Alzheimer’s

Dr. Kerry Hildreth of the University of Colorado–Denver, who’s conducting research on ways to prevent or slow cognitive decline in patients with memory impairment, weighs in on our aging population, Alzheimer’s disease treatments, and the potential of her team’s clinical trial.

5280: Earlier this year, there was a lot of buzz about the speculation that Ronald Reagan had Alzheimer’s when he was president. This is a major health issue in our society, especially as the first wave of baby boomers turns 65 this year.
Dr. Hildreth: It’s a huge and growing problem for our aging population, especially because we don’t really have any way to prevent or treat it at this point. It’s really scary.

5280: According to the Centers for Disease Control and Prevention, Alzheimer’s is one of the top 10 causes of death for men in the United States. What’s the prevalence of the disease in men versus women?
Dr. Hildreth: Actually, it’s a little more common in women than in men. Women live longer, and that’s part of it, but there have been some suggestions that it goes beyond longevity. But, yes, obviously this is a disease that strongly affects men; I think it’s now the fifth leading cause of death in people over the age of 65.

5280: What about treatments for Alzheimer’s? Dr. Hildreth: As you may know, there are approved treatments for Alzheimer’s, but they’ve been pretty disappointing. They don’t really do anything to affect the underlying course or progression of the disease. They address some symptoms in some people, pretty modestly. The bottom line is that we don’t really have any good treatments right now.

5280: Tell me a bit about the work you’re doing at CU.
Dr. Hildreth: One of the things we’re most interested in is prevention—is there a way to prevent the disease, or a way to slow the decline so that people may have some mild impairments, but they don’t get to the functional impairments where they can’t take care of themselves and need 24-hour help? So far, nothing’s really been proven definitively on this front.

5280: That’s a little disheartening, isn’t it?
Dr. Hildreth: Well, with that said, there are a number of factors that keep showing up that look like they’re related to the development of Alzheimer’s disease. And what we’re really interested in looking at is this connection between cardio-metabolic risk factors. These are the same things that put you at risk for cardiovascular disease, diabetes, and stroke. All of those things—high blood pressure, high cholesterol, obesity, diabetes, and what we’re studying specifically, pre-diabetes—either individually or in aggregate have been linked to Alzheimer’s. What we’re looking at is if you address those, does that have any effect or delay things at all?

5280: So diabetes or pre-diabetes is somehow related to Alzheimer’s disease?
Dr. Hildreth: We know that insulin is important in regulating blood sugar, but it’s also active in the brain in ways that have to do with learning and memory. The thinking is that if we can take people that are insulin-resistant and treat that very early, can that make any difference in their cognitive function? This is an area that’s really exciting because it’s actually something we can do something about. We can’t do anything about our age, we can’t do anything about our genetics. But there are a lot of things we can do about lifestyle, and if that makes a difference, that will be great.