The “senior moment”: Is it a normal part of aging or a harbinger of disease? Until recently, doctors and scientists haven’t been sure. Now, new technologies are allowing researchers to come closer to understanding how our brains age and why, how to predict when an older person is in the early stages of cognitive decline, and how to find effective ways to prevent this decline.

Eric Reiman, MD, Executive Director of the Banner Alzheimer’s Institute, Clinical Director of the Neurogenomics Division at the Translational Research Institute, and Professor of Psychiatry at the University of Arizona, is a leading neuroscience researcher specializing in using brain imaging techniques like positron emission tomography (PET). He utilizes this technology for early detection and tracking of Alzheimer’s disease. He is also interested in developing new ways to quickly identify effective disease-slowing and prevention therapies for this disorder.

Dr. Reiman and colleague Mony J. de Leon, EdD, Professor of Psychiatry and Director of the Center for Brain Health at the New York University School of Medicine, hosted a question and answer session with the media on March 1, 2006, on the topic of the aging brain. The two researchers will also speak at the Imaging and the Aging Brain Conference sponsored by the American Federation for Aging Research and the New York Academy of Sciences, to be held in New York on May 16-17, 2006. Here, Dr. Reiman addresses Infoaging’s questions on the latest advances in the study of aging, neurobiology, and cognitive decline.

Infoaging: How does aging affect the brain?

Dr. Reiman: Advancing age seems to cause gradual declines in some aspects of memory and thinking, brain structure, and brain functioning, while sparing others.

Normal aging appears to affect our ability to store new facts so they can be recalled later, to briefly hold onto facts in our mind—like a person’s phone number—even before they are stored, and to rapidly process information. On the other hand, we retain knowledge of our selves, our world, and our vocabulary. Indeed, the accumulation of life’s experiences, the retention of known facts, and new strategies to handle this information might contribute to the wisdom that may come with older age.

Researchers are still trying to learn more about how the healthy brain ages, to find ways to measure cognitive and neurobiological aging, to understand the cellular mechanisms that lead to age-related neurological changes, and to consider ways in which to prevent or even reverse some of these changes.

Infoaging: When do these changes begin?

Dr. Reiman: Some of the brain and mental changes associated with advancing age may begin in early adulthood, and some may only be found at very advanced ages. The more disabling changes may coincide with the onset of age-related brain disorders like Alzheimer’s disease.

Infoaging: Much of your work focuses on using imaging technology for early detection of brain changes related to Alzheimer’s disease. Why is this so important?

Dr. Reiman: Alzheimer’s disease affects about 10% of those over 65 and almost half of those over the age of 85. As people live to older ages, the number of affected people and burdened caregivers is expected to multiply. The financial and human toll of this disorder is projected to become overwhelming. The good news is that there are an increasing number of promising ways to prevent Alzheimer’s disease. Unfortunately, right now it would take too many healthy people, too much money, and too many years to evaluate the effectiveness of these promising treatments. We would have to wait years for a sufficient number of research volunteers to develop memory and thinking problems.

To address this problem, we and other brain imaging researchers are working to expedite the process of testing treatments for patients with Alzheimer’s disease or a milder problem known as “mild cognitive impairment,” which often leads to Alzheimer’s. Imaging techniques may let us test preventive or disease-slowing treatments in fewer patients and in a shorter time than would be otherwise possible. This would help pharmaceutical and biotechnology companies invest their resources in the most promising treatments.

Our strategy is to use brain imaging techniques to detect and track brain changes in people at increased genetic risk for Alzheimer’s disease. We have been developing a way to use these techniques to evaluate a promising prevention therapy’s effectiveness to slow down these brain changes in about 100 late-middle-aged people over the course of two years. Our ultimate goal is to find an effective prevention therapy quickly so we don’t lose a generation of older people. Indeed, we want this kind of treatment to be available to the baby boomer generation. 

We are also interested in using these techniques to track the changes associated with normal aging in the hope that we may be able to identify ways to slow down normal aging processes themselves.

Infoaging: Are you interested in other areas of neurobiology research in addition to imaging?

Dr. Reiman: At the Translational Genomics Research Institute, we are also interested in discovering more of the genes that contribute to a person’s risk for developing Alzheimer’s disease. We want to clarify the molecular events involved in the development of Alzheimer’s, because that would identify targets at which to aim new treatments. And we are interested in discovering some of the genes that account for individual differences in normal human memory, providing a foundation for the discovery of treatments to improve some of the memory changes associated with normal aging.

Infoaging: Are there any promising therapies for Alzheimer’s disease on the horizon?

Dr. Reiman: In the last few years, there has been remarkable progress in the scientific understanding of Alzheimer’s and in the development of promising ways to treat and prevent it.

Genetic research is providing targets at which to aim new treatments, suggesting new ways to prevent Alzheimer’s disease, and providing a way to identify people who might benefit the most from early intervention. In addition, researchers have developed an impressive portfolio of promising ways to slow down the brain disease itself—including but not at all limited to the development of promising medications and immunization therapies to slow down the accumulation of plaques that are deposited in the brains of Alzheimer’s patients.

There are also an increasing number of promising but still unproven ways to help prevent Alzheimer’s disease. Some may also help slow down the changes associated with normal aging, and some of have already been shown to help our hearts. These include getting regular mental and physical exercise; eating a diet rich in antioxidants, omega-3 fatty acids, and folic acid; lowering cholesterol levels; and losing excess weight. There is an urgent need to evaluate the effectiveness of these and other promising treatments, and to find ways to do that in the shortest possible time.

If we can find an effective, safe, and well-tolerated way to delay the onset of Alzheimer’s disease by only five years, we could cut the number of new cases in half. I am extremely hopeful that we can do much better than that. We have an unprecedented opportunity to make a major difference in the lives of people affected by and at risk for Alzheimer’s, and it is my sincere hope that we will be able to do that within the next dozen years.

Resources

Infoaging Neurobiology of Aging Information Center

Infoaging Alzheimer’s Disease Information Center

Arizona Alzheimer’s Disease Research Center

NYU Medical Center: Center for Brain Health