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CNN Live Event/Special
The Last Alzheimer's Patient. Aired 8-9p ET
Aired July 07, 2024 - 20:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[20:00:00]
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Lifestyle changes. We've seen what they can do for heart disease, we're now getting an idea of what these lifestyle changes can do for brain disease as well, such as Alzheimer's, and about 40 percent probably of Alzheimer's cases, according to these big trials around the world, 40 percent is preventable. These are big numbers worth paying attention to. And that's why we're so excited about this documentary -- Pamela.
PAMELA BROWN, CNN HOST: Yes, I can't wait to watch it. Dr. Sanjay Gupta, thanks so much. "THE LAST ALZHEIMER'S PATIENT" airs next on CNN.
And thank you so much for joining us tonight. I'm Pamela Brown. I hope you have a wonderful rest of the evening.
BRIANNA KEILAR, CNN ANCHOR: A new report shows Alzheimer's disease is a growing problem. The number of patients is expected to double by the year 2050.
DON LEMON, FORMER CNN ANCHOR: Alzheimer's affects 55 million people globally.
MARIA SHRIVER, FOUNDER, THE WOMEN'S ALZHEIMER'S MOVEMENT: Two thirds of those living with Alzheimer's are women.
JACQUELINE HOWARD, CNN HEALTH CORRESPONDENT: Alzheimer's and other types of dementia will cost the United States about $345 billion this year.
GUPTA (voice-over): Alzheimer's disease. For far too long there's been too little good news.
LEMON: The results from a study of an experimental treatment shows that it failed.
UNIDENTIFIED FEMALE: Clinical trials showed it didn't significantly improve brain function and memory.
DR. RICHARD ISAACSON, PREVENTIVE NEUROLOGIST IND. ORG: 99 point something percent of Alzheimer's drugs fail.
POPPY HARLOW, CNN ANCHOR: Why is it so hard to find an effective treatment for Alzheimer's?
GUPTA: But over the last five years, I've been investigating breakthroughs. And now, finally, a bit of hope.
DR. MARIA CARRILLO, ALZHEIMER'S ASSOCIATION CHIEF SCIENCE OFFICER: This is an absolutely transformational moment.
ISAACSON: Nowadays, we have multiple FDA approved.
DR. DEAN ORNISH, PREVENTIVE MEDICINE RESEARCH INSTITUTE: Our genes are pre-dispositioned. Our genes are not our fate.
ISAACSON: Four of every 10 cases of dementia may be preventable.
CARRILLO: We must be able to slow or stop this disease now.
CICI ZERBE, ALZHEIMER'S PATIENT: I could use a strong cup of coffee.
GUPTA: This is Cici Zerbe and her husband John back in 2019.
C. ZERBE: Will you come see Grandma?
GUPTA: Cici is best described as the matriarch of a huge, tight-knit family. Over her 80 years on earth, she has created a rich life filled with love and lasting memories.
C. ZERBE: Oh, my goodness.
GUPTA: But in early 2018, her family began to notice something had changed.
JOHN ZERBE, CICI'S HUSBAND: She would forget things, couldn't remember what we were supposed to be doing, and it slowly got worse until she would repeat herself about three times.
FRANNY DEFATTE, CICI'S DAUGHTER: At first she didn't believe us that she had it, you know, no, that's no big deal. I just repeat myself once in a while. Who cares?
C. ZERBE: John, being the kindest husband in the world, he said, Cici, yes, you do, you do repeat yourself a lot. But there's something more, too. He said let's just, you know, let's go see a doctor.
GUPTA: A neurologist diagnosed Cici with mild cognitive impairment and dementia due to Alzheimer's, and scans soon confirmed the worst. Her brain showed signs of the disease. Now Cici was no stranger to Alzheimer's. She had had loved ones she watched wither away slowly from it.
C. ZERBE: My grandmother, she would sit forever and just twiddle her dress, and stare into space and wouldn't talk too much.
J. ZERBE: Her mother they finally put her in a home because her father couldn't take care of her. My greatest fears were that she would end up like her mother and grandmother, where I couldn't take care of her.
DANIELLE ALLEN, CICI'S GRANDDAUGHTER: It was a hard word to hear, Alzheimer's. It hit really deep. You know, you don't want to lose your grandma. [20:05:01]
DEFATTE: The worst part was seeing my mom being uncomfortable going to parties and not feed herself. And the person that we love and not be confident in herself like she always has been.
GUPTA: When the doctor told you and you got your cognitive testing, how did they tell you?
C. ZERBE: Well, I had an office visit to get all the results of the tests and he said, well, there is a memory problem but I have the best place for you. And that was here in Sausalito.
GUPTA (voice-over): And that's where I first met Cici and John five years ago.
I've made my way to Sausalito, California. I'm going to spend time here with this world renown doctor who believes he's figured out a way not just to prevent Alzheimer's but to reverse it.
ORNISH: When people get diagnosed with Alzheimer's, it's a progressively isolating experience.
GUPTA (voice-over): In 1990, Dr. Dean Ornish changed the medical world with his groundbreaking work on heart disease. His randomized clinical trial was the first to show that coronary heart disease could be reversed with nothing more than stress reduction, social support, diet, and exercise.
ORNISH: Part of the value of science is to increase awareness.
GUPTA: While Ornish's approach has sometimes been criticized for being too strict, not practical enough, some others have pointed out a lack of research showing that plant-based diets could definitively decrease disease. But Ornish turns to his decades of work as proof.
ORNISH: You really can eat more and weigh less if you know what to eat.
GUPTA: That what is good for the heart is almost certainly good for the brain.
ORNISH: The same lifestyle changes could reverse high blood pressure, high cholesterol, type two diabetes, obesity, early stage prostate cancer can be slowed, stopped, even reversed. And now we're hoping to show that these same lifestyle changes may reverse the progression of early stage Alzheimer's.
GUPTA: Five years ago in the early stages of the study.
Do you remember what you're experiencing before your diagnosis?
UNIDENTIFIED MALE: I couldn't formulate words.
GUPTA (voice-over): I spent some time with patients and their support partners for their four-hour long, three-day-a-week meetings. And I got a really detailed look at the Ornish Lifestyle Intervention Program. The exercise, the yoga, and the meditation regimen. Sitting in on their support groups and eating the provided plant-based meals.
What do you tell the participants in the trial?
ORNISH: Well, we tell them that we don't know if this is going to work, but we hope that it does. If you're trying to give people the message that you can reverse something then you need to have really solid science from randomized trials before doing that.
GUPTA (voice-over): It all matters preserving, even restoring the memories of a life well-lived.
C. ZERBE: That no matter what happens if I don't get better just know that somewhere deep down outside my brain, I will always love him.
GUPTA: Now, again, that meeting in Sausalito was five years ago. Seemingly a lifetime has passed since then. A global pandemic shut down the world. Driving up loneliness and disconnection. But in 2024, we finally got word. Dr. Ornish was ready to release his findings to us.
Five years ago one of the things that you are trying to figure out is, could those lifestyle changes in some people actually lead to a reversal of Alzheimer's disease?
ORNISH: Yes.
GUPTA: What's the answer?
ORNISH: The answer is in many people it did.
GUPTA: I mean, it's extraordinary, reversing something that seems so preordained. It's fixed. This is my life now, it sounds extraordinary.
UNIDENTIFIED FEMALE: How's that feeling?
UNIDENTIFIED MALE: Good.
UNIDENTIFIED FEMALE: Good? OK.
GUPTA (voice-over): It is the first randomized controlled clinical trials showing that some Alzheimer's patients could experience cognitive improvement in just five months, with intensive lifestyle changes alone.
UNIDENTIFIED FEMALE: Rising up into the middle back.
GUPTA: And importantly, those who did not make any changes in the trial worsened. Those peer-reviewed findings go public in the journal "Alzheimer's Research and Therapy" in June 2024.
[20:10:04]
ORNISH: So the more you change, the more you improve. But to get reversal, you have to make really big changes. GUPTA: Which again the big changes we're talking about, a vegan diet.
ORNISH: Yes, and it's not just a vegan diet, you know, Twinkies are vegan, you know. It's a healthy vegan diet. It's fruits, vegetables, whole grains, legumes, soy products, as close to possible as they come in nature.
GUPTA: A half an hour to an hour of moderate or brisk activity, four, three times a week, and group support, and there was yoga-slash- meditation. You could do it in a secular way, you could do it however you want to do it.
ORNISH: Yes. For an hour a day.
GUPTA: For an hour a day.
ORNISH: It's a big commitment.
GUPTA (voice-over): A big commitment but also doable. Cici did it. And now I wanted to see how she was doing. It has been five years since she first joined that study.
Hey, Cici.
C. ZERBE: Sanjay.
GUPTA: How are you?
C. ZERBE: I'm good, I'm a lot better now. Yes.
GUPTA: It's good to see you.
C. ZERBE: Same here.
GUPTA: It's been five years.
C. ZERBE: I can't believe it.
GUPTA: How have you been?
C. ZERBE: I have been great. I've been fine. I live with this man who has the patience of a saint and that helps. That helps.
J. ZERBE: Cici is doing very well. She goes out in the morning. She'll go for a walk. Almost every morning she goes for a walk. I think she's doing very well.
GUPTA: Does it surprise you?
J. ZERBE: Yes, after seeing her mother and grandmother, yes. Because I was triggered by this tension of being in a home or something.
GUPTA: How are you doing now do you think as compared to five years ago?
C. ZERBE: Much better. Much better. GUPTA: Did this help reverse some of the symptoms of Alzheimer's?
C. ZERBE: Yes. Yes.
GUPTA: I guess the question is, why, right? What do you attribute this to?
C. ZERBE: The program, the meditation, the diet, the exercise. My choice of a meal before this was a breaded veal cutlet. I haven't had one in five years.
GUPTA (voice-over): And there is this other crucial element. You got to have a partner.
J. ZERBE: Want a piece of bread? Here.
C. ZERBE: Thank you.
GUPTA: John did every step of the program right alongside Cici.
J. ZERBE: The food was a little bit hard to get used to. I miss my biscuits and gravy. We're just doing without for now.
GUPTA: Cici is now 85 years old. John, 92.
ORNISH: For Cici, she was initially randomly assigned to the comparison group of our study. So she didn't make changes for the first 20 weeks and she got worse, and then she crossover got the program since then she's shown improvement in three of the four tests and no change in one of them.
GUPTA: So for the first 20 weeks, she was sort of living her life?
ORNISH: Correct.
GUPTA: And everything worsened.
ORNISH: It also shows you how dynamic these biological mechanisms are in both directions. You can get better quickly, you can get worse quickly.
GUPTA: OK. Everybody good? I got to say this is a good looking family here.
(Voice-over): I had a chance to sit down with a few members of the Zerbe family.
Cici and John, you guys have done well.
(Voice-over): Including their daughters Franny and Alicia.
Alicia, I don't want to overstate the impact of this or understate it. I want to be just really fair about this. For people who may be dealing with this, how would you describe the impact that this program has had on Cici?
ALICIA MANZONI, CICI'S DAUGHTER: Tremendous. It's really helped. It's I think slowed it down. It's just amazing in my opinion.
DEFATTE: I mean, how many people five years into dementia get to go outside and go for a walk by themselves every day? Not very many.
GUPTA: Cici, I remember when we spoke back in 2019, you were very clear with me that one of your greatest fears was going through the same thing you had seen with your mom and your grandma. Do you still fear that?
C. ZERBE: No, I think I passed that a long time ago.
GUPTA: That's kind of incredible.
C. ZERBE: Yes. And here I am.
GUPTA: Here you are.
C. ZERBE: Here I am.
GUPTA (voice-over): Coming up, in the five years of making this documentary.
The 20-year-old newlyweds.
(Voice-over): I've met with patients all around the country who were diagnosed or at high risk for this devastating disease.
Do you remember this time in your life, Mike?
(Voice-over): It made me really start to think about my own brain. I have a family history of Alzheimer's as well. Sometimes I feel a little rusty. Sometimes I worry that I make mistakes, that maybe my friends and family are too polite to tell me about.
[20:15:04]
ISAACSON: We'll look at your body composition.
GUPTA: So that's why I decided to do something quite personal.
ISAACSON: Your muscle mass, your body fat.
GUPTA: Quite revealing.
UNIDENTIFIED FEMALE: That wasn't quite right.
GUPTA: I went through a battery of tests to assess my own risk.
ISAACSON: Just like we get a cholesterol test every year and check your blood pressure, got to do the same thing for the brain.
GUPTA: And what did I find?
ISAACSON: I'll just say it.
GUPTA: That's coming up. (COMMERCIAL BREAK)
GUPTA: So we've made our way to Miami now. By the year 2050 it is expected that more than 152 million people around the world will be diagnosed with Alzheimer's. It's part of the urgency of these researchers and why they're working so hard and so fast to try and get things done.
(Voice-over): That vital work is happening at places like the University of Miami Miller School of Medicine.
So every brain that we're seeing here, the inhibiter of these brains at one point had Alzheimer's disease. Is that right?
DR. DAVID DAVIS, ASSOCIATE DIRECTOR, BRAIN ENDOWMENT BANK: That's correct. The majority of these brains, yes.
GUPTA: You know, the most amazing thing is when I was in medical school in the early 1990s, the conventional wisdom was, you got a certain number of brain cells and that was it. Over your life you could drain the cash. Things like alcohol might speed up that process but you got what you got. By the time I finished in the year 2000 everything had changed. We realized that you could continue to grow new brain cells which was kind of incredible.
DAVIS: Our goal is to make sure that we get high-quality donations that could be used by investigators all around the world.
GUPTA (voice-over): Dr. David Davis is the associate director of the Brain Endowment Bank.
DAVIS: All in the cause of better understanding the progression of the disease and potentially hopefully finding therapies and cures.
GUPTA: I started training in neurosurgery 30 years ago. And still every time I look at the human brain, I am still filled with awe. Everything we are is located right here. Every love, every memory, every desire. All here in this enigmatic 3.5 pounds of tissue.
UNIDENTIFIED MALE: How are your memory?
UNIDENTIFIED FEMALE: Not so good.
UNIDENTIFIED MALE: Are you able to remember my name, for example?
UNIDENTIFIED FEMALE: No.
UNIDENTIFIED MALE: No.
UNIDENTIFIED FEMALE: I forget mine.
GUPTA (voice-over): What you are watching is from 1966. Fact is we've been talking about Alzheimer's disease for a long time now. The first known case of the disease was reported in 1906. But before the early 2000s, there was only one way to be sure someone actually had the disease or not. UNIDENTIFIED MALE: The only way to definitively diagnose the disease
is by an autopsy after death.
[20:20:04]
GUPTA: We've come a long way since then. We can now peer into the brain when the patient is very much alive.
DR. RONALD PETERSEN, MAYO CLINIC ALZHEIMER'S DISEASE RESEARCH CENTER: These are PET scans that pick up the two proteins in the brain that define Alzheimer's disease, amyloid and tau. The redness indicates that the amyloid protein is present. So that's the protein that makes up the plaque. One of the defining features.
GUPTA: Dr. Ronald Petersen is director of the Mayo Clinic Alzheimer's Disease Research Center.
PETERSEN: The amyloid protein that gets laid down in the brain. This can happen up to 10, 15, 20 years before a person become symptomatic. So many people are out there walking around with some amyloid in the brain, but they're doing fine clinically.
GUPTA: Connie Grumdahl is one of those people. Lots of amyloid in the brain but zero symptoms.
CONNIE GRUMDAHL, ALZHEIMER'S STUDY PARTICIPANT: So I know that I do have plaque in my brain. I don't understand how that affects some people and not others.
Nice to meet you as well so much.
GUPTA: We first met Connie at Dr. Petersen's clinic five years ago in 2019. And at the time, 69-year-old Connie was halfway through a highly anticipated Alzheimer's study called the A4 trial. It was designed for those with plaque in their brains but so far living a normal life.
GRUMDAHL: So I'm one of 19 children.
PETERSEN: Wow.
GRUMDAHL: Number 18.
PETERSEN: OK.
GRUMDAHL: And three of my sisters have died. I have two in memory care. So it's personal.
Hello, how are you? You look so beautiful today. You have a lot of pictures from --
GUPTA: Today we listen in on an extraordinary visit to the memory care ward. Connie has come to see her sister, Vera, who is 12 years older.
GRUMDAHL: We're in order of how we were born.
GUPTA: Again in a family of 19 children. GRUMDAHL: And this one is getting older.
VERA LOIS ERICKSON, CONNIE'S SISTER: And so is this one right here.
GRUMDAHL: OK. Here we go. This is what you wrote a long time ago for your doctorate when you were --
ERICKSON: I put it in here.
GRUMDAHL: Yes. This is all your work.
GUPTA: Vera was once a trailblazing psychology professor at the University of Minnesota. A loving mother, grandmother. About seven years ago, though, her memory started to fade and the decline was steep.
GRUMDAHL: One night she'd left the house in the middle of the night and we didn't find her until noon the next day. Today with Vera, it was one of the most special days that I've had in a long time with her. Looking at my family history, my brothers are fine, my sisters are not. But some of my sisters are. Will I be a lucky one? I don't know.
GUPTA: Those confusing unanswered questions are what fuel Connie and what fuels the scientists who are caring for her. In 2019, she was midway through the four-and-a-half year study to try and prevent what she had seen happened to her older sister. Even during the pandemic, Connie would drive more than an hour each way from her home in Minneapolis to the Mayo Clinic in Rochester, Minnesota. She would undergo cognitive, motor, and general health testing.
UNIDENTIFIED FEMALE: And we are going to be giving you research IRB. That's the Lenon's map (PH).
GUPTA: And almost every month.
GRUMDAHL: Oh, I can feel that going.
GUPTA: She would receive this IV transfusion.
GRUMDAHL: So this is, what, about an hour? It's time consuming. I feel like I'm contributing even if it's not for me. It's for research, and it might help my kids, it might help my grandkids or the greater good.
PETERSEN: When you're dealing with people who get enrolled in a clinical trial, it's important to really be realistic to say, we're hopeful that the drug that you may receive is going to help us with treating this underlying disease. But there's a possibility it could go in the other direction.
GRUMDAHL: You either agree to that risk or you don't. I don't have an alternative right now.
I love you. I'll walk you in.
GUPTA: In September 2022 Vera passed away after her long battle with Alzheimer's. Then in 2023, news came after a decade of research, after tracking more than 1100 study participants.
DR. REISA SPERLING, PRINCIPAL INVESTIGATOR, A4 STUDY: I'm Dr. Reisa Sperling, I'm the principal investigator at the A4 Study.
[20:25:00]
GUPTA: The long-awaited results were finally in.
SPERLING: We did not unfortunately slow the cognitive decline with this particular antibody.
GUPTA: Disappointing findings for patients like Connie, who is now 74 years old.
CARRILLO: The A4 Study, it turned out that the approach is right. The drug was not the right one.
GUPTA: Lessons learned. That laid the foundation for newer drugs like one you may have heard of. Lecanemab.
KEILAR: A potential breakthrough this morning for millions of Americans affected by Alzheimer's. A new antibody treatment for the disease could slow the progression of cognitive decline by 27 percent.
GUPTA: There's not been a significant treatment that has had this degree of improvement in these patients really in a long time, if ever.
(Voice-over): Lecanemab or Leqembi is part of a new class of drugs called monoclonal antibodies. They are given every other week. A similar drug, Donanemab, is administered monthly. Let me show you how they work. Remember beta amyloid? That's the sticky compound of protein fragments that can accumulate in the brain and can clump together to form amyloid plaques, disrupting cellular communication and eventually cause neuronal death.
Well, these new drugs stimulate the immune system to attack some of the building blocks of these amyloid proteins and eventually break up the plaques. But it is important to note that there are potential side effects.
HOWARD: Some of those adverse events or side effects in a small percentage of the Lecanemab group, including brain swelling and brain bleeding.
GUPTA: It's not a homerun, but there's been so little progress when it comes to Alzheimer's. This incremental progress is important.
PETERSEN: Lecanemab slowed the rate of progression by about 27 percent.
GUPTA (voice-over): 27 percent. It's enough for someone like 73-year- old Barbara Otis (PH).
UNIDENTIFIED MALE: So are you ready for this, dear?
BARBARA OTIS, ALZHEIMER'S PATIENT: I am ready.
GUPTA: Alongside her husband Jim, she is here for her second Alzheimer's treatment with Lecanemab.
OTIS: I never thought this would happen to me. Let's go.
GUPTA: She'll be coming here every other week for the next 18 months. Both retired teachers, she and Jim read to one another to pass the time.
OTIS: Kate sat by the firepit. The flames lighting up her face.
Well, I hope to see that my memory is steadfast and everything is in place.
GUPTA: So far there are approximately 2,000 people using the drug in the United States. And it's not cheap. This price for the medication is $26,500 per year. But Medicare does often cover a good portion of it.
UNIDENTIFIED MALE: This is the number one priority. So, you know, we have to sell the place or the house or whatever we have to do. This is a priority. We don't expect that that's going to happen, but we do what we're going to do.
OTIS: Be not afraid.
GUPTA: They're teachers so no surprise they've studied all the data, all the papers, and they know the odds. But here's the thing. They're looking for more time to spend together and the chance for more scientific breakthroughs. Maybe even a cure.
UNIDENTIFIED MALE: If in fact you can continue pushing this back, right, that maybe who knows that maybe that will be opened and you and others can be better.
GUPTA: Coming up, can Alzheimer's be prevented?
UNIDENTIFIED FEMALE: I would say, yes, drop all fried food.
GUPTA: Inside a prevention program that is now being tested all over the country.
(COMMERCIAL BREAK)
[20:33:53]
GUPTA: This is 71-year-old Mike Carver. Today he's at his Rock Steady boxing class in Berkeley, California. While Mike has no known family history of Alzheimer's, he was a carrier of both copies of the APOE4 gene. That's the genotype that can increase a person's risk at least tenfold and in 2017 he was diagnosed with early onset Alzheimer's.
MIKE CARVER, EARLY ONSET ALZHEIMER'S PATIENT: All right. Time.
GUPTA: Mike, they tell you that this is the diagnosis and then do they tell you at all what to do about it?
CARVER: Not really. Just kind of go home and, you know, start putting things away.
GUPTA: Really?
M. CARVER: Yes.
GUPTA: That must have been really hard.
PAT CARVER, WIFE OF EARLY ONSET ALZHEIMER'S DISEASE PATIENT: If there's something you want to do, do it in the next couple of years because we don't know how fast this will move.
GUPTA: Wow.
P. CARVER: Early onset can be very, very fast decline for some people.
GUPTA (voice-over): Desperate for answers, Mike's wife went to the Web. She searched for support groups, studies to join, anything to help slow this down.
[20:35:02]
ORNISH: Welcome, everybody.
GUPTA: Eventually, they found Dr. Dean Ornish and this clinical trial. That's the same one Cici Zerbe has been a part of.
P. CARVER: It was probably only maybe three or four months into the study that I realized Mike wasn't asking repetitive questions the way he had been and those stopped and those have kind of stayed away.
GUPTA: You're a meat and potatoes kind of guy.
M. CARVER: Yes.
GUPTA: They're asking you to do a vegan diet.
M. CARVER: Yes. I'm from Kansas City. There's meat there.
(LAUGHTER)
GUPTA: How hard was that for you?
M. CARVER: It was pretty difficult to start with, then I just had to turn around and say, this is the best I can do to stay alive, and I want to live with my wife as long as I can.
GUPTA (voice-over): Dr. Ornish reports that after 40 weeks, Mike's cognitive tests improved.
P. CARVER: Our neurologist said, honestly, he has never had a patient actually show an improvement on a score. He was pretty amazed about that. And actually it was kind of shocking.
M. CARVER: Yes.
P. CARVER: That was kind of when he was like at his best.
GUPTA: They were in the Ornish study during COVID and they had to move the four-hour, three-time-a-week group sessions to Zoom. They enjoy their support group so much that they still meet weekly all these years later. Throughout the study, they both lost weight. They improved their cholesterol numbers and they're resting heart rate. It's been seven years now since the diagnosis of Alzheimer's, and five since they took on the lifestyle changes. No new medications, no new therapies, just a change in their habits.
M. CARVER: I know that there's going to be other bad things happen down the road and I'm working hard to make that longer.
GUPTA: The Carvers confessed that if they knew then what they know now they would have changed their lifestyle much earlier.
P. CARVER: If we can find ways to educate people, to help them understand what they're putting inside their bodies, how they're responding to life, there's hope, there's something we can do for our kids, for our grandkids to make a difference.
GUPTA: And what if that hope could be brought to the masses.
UNIDENTIFIED FEMALE: What have you learned from the Pointer Study?
UNIDENTIFIED FEMALE: Eat vegetables and fruit.
UNIDENTIFIED FEMALE: Eat vegetables and fruit.
GUPTA: 2,000 patients across five American cities.
DR. LAURA BAKER, U.S. POINTER STUDY CO-PRINCIPAL INVESTIGATOR: Our studies are two-yearlong intervention and in older adults. The goal of the study is to prevent cognitive decline.
GUPTA: An Alzheimer's prevention study without any drugs designed to work for as many Americans as possible.
BAKER: Black African-American, Hispanic, Native American. These individuals are at higher risk floored cognitive decline and dementia. We want to make sure that they were adequately represented in our study.
GUPTA: Overall, Alzheimer's research often gets criticized for its lack of diversity in study participants.
CAROLYN O'NEAL, U.S. POINTER STUDY PARTICIPANT: In many of these studies that have been done over the years, there's no African- American representation.
ERTHEL HINES, U.S. POINTER STUDY PARTICIPANT: I was just saying to myself, how can the data be correct for a person like me, if there are not people like me this instant?
UNIDENTIFIED FEMALE: If you participated in Pointer and are considered an alum, can you please raise your hand?
BAKER: So in U.S. Pointer, you had the sedentary, not a regular exerciser, you had the not already be eating healthy diet.
ERVIN PURVIS, U.S. POINTER STUDY PARTICIPANT: Well, before I started the Pointer Study, fast food hauling.
SHEILA SMALLWOOD, U.S. POINTER STUDY PARTICIPANT: I would say I was allergic to exercises. It causes me to sweat. It causes me to turn red, and it causes me to have shortness of breath.
BAKER: You had to have some mild cardiovascular disease, so like mild hypertension, mild high cholesterol, mild high blood sugar, but also we're looking for people who have memory problems in their family.
PURVIS: My father was diagnosed and my dad couldn't function, sometimes he would just go into rages.
SMALLWOOD: My favorite aunt has dementia today. My mom died. That first year of not knowing anything, of taking the Christmas gifts to her that year, and she couldn't even remember how to open them.
HINES: My maternal grandmother back in the '50s, they weren't saying Alzheimer's but that's what it was. Her memory was gone.
[20:40:03]
BAKER: For years drug was the focus always to treat the disease. Lifestyle, exercise, yes, yes, yes. It's beneficial, everybody should be doing it, but we're not going to study it as a prevention strategy. That's not the case anymore. Now lifestyle, risk modification has a place at the table.
GUPTA: She has a family history, you said?
DR. MIA KIVIPELTO, WORLD WIDE FINGERS NETWORK SCIENTIFIC LEAD: Yes.
GUPTA (voice-over): That place at the table was earned in large part by this world renowned scientist, Dr. Mia Kivipelto, who pioneered the largescale clinical lifestyle trial.
Does the medical community believe that lifestyle changes alone can slow or even halt dementia?
KIVIPELTO: 40 percent of dementia is linked to modified risk factors. Now we have at least this 40 percent chance of doing something.
GUPTA (voice-over): She published her landmark finger research from Finland in 2013. And it completely changed the field.
CARRILLO: The finger study was revolutionizing. Reducing risk over two years could actually help people preserve their cognition.
GUPTA: That work is the backbone of Dr. Ornish's approach as well as the U.S. Pointer Study, and the intervention is being tested and adapted to more than 60 countries in the Worldwide Fingers Network. KIVIPELTO: We had five fingers, easy to remember. Healthy follows
diet, very important for the brain health. Physical activity, one of the most powerful medicines we have for the brain. Third one is the cognitive activity. We need to use our brains. We had the concept brain plasticity. Fourth finger is the social activity and even relaxation. And the fifth one is taking care of all vascular metabolic risk factors, like blood pressure, cholesterol, diabetes, and obesity.
CARRILLO: That finger study was conducted in Finland. The Fins are very different than Americans. Could we deploy a risk reduction strategy and actually see similar results in the United States with a diverse population?
UNIDENTIFIED MALE: What would you say about dropping all fried foods?
UNIDENTIFIED FEMALE: I would say, yes, drop all fried foods.
GUPTA: All the participants we spoke to had seen positive results so far.
UNIDENTIFIED FEMALE: We can make these changes together.
GUPTA: Significant weight loss, improved numbers for cholesterol, a1c and blood pressure. And they all say they're feeling better and they're thinking more clearly. Full study results are expected by summer 2025.
Coming up, I'm testing for Alzheimer's.
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[20:47:35]
GUPTA: Boca Raton, Florida, a place where about one in four residents is age 65 or older. No surprise then that this region of South Florida also happens to have the highest percentage of people living with Alzheimer's.
I've come to figure out whether I'm at risk for later dementia in life. This is what you do.
ISAACSON: This is what I do. Yes.
GUPTA (voice-over): Dr. Richard Isaacson is a world renowned neurologist and Alzheimer's expert.
ISAACSON: Looks like a lot of blood. It's not that much.
GUPTA: Sure looks like a lot.
ISAACSON: OK.
GUPTA (voice-over): You're not going to find many places like this around the country. A place that practices preventative neurology, highly personalized, and most importantly for me, predictive. So Holly here has graciously plucked me with a needle, is now drawing
my blood, for all sorts of different things. For basic cardiac metabolic sort of risk factors, but also many of these purple tubes here as part of a research study to see what some of these biomarkers for Alzheimer's are for me and what they might mean.
UNIDENTIFIED FEMALE: Try to concentrate as you look at them now. That's correct. That wasn't quite right.
GUPTA (voice-over): There is a lengthy cognitive test.
UNIDENTIFIED FEMALE: Place your heels on --
ISAACSON: You're looking at your body composition. Your muscle mass, your body fat, where the body fat is.
UNIDENTIFIED FEMALE: Starting your in-body test.
GUPTA: And an exhaustive intake of my medical, personal and family history.
My grandmother, his mom, and my dad both had diabetes.
(Voice-over): Now my test results are going to take a couple of weeks to come back. But while I was there with Dr. Isaacson, he did tell me about this patient right around my same age. Simon Nicholls. Now, to be clear, he was never diagnosed with Alzheimer's but he does carry the strongest known genetic risks.
SIMON NICHOLLS, 55-YEAR-OLD PREVENTIVE NEUROLOGY PATIENT: My mother passed away from Alzheimer's so I was very worried. I have a 3-year- old son and an 8-year-old son. It's really important for me as I get older to try and be there for them in the future. Post-COVID, I started noticing some memory losses. I mean, it could have been from a number of reasons.
GUPTA: So tell me more about that, like, what were you experiencing?
NICHOLLS: When I started to have this sort of memory loss, I think, oh, my god, what's going on? What's happening?
DR. ARTHUR AGATSTON, PREVENTIVE CARDIOLOGIST: So regular exercise helps.
[20:50:02]
GUPTA (voice-over): Simon had already been seeing Dr. Arthur Agatston who is famous for the South Beach Diet. He was seeing him for his heart health.
AGATSTON: OK. So --
GUPTA: And Dr. Agatston referred him to Dr. Isaacson for his Alzheimer's concerns.
UNIDENTIFIED FEMALE: Do not talk or move during the test. ISAACSON: He came to join a study in January 27th, 2023. We would
treat his cholesterol. We would treat his sleep. We would change his nutrition. We kept checking everything. Basically over the year he went from positive amyloid and positive tau to negative amyloid and tau.
GUPTA: Simon had fewer telltale signs of Alzheimer's disease, closer to normal levels of amyloid and tau in his blood, which corresponds with less amyloid and tau in his brain.
ISAACSON: Today, we're looking at his brain volumes.
GUPTA: As we reviewed Simon's studies there was something else that Dr. Isaacson's team found stunning.
ISAACSON: There were six regions of his brain that were below the 25th percentile in 2022. It's now 2024, and there's only three regions of his brain that are below the 25th percentile.
GUPTA: So not only has he not lost more volume, he's actually grown.
ISAACSON: This is early days.
GUPTA: Right.
ISAACSON: One case. This guy did everything right. We normalized his risk factors. We improved his amyloid and tau quantifiably, verifiably his brain grew. His belly size got smaller. His brain got larger.
GUPTA (voice-over): But here is the critical question. What did these astonishing test results really mean for Simon himself and his daily life?
Did you notice a change in your cognition?
NICHOLLS: Yes. I still have memory issues. Might be normal, OK, because looking at my MRIs, my MRIs and my blood tests, it seems I haven't got Alzheimer's, so hopefully I'm OK.
GUPTA: I know you're a health span guy, not necessarily lifespan guy, but how long do you want to live?
NICHOLLS: 136 years old.
GUPTA: Yes. Right. It's a good number.
NICHOLLS: I love to see my son get married, have his own kids.
GUPTA (voice-over): Coming up, the results.
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[20:56:36]
GUPTA: It's been two weeks after my own testing for Alzheimer's risk. It was time for the results and I have to admit I was kind of nervous. ISAACSON: Based on some of the findings that we have, in some ways you
are a walking modifiable risk factor for Alzheimer's disease.
GUPTA: I am a walking modifiable risk factor.
ISAACSON: Four of every 10 cases of dementia may be preventable if that person does everything right. It's my belief based on all the assessments we did you are absolutely in that four out of 10.
GUPTA (voice-over): So that's a relief. My genes at least don't carry an increased risk and there is no signs of elevated plaque or tau in my blood but there are also no guarantees for me or really for anyone.
ISAACSON: Age is the number one risk factor. Every year you get older, you're at higher risk of Alzheimer's disease.
GUPTA: Dr. Isaacson and his team spent hours analyzing and explaining my test results. Some recommendations, obvious. Go plant-based as much as possible. Get exercise. But I was also told more surprising things.
ISAACSON: Take a brisk walk possibly with a weighted vest. Wear something called a continuous glucose monitor. And you can track the fluctuations in blood sugar.
GUPTA: And pay attention to my grip strength.
ISAACSON: Grip strength is a terrific, inexpensive, quick screening test for cognitive decline.
GUPTA: Preventing problems down the road. Well, that is healthcare instead of sick care. But no question it comes with a cost.
CARRILLO: If an individual wants to seek that out, they certainly should. We at the Alzheimer's Association just don't have that evidence to be able to go out to public health agencies and say, hey, this is something that works. Let's do it for all. It's just not for the masses yet, but that's what we want, right?
GUPTA: But Dr. Isaacson and his team they're working on fixing that as well.
This is the kind of cognitive test that you can do at home. You don't have to come to a place like this.
(Voice-over): Funded by the National Institutes of Health, they are now testing software designed to reduce the risk of getting Alzheimer's.
ISAACSON: The software does a risk assessment, does a memory test. It tells you what to do. In the future we're going to add blood biomarkers.
GUPTA: All of this, all this testing you could do in your own home? Do your own blood test, get these measures and come up with a personalized plan. ISAACSON: Can't do this at scale just yet, but using software and at-
home testing, this is the way to get people off the roads to Alzheimer's disease.
GUPTA (voice-over): And today getting off that road for Alzheimer's and dementia is so much simpler than we previously thought. All those little decisions we make every day, to move more, to eat healthier, read that label, learn a new skill, spend time with loved ones. They sound so easy. But the evidence is clear. It can and it will add up to better brain health.
