June is Alzheimer’s and Brain Awareness month, a time to reflect on a brain disorder that affects more than 6 million Americans.
Alzheimer’s disease weakens memory and reasoning. Its symptoms worsen over time and lead to death. There is no cure, and scientists don’t fully understand what causes it, but age is the biggest-known risk factor.
Researchers in Dallas and across Texas have been working for decades to understand Alzheimer’s effect on the brain, develop treatments that slow its symptoms and improve patients’ quality of life.
In 1999, the Texas Alzheimer’s Research and Care Consortium was established by state law. A collaboration between several of the state’s leading medical institutions, it aims to improve Alzheimer’s diagnosis and treatment. Its initial members included the University of Texas Southwestern Medical Center and the University of North Texas Health Science Center, both in D-FW.
The Texas-based Darrell K. Royal Research Fund for Alzheimer’s Disease, founded in honor of the former football coach and athletic director at the University of Texas at Austin, annually awards research grants to universities like UT Southwestern, UT Dallas and the Baylor College of Medicine.
Putting the pieces together
At the start of Alzheimer’s disease, abnormal amounts of a protein called amyloid beta begin clumping up in the brain. Harmful versions of another protein called tau then accumulate and cause brain damage.
Scientists don’t yet understand the relationship between those two steps and don’t know how to stop the dangerous accumulation.
At UT Southwestern Medical Center, researchers are tackling several pieces of the Alzheimer’s puzzle. They’re studying how tau proteins misfold and damage patients’ brain cells at the beginning of Alzheimer’s; how damaged cells lead to Alzheimer’s symptoms in mice; and how brain damage progresses in humans.
“If you want to study a disease, it’s very hard to just study a molecule, or just study a patient, or just study a cell,” says Dr. Marc Diamond, founding director of UT Southwestern’s Center for Alzheimer’s and Neurodegenerative Diseases.
At the moment, patients diagnosed with early-stage Alzheimer’s can take two FDA-approved drugs that moderately slow the disease’s progress. Late-stage patients are too far along, and can only take medication to treat their symptoms.
But Diamond sees reason for hope. Scientists are making progress with other neurodegenerative diseases, he says, including a “miraculous” FDA-approved, ALS drug called tofersen that stops production of toxic ALS proteins. The mechanism that powers tofersen could also be effective in stopping harmful tau protein accumulation.
“I’ve been working on these diseases for … 25 years or so, and I’ve never been so optimistic,” Diamond says.
Diverse impacts of Alzheimer’s
The fight to treat Alzheimer’s is personal for UNT HSC’s Sid O’Bryant, whose grandmother died from it. In October, O’Bryant received a nearly $149 million grant from the National Institute for Aging to study the impact of Alzheimer’s on diverse communities. It’s one of the largest awards ever dedicated to Alzheimer’s research and the largest ever received by the UNT system.
“To me, the single biggest gaping hole in the science was that we had no idea, really, how this disease looked and progressed across different racial and ethnic groups,” says Bryant, who is Executive Director of the HSC’s Institute for Translational Research.
He’s recruited more than 3,000 D-FW residents and is looking for about 1,500 more to participate in brain scans and memory tests over the next 30 to 40 years. O’Bryant says the study, which will likely outlive his tenure at the university, could reveal the earliest signs of Alzheimer’s so that researchers can prevent the disease before its symptoms start.
Caring for the caregiver
UTD Center for BrainHealth’s Audette Rackley says the wealth of Alzheimer’s research across Texas is a testament to the disease’s complexity. In addition to studying how the disease looks in the brain, she says it’s important to give Alzheimer’s patients and their caregivers as full a life as possible.
“When a person gets a diagnosis of Alzheimer’s,” she says, “there’s really two patients.”
The Center for BrainHealth focuses less on what early-stage Alzheimer’s patients have lost — their short-term memory — and more on what they still have: their childhood memories, hobbies and even their opinions.
A 2004 study led by the Center found that medicated Alzheimer’s patients who consistently discussed their lives and interests over eight weeks reported a higher quality of life, and declined more slowly.
Today, the Center enrolls Alzheimer’s patients and their caregivers in monthslong online studies designed to cultivate healthy brain habits. Patients and their caregivers learn to accept the diagnosis and the subsequent changes, Rackley says, and focus on the variables they still have control over.
“We don’t want people to just focus on the reality and the negative and the challenges, but to step back and realize there’s still life to live, and there’s still a way forward.”
Adithi Ramakrishnan is a science reporting fellow at The Dallas Morning News. Her fellowship is supported by the University of Texas at Dallas. The News makes all editorial decisions.
