns. The wave of Americans living longer, particularly with Alzheimer’s disease, is going to bankrupt Medicare. While the statistics are shocking, as anyone who has cared for a loved one with Alzheimer’s disease knows, the realities of losing your cognitive health are unbearably painful. Diabetes sufferers are at risk of losing toes and even their eyesight, but those with Alzheimer’s will lose their memories, their most precious asset.
Like diabetes in 2009, there are no drugs approved to prevent Alzheimer’s disease. Pharma is spending billions of dollars on research but the results of recent trials have been disappointing. In the same way no one believed that diabetes could be prevented, very few people believe that Alzheimer’s disease can be either. This is despite a strong and growing body of scientific evidence, which shows that many cases can be slowed, if not prevented entirely. A recent study from the UK showed that 1 in 3 cases worldwide could be prevented with lifestyle changes.
If we look deeper at the evidence, the parallels between these two diseases continue to emerge. The Diabetes Prevention Program was the inspiration for the FINGER Study. The FINGER Study was one of the landmark studies that showed you can improve your ability to pay attention and problem solve (executive function) by 53% and your ability to process information by 150% through diet, exercise, cognitive training, and vascular risk monitoring. Another landmark study, the MIND diet, showed that by eating brain healthy foods like nuts, berries and fish, you can reduce your risk of developing Alzheimer’s by as much as 53%. What I love about the MIND diet is that it’s not about counting calories and losing weight; it’s about adding brain healthy foods to your diet and reducing the foods that increase your risk of memory loss.
That’s why I’m so passionate about the work that I’m doing at Neurotrack. We have a cognitive assessment that can measure the health of your brain and if you get a “below expectations” score, we encourage you to create a personalized Cognitive Health Program, based on the science of the studies above. We’re giving people the tools they need to take charge of their brain health.
Alzheimer’s disease in 2022
I desperately hope that in five years’ time pharma will have a drug approved to prevent Alzheimer’s disease. If that doesn’t happen, I strongly believe that in 2022 the idea that Alzheimer’s is preventable will be widespread. Early diagnosis of Alzheimer’s will no longer be a taboo but the gold standard of medicine, and physicians will prescribe lifestyle changes for cognitive decline the same way they do for prediabetes. Tests to detect Alzheimer’s risk will be championed by the Alzheimer’s Association and prevention programs will be reimbursed by Medicare. Best of all, fewer people will receive a diagnosis of Alzheimer’s disease.