Dementia Matters

Alcohol and the Brain: One Drink a Day Associated with Brain Shrinkage

There are many conflicting studies on how alcohol consumption can impact a person’s health, with some studies suggesting light drinking can protect against coronary heart disease and others concluding that drinking can increase your risk for cancer. What does research say about alcohol and the brain? Dr. Remi Daviet joins the podcast to discuss his latest study that found that just one alcoholic drink a day was associated with brain shrinkage, and drinking more could increase that rate exponentially over time.

Guest: Remi Daviet, PhD, assistant professor, Wisconsin School of Business

Episode Topics

3:40 How do you suggest people balance all of the conflicting messages surrounding research on alcohol consumption?

7:30 Is there an interaction between alcohol consumption and getting older?

8:10 What did your results show in this study?

13:45 How are you defining alcohol consumption? What is a unit of alcohol defined as for beer, wine, and hard alcohol?

Show Notes

Read Dr. Daviet’s study, Associations between alcohol consumption and gray and white matter volumes in the UK Biobank, through the online journal Nature.

Read more about Dr. Daviet on his website and through his bio on the Wisconsin School of Business website.

Women’s Health Month: Women and Alzheimer’s Disease

In honor of Women’s Health Month, Dr. Jessica Caldwell joins the podcast to discuss sex differences in aging and Alzheimer’s disease. She explains some of the ways women experience aging and Alzheimer’s disease differently than men and how she incorporates research findings into patient care. 

Guest: Jessica Caldwell, PhD, director, Women’s Alzheimer’s Movement Prevention Center, Cleveland Clinic in Las Vegas, assistant professor, Case Western Reserve University

Episode Topics

2:59 What are the sex differences in experiencing normal aging and in experiencing Alzheimer’s disease?

7:33 Why are women more affected by Alzheimer’s disease than men?

10:03 Are there other theories that have been speculated but aren’t true regarding the differences between men and women aging?

23:18 What type of prevention approaches do you discuss in your clinic?

Show Notes

The Women’s Alzheimer’s Movement Prevention Center at Cleveland Clinic in Las Vegas is the world’s first Alzheimer’s prevention center exclusively for women. Learn more at their website.

Read the referenced studies by Dr. Caldwell on differences in brain health across sexes through the National Library of Medicine’s website, specifically the 2021 study on tau protein differences, the 2018 study on amyloid level differences, and the 2022 study on cortical thickness differences. 

The Alzheimer’s Association has a women’s and Alzheimer’s webpage to learn more.

The US Department of Health & Human Services Office on Women’s Health sponsors National Women’s Health Week.

Disaggregating Racial Data: How Studying Ethnic Subgroups Can Improve Research

A graduate student from the University of Wisconsin–Madison is pushing for the disaggregation of data in research to better understand how individuals from different ethnic subgroups are represented as research participants and as researchers. Kao Lee Yang began writing and discussing the topic after the Howard Hughes Medical Institute’s Gilliam Fellowship for Advanced Study rejected her application for not meeting their racial and ethnic underrepresentation criteria, despite often being the only Hmong American scientist in many research spaces. Yang joins the podcast to discuss her opinion piece for STAT News, the problems with using aggregated data, and how the push to study individual ethnic groups could improve Alzheimer’s disease research.

Guest: Kao Lee Yang, MPA/PhD candidate in the Neuroscience and Public Policy Program and Bendlin Laboratory, University of Wisconsin–Madison

Episode Topics

6:12 Why is combining all Asian people into one category detrimental? What is improved when this population is broken down by specific heritages and ethnicities?

8:40 How did people respond to your initial article in STAT News?

9:30 Why do you think it’s important to look at the individual ethnic groups within research?

11:17 How does the problem of aggregating data on Asian Americans impact the field of Alzheimer’s disease research?

Show Notes

Read Yang’s opinion piece, “I’m almost always the only Hmong American scientist in the room. Yet I was told I come from a group overrepresented in STEM,” on STAT News’ website.

Read Yang’s correspondence, “Disaggregate data on Asian Americans — for science and scientists,” on Nature’s website.

To learn about more Hmong researchers and scientists like Kao Lee Yang, follow the Twitter account she recently launched, @HmongInBioSci.

Read about Alzheimer’s disease research in the Bendlin Lab.

Incorporating Cultural Knowledge: Improving Alzheimer’s Disease Research for Veterans and Native Americans

Dr. Cynthia Carlsson and Daniel A. King join the podcast to discuss some of the unique ways that Alzheimer’s disease affects Veterans and Native Americans. Their work at the Wisconsin Alzheimer’s Disease Research Center allows them to connect with people who are at higher risk for Alzheimer’s disease and help educate them on how to maintain brain health, both through Dr. Carlsson’s research and clinical practice and Mr. King’s outreach to Veterans and Native Americans. Discussing the importance of current outreach and educational efforts as well as what they’ve learned from engaging with Veterans and Native Americans, Dr. Carlsson and Mr. King describes how understanding different cultures and community experiences can help Alzheimer’s disease research better support underserved populations.

Guests: Cynthia Carlsson, MD, MS, professor of medicine and Alzheimer’s disease researcher, University of Wisconsin School of Medicine and Public Health, geriatrician, William S. Middleton Memorial Veterans Hospital, and Daniel A. King, member of the Oneida Nation of Wisconsin, Veteran recruitment coordinator, Wisconsin Alzheimer’s Disease Research Center

Episode Topics

1:47 Why do Veterans have a higher risk for Alzheimer’s disease?

2:52 What does this new program at the ADRC, focused on Veterans, look like, and why have it here?

5:19 How do your caregiving experiences influence the conversations you have educating others about Alzheimer’s disease?

20:25 What needs to change within research to do a better job serving veterans, Native Americans, and other underserved populations?

Show Notes

Read more about Dr. Cynthia Carlsson in her bio. 

Read about Veterans and Alzheimer’s disease on our website.

Read about Native Americans and Alzheimer’s disease on the Alzheimer’s Association website or the U.S. Centers for Disease Control website.

Update on Blood Tests for Alzheimer’s Disease

Research in the field of fluid biomarkers is leading to new developments in Alzheimer’s disease identification, including new tests that can predict Alzheimer’s based on biomarkers in blood. Ahead of his keynote address as part of Alzheimer's Disease & Related Dementias Research Day on April 5, 2022, Dr. Thomas Karikari joins the podcast to discuss his work with these new blood tests, how accurate they are, and what research needs to be done before they are made available for clinical use.
Guest: Thomas Karikari, PhD, assistant professor, University of Gothenburg, University of Pittsburgh

Episode Topics

3:12 How close do you think we are to using these Alzheimer’s tests in doctor’s offices?

8:28 How accurate are the current available tests, such as spinal taps and these new blood tests, at identifying Alzheimer’s disease?

17:40 How early can these tests identify Alzheimer’s disease proteins before an individual shows symptoms?

21:41 How accurate can the risk calculators used with the blood tests be?

Show Notes

Learn about Dr. Thomas Karikari in his bio on the BrightFocus Foundation’s website.

Register for the annual Alzheimer's Disease & Related Dementias Research Day at the Alzheimer’s Disease Research Center’s website. The April 5 event is designed to encourage collaboration and promote scientific thought among faculty, students and researchers from a wide range of disciplines across the UW–Madison campus.

Harnessing the Power of Autophagy to Treat Alzheimer’s Disease

The Puglielli lab at the University of Wisconsin School of Medicine and Public Health has found a way to manipulate autophagy — a process where cells clean out damaged materials — to rid the brain of toxic proteins like amyloid and tau. Researchers hope to use the power of this process to develop future treatments for Alzheimer’s disease and other diseases of aging. Luigi Puglielli joins the podcast to discuss his team’s research over the past 15 years, why the scientific process can take years to turn ideas into possible treatments, and how he hopes this research can be used in the future.

Guest: Luigi Puglielli, MD, PhD, professor of medicine, University of Wisconsin School of Medicine and Public Health

Episode Topics

7:47 Tell us about how you manipulated this process of autophagy. Why is this discovery so important?

15:14 What role does acetyl-CoA play in the brain?

19:58 What does the future look like for this research?

Show Notes

Learn more about Luigi Puglielli, MD, PhD, and his work in his bio and on the Puglielli Lab website.

Read Dr. Puglielli’s recent paper “ATase inhibition rescues age-associated proteotoxicity of the secretory pathway,” published online on February 25, 2022 in “Communications Biology.”

Go with the (4D) Flow: Neuroimaging Technology Used to Study Overlap of Cerebrovascular Disease and Alzheimer’s

A recent study from Alzheimer’s disease researchers at the University of Wisconsin–Madison used neuroimaging technology called 4D Flow MRI to study the relationship between blood vessel disease and Alzheimer’s disease. Published in December 2021, the study found that people with Alzheimer’s disease symptoms had stiffer blood vessels in their brains, which could lead to inflammation and a buildup of Alzheimer’s biomarkers like amyloid and tau proteins. Lead researcher Leonardo Rivera-Rivera joins the podcast to discuss his findings, the developments made with new 4D Flow MRI scans, and how these developments could impact future Alzheimer’s disease research and clinical practices.

Guest: Leonardo Rivera-Rivera, PhD, neuroimaging scientist, Wisconsin Alzheimer’s Disease Research Center

Episode Topics

8:55 How does the 4D Flow MRI technology used in your study compare to MRIs used in clinics?

13:18 What did you look at in your study? What were your findings?

17:54 Did you see more pronounced findings in particular individuals with APOE4 or other chronic conditions like diabetes?

20:37 Why is this an important finding for Alzheimer’s disease research? Do you think 4D flow MRIs could be incorporated into clinical settings?

Show Notes

Read Leonardo Rivera-Rivera’s publication “Cerebrovascular stiffness and flow dynamics in the presence of amyloid and tau biomarkers,” published in the journal Alzheimer’s and Dementia: Diagnosis, Assessment & Disease Monitoring. 

Learn more about Leonardo Rivera-Rivera’s research at the Wisconsin Alzheimer’s Disease Research Center website.

Breaking Down Medicare’s Proposed Decision on Aducanumab and Monoclonal Antibody Treatments

On January 11, the Centers for Medicare and Medicaid Services (CMS) announced its much-anticipated coverage proposal for monoclonal antibody treatments that target amyloid for the treatment of Alzheimer’s disease. According to the proposed policy, this class of drugs, which includes aducanumab, also known by the brand name Aduhelm, would be covered for people with Medicare only if they are enrolled in qualifying clinical trials. Dr. Jason Karlawish joins the podcast to discuss the recent proposal, share his reaction to the decision, and tell us how this coverage policy could impact the development of other Alzheimer’s disease treatments in the future.

Guest: Jason Karlawish, MD, co-director, Penn Memory Center, professor of medicine, medical ethics and health policy, and neurology, University of Pennsylvania

Episode Topics

1:48 What’s the difference between the FDA and Centers for Medicare and Medicaid Services?

3:58 What is the purpose of sharing a proposal and allowing public comment after? Is it possible the proposal could change?

9:09 What are your key takeaways from the CMS proposal?

11:58 Who’s being charged the cost of the treatment if it is part of a clinical trial?

18:33 What does this decision, with its focus on research often occurring in major urban medical centers, mean for equity and access?

26:27 What is the future of Alzheimer’s disease research after the CMS decision?

Show Notes

Read the Center for Medicare and Medicaid Services’s press release about the proposed coverage policy, view submitted public comments about the decision, and submit your own comment.

Learn more about Dr. Jason Karlawish’s work and writing at his website.

Listen to our four-part episode series with Dr. Jason Karlawish about his book, The Problem of Alzheimer’s, on our website (episode 1, episode 2, episode 3, episode 4).

Nasal Vaccine for Alzheimer’s Disease Enters Clinical Trial

In November 2021, Brigham and Women’s Hospital in Boston launched the first human trial of a nasal vaccine for Alzheimer’s disease. Nearly 20 years of research went into developing the vaccine, which uses the immune system to clear Alzheimer’s disease-related proteins from the brain. Lead researcher Dr. Howard Weiner joins the podcast to discuss the science behind the vaccine and how it could introduce new ways of treating other neurodegenerative diseases in the future.

Guest: Howard Weiner, MD, professor of neurology, Harvard Medical School, co-director, Ann Romney Center for Neurologic Diseases, Brigham and Women’s Hospital

Episode Topics

How does the vaccine work?

Why would a vaccine be a potentially better approach to treatment than a monoclonal antibody?

Do you think a vaccine could ever be used for prevention reasons instead of treatment?

Why a nasal vaccine versus into the muscle, like the COVID vaccine or flu vaccine?

Show Notes

Learn more about Brigham and Women’s Hospital’s nasal vaccine trial at their press release.

For those interested in participating in the study, you can call the Ann Romney Center for Neurologic Diseases at Brigham and Women's Hospital at 617-723-5588 or email protollinstudy@bwh.harvard.edu.

Watch Dr. Weiner’s film, What is Life?, The Movie, on YouTube.

Learn more about Dr. Weiner’s film, Abe and Phil’s Last Poker Game, on IMDb.

‘American Dementia’: Author Interview with Dr. Daniel George and Dr. Peter Whitehouse

Medical anthropologist and professor of humanities and public health sciences Daniel George, PhD, and professor of neurology and medicine Peter Whitehouse, MD, PhD, join the podcast to discuss their recent book, American Dementia: Brain Health in an Unhealthy Society. In it, they argue that 20th century policies focused on reducing inequality, increasing access to education and healthcare, and protecting the environment contributed to today’s declining dementia rates, but inequalities in the 21st century are reversing these trends. Discussing the pros and cons of current social and clinical approaches to Alzheimer’s disease, our guests challenge assumptions about dementia caregiving and show how we can work together to create a healthier society.

Guests: Daniel George, PhD, medical anthropologist, associate professor of humanities and public health sciences, Penn State College of Medicine, and Peter Whitehouse, MD, PhD, professor of neurology, Case Western University, professor of medicine, University of Toronto

Episode Topics

3:04 Why use the title American Dementia? What does that mean for you?

8:54 What do you think is wrong with our current societal, cultural and clinical approaches to Alzheimer’s disease?

16:10 What are the inequalities we’re facing in the 21st century compared to the 20th century? How are they affecting brain health?

19:04 How does climate change affect our cognition and brain health?

25:33 What would you want your reader to do next after finishing the book?

Show Notes

Read about American Dementia: Brain Health in an Unhealthy Society on Goodreads.

Listen to our episode about creative care with TimeSlips founder Anne Basting, who Dr. George mentions at 23:00, on our website, Spotify, Apple Podcasts, and more.

Find and follow Dementia Matters on Facebook, Twitter, or find us on our website.