Tag Archives: health

Bladder, prostate developments more precise

REAL-TIME BLADDER MONITOR

It can be quite burdensome for a person with an overactive bladder or bladder-leakage problem to endure the diagnostic process. He has to come to the clinic, get undressed in an unnatural environment, empty the bladder, get a catheter, refill the bladder with room temp water, urinate… The whole experience causes embarrassment, anxiety, and discomfort for the patient. Furthermore, it’s not a natural situation and really doesn’t allow us to accurately assess what happens in the real world— when the person is exercising, or out running errands.

I’m enthused about the new UroMonitor which we are developing. It’s like a Fitbit for the bladder. It requires a simple insertion, and then we get real-time, real-world data that tells us what is happening in the patient’s bladder. And he doesn’t even have to come to Cleveland Clinic. He can have the monitor inserted locally, then do a virtual consult with an expert here. It has the potential to help tens of millions of people who are affected by bladder issues.

400,000 MEN COULD AVOID BIOPSY

Another thing I’m excited about is a new blood test for prostate cancer screening we’re developing. I have to disclose it’s being formulated by Cleveland Diagnostics, which Cleveland Clinic owns part of, within which I have no personal financial stake.

We know that the current screening for prostate cancer, which has been around for decades, is far from perfect. It results in a large number of false positives, which lead to prostate biopsies. It also leads to over-detection of low-grade cancers that we’d rather not know about because most of them don’t need to be treated.

This new blood test is far better at determining who might have a higher-grade cancer that does need treatment. We have studied this and validated our findings in a second study, and we’re just about to publish our findings in medical journals. It’s very exciting.

There are about 1 million biopsies every year—and this blood test could eliminate the need for 40 percent of them. That’s 400,000 men who won’t need to go through this uncomfortable procedure and its associated risks. Instead we’ll have a much better diagnostic test for every man, not just those who come to Cleveland Clinic.

PHILANTHROPY’S DIFFERENCE

The National Institutes of Health budget has been restricted in recent years. For example, they only fund 8 percent of all cancer research grant requests. In such a restrictive environment, it’s impossible without philanthropic support to do the high-level research that could improve patients’ lives. We must supplement what’s received from government grants, or we simply wouldn’t have enough. A much-needed philanthropic gift we recently received from Healthnetwork and its partners, just opened the scope of what we can do and the number of lives we can affect.

ERIC KLEIN, MD, is chair of the Glickman Urological and Kidney Institute at Cleveland Clinic, one of Healthnetwork’s GOLD hospitals. Dr. Klein was given a Healthnetwork Service Excellence Award for his outstanding patient care. Cleveland Clinic’s urology program is ranked No. 1 in the specialty.

Avert major risk factors for heart attack

You can control your risk of heart attack, the number-one killer of Americans, even if you were dealt a bad genetic hand with a family history of heart attacks, bypass surgery, or coronary stent placement.

A large majority of people who sustain heart attacks before age 40 are smokers. Even a few puffs on a cigarette initiate abnormal changes in the lining of arteries. Continued smoking promotes cholesterol-plaque buildup, plaque instability, and eventually plaque rupture that triggers blood clots. When the clot blocks a coronary (heart muscle) artery, a major heart attack results. Fatal abnormal heart rhythms can occur just seconds after a heart attack begins. If you don’t want a heart attack, don’t smoke!

Study after study has definitively proven that high cholesterol, particularly LDL (“bad”) cholesterol, is highly correlated with coronary artery disease and coronary events. The American College of Cardiology (ACC) and the American Heart Association provide easy-to-use risk calculators online. Guidelines recommend that if your 10-year risk of atherosclerotic cardiovascular disease is greater than 7.5 percent, then a cholesterol-lowering medicine called a “statin” should strongly be considered. Statins prevent thousands of heart attacks each year and cause no side effects in 95 percent of patients. A survey at a recent national ACC meeting found that well over half of all cardiologists attending were taking a statin. Maybe they know something? A statin may be right for you.

Diabetes is a major risk factor, and nearly 90% of patients with diabetes are overweight. If every person diagnosed with diabetes lost 15 percent of their body weight, most would no longer even have diabetes. Staying near ideal body weight, along with exercise, will dramatically lower your risk of getting diabetes – and a heart attack.

High blood pressure (>130/80) contributes to heart attack risk. Salt restriction, weight loss if needed, and exercise are the first line of treatment, but most people will still need medicine. Dozens of highly effective meds are affordable – there’s no reason to have high blood pressure in 2019, but sometimes it may take 3 or 4 different medications to achieve that goal.

Next, everybody’s favorite subject – diet. Nutritional guidelines keep changing, but there are certain dietary recommendations for preventing heart disease that are unlikely to change. Minimize red meat, and avoid processed meat. Eat more fatty fish like salmon, but skip fried fish! Eat lots of vegetables. Avoid fast food. Reduce your carbohydrate load to prevent hunger and weight gain. It is really that simple.

Lack of physical activity compromises life. Regular exercise prolongs life, lowers blood pressure, keeps weight in check, increases brain endorphins to bolster mood, and lowers risk of cardiovascular disease for a more productive earthly life to better serve the Lord.

DAVID A. KAMINSKAS practices cardiology in Fort Wayne, Indiana and is the treasurer of the Dr. Jerome Lejeune Catholic Medical Guild of Northeast Indiana.

Cancer-ravaged bone can be ‘tricked’ into regenerating

When I was a student at Yale University School of Medicine in the early 2000s, one of my professor-mentors introduced me to the concept of bone regeneration. I hadn’t known it was possible for the body to heal and regenerate itself to such an extent, and I found it absolutely fascinating!

An idea struck. What if we could tap into the body’s ability to regenerate bone to help cancer patients? It was a novel concept … or so I thought.

High-grade bone cancers used to be a death sentence. If a person was lucky, he would get a limb amputated and live a few more years. Then chemotherapy came along and suddenly 70 percent of younger patients with these aggressive bone cancers were surviving.

Doctors could now treat the cancer with chemo, remove the tumors, and replace the bone defect with metal implants. However, metal things tend to break and wear out. As people got older, they needed multiple surgical interventions to fix or replace the implants. That meant hospital stays, risk of complications, sometimes infection.

Instead of medical implants, what if we could use the body’s natural ability to regenerate bone?I couldn’t wait to tell my mentor.

“It is a great idea,” he said. “But not a new idea.”

Turns out a professor in Japan had been exploring this idea for 25 years already. Still, my mentor assured me, it was a good idea and there was room to explore and expand on it.

I was fortunate in 2014 to be recruited onto the team at the Memorial Sloan Kettering Cancer Center, and we began to explore the possibilities of bone regeneration. I’m excited to say the research and clinic trials we are doing are game-changing, especially for younger people with bone cancer.

Essentially, we are helping the patient’s body heal itself. We trick the body into thinking there’s a fracture, and we can slowly but surely use the fracture healing response to make new bone to seal the gap where the tumor was removed. In this way we can avoid the need for metal implants and help people grow back their own bone. And—most importantly— we can set up a young person for a much better quality of life for a longer period of time than ever before. As of now, Memorial Sloan Kettering is the only place in the U.S. using this limb-lengthening technique, but I hope it won’t be long before others follow suit.

In 2018, I was honored with a Service Excellence Award from Healthnetwork Foundation to support research in the field of bone regeneration in patients affected by bone cancers. Our research focus is to better understand the process of distraction osteogenesis to optimize bone healing for each individual. Those who support Healthnetwork should know this kind of funding is important in getting a project like this started. We often use such funding to hire researchers or grad students, helping launch a project in the early stages; then, we can turn it into much bigger things.

DANIEL E. PRINCE, MD, MPH is a surgeon specializing in orthopedics and musculoskeletal oncology at Memorial Sloan Kettering Cancer Center in New York. He created their bone regeneration team which focuses on limb- and joint-sparing reconstructive techniques to optimize patients’ function and quality of life.

Recipe for skin cancer: 15 sunny steps

1. Believe, “skin cancer can’t happen to me. I won’t be one of the 10,000 Americans diagnosed daily with skin cancer.” If you apply sunscreen, use the lowest number you can find and apply it like a typical American who puts it on so thin that they achieve only a quarter to half the protection listed on the sunscreen bottle.

2. Remove as much clothing, hats, and glasses as possible when in the sun.

3. Marinate in the sun for your vitamin D, even though half of Hawaiian surfers who spent 29 hours/week in the sun year-round were vitamin D deficient

4. Ignore non-healing sores lasting more than a month – especially on the face.

5. If you wear a hat, use a visor or baseball hat, and stay away from hats with a 2” or wider circumferential brim.

6. Win the ‘lobster-man’ or ‘lobster-woman’ award for the best ‘grimace-inducing sunburn’ at your local Yacht Club – as many years running as possible.

7. Choose parents who will give you fair skin, for as a red-headed, fair-skinned Irish priest patient once said, “The Irish are God’s gift to dermatology.”

8. Repeat, “Skin cancer can’t happen to me. I won’t be in the one-third of Americans who will grow one by the age of 70.”

9. Braise in a tanning bed to acquire the mythical ‘base tan’ that requires killing skin cells to alert other skin cells to make a tan – that provides as much protection as SPF 3 (three!) sunscreen – and don’t forget, the tanning bed rays accelerate skin wrinkles compared to the sun. Wrinkles give your face character.

10. Bake exposed skin in the sun as close to the equator – and to mid-day – as possible.

11. Fertilize and cultivate your garden in the middle of the day. Not only does the sun feed your fruits, vegetables, and flowers, but nothing motivates a skin cancer like sunlight!

12. Appreciate those multi-colored, growing “moles” – after all, they’re just ‘beauty marks,’ and they can’t kill anyone (except 7,200 other people annually in America).

13. Avoid websites like www.skincancer. org that could help you prevent skin cancer or get it diagnosed early.

14. Contribute monthly (and don’t forget to fill out your company matching-gift form) to “MakeAmericaTanAgain.Com.”

If you have already had a skin cancer, follow all of these instructions, because doing these things will reduce your number of future cancers.

15. Stew slowly with the thought, “Skin cancer can’t happen to me”, and believe, ”Skin cancer isn’t a big deal, even if I get it, because Hugh Jackman and Melanie Griffith have proven that you can still be attractive with cancer surgery scars on your nose.”

Put your dermatologist on speed-dial; he/she will want to admire the results of your efforts.

TOM MCGOVERN is a Legate who practices Mohs Surgery full-time at Fort Wayne Dermatology Consultants in Fort Wayne, IN. He co-hosts the Doctor, Doctor radio shows/podcasts for the Catholic Medical Association.

Follow Church prescription for a Catholic living will

Living wills were first introduced by the Euthanasia Society of America in 1967, and were popularized by one of its members, advice columnist Abigail Van Buren (“Dear Abby”). Given the disreputable history of the living will, Catholic patients should ensure that end-of-life documents follow Church teaching. Living wills do not become activated until patients cannot speak personally to express their desires. Health care surrogates, usually family members, need to be assigned to speak for the patients then. A Catholic living will should also address the following 5 principles, to avoid the dangers of secular end-of life documents.

1. Relieving pain. Church teaching strongly supports patients being kept as free of pain as possible. This needs to be balanced with patients’ moral and family duties as they prepare with full consciousness to meet Christ.

2. Assessing treatments as ordinary or extraordinary. Patients and their families need to be given adequate information for a clear understanding of any end-of-life treatment. Is each treatment: 1) serving as a bridge to recovery from an acute medical problem, 2) alleviating suffering from an ongoing condition, or 3) offering little hope of benefit and actually becoming burdensome? There is no obligation to accept extraordinary treatments that have significant risks which may outweigh benefits.

3. Providing food and nutrition. A written request for receiving food and water, even if by artificial means, is generally not included in a standard secular living will that views assisted nutrition and hydration as medical treatment, but the Catholic Church views assisted nutrition and hydration as normal care. Pope St. John Paul II wrote:

“The administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act.”

When a terminally ill patient, however, is at the brink of death, body systems are shutting down and can no longer digest food. At this point assisted hydration and nutrition become burdensome and could be discontinued.

4. Prohibiting euthanasia. The immorality of Euthanasia and Physician-Assisted Suicide (PAS) predates Christianity, as Hippocrates prohibited this practice 2,400 years ago. The Catholic Church has always taught that these are grave violations of God’s law. In an age where PAS is being legalized, it is important to clearly state an opposition to this misguided autonomy and false mercy.

5. Requesting spiritual care. This provision asserts that a priest be notified and that the Sacraments be given. The Sacraments of Penance, Anointing of the Sick, and Viaticum are the healing Sacraments that give peace, strength, and grace in preparation for death. The Anointing of the Sick unites a person more closely to Christ’s Passion and uses suffering as a participation in His saving work.

A Catholic living will that includes these 5 principles — and a designated surrogate committed to Catholic principles to speak when the patient cannot — serves not only the patient’s own well-being, but also acts as a tool for evangelization by witnessing to the truth about human dignity, the redemptive value of suffering, and hope in eternal life. For a model Catholic end-of-life document: https://www. flacathconf.org/documents/2018/11/CDLD.pdf

Dr. PETER MORROW is the immediate past-president of the Catholic Medical Association, and practices geriatric medicine in Saint Cloud, Florida.

Accessing priceless, timely health intervention

Healthnetwork has been a Godsend to our family. My first experience with Healthnetwork was over 10 years ago. While on a family vacation to Egypt, my mother (85) slipped and dislocated her shoulder. She was taken to a local hospital, where they manipulated her shoulder back into place, then immobilized her arm until she could return home to a specialist.

Upon her return, although not in pain, Mom was still unable to move her arm. She consulted two different orthopedic specialists, who both stated that she tore her rotator cuff and needed surgery. She scheduled surgery, but something just did not feel right to me. We were longtime Legatus members, and I thought maybe Healthnetwork could be of help for a third opinion!

Since my mom was already scheduled for surgery, Healthnetwork secured an appointment in just three days with Dr. John Brems at Cleveland Clinic. He spent 45 minutes with my mother, explaining test results and why he felt her rotator cuff damage was age-related, not a result of the fall. He ordered a test which confirmed the auxiliary nerve to the deltoid muscle was damaged. Dr. Brems gave her exercises to remedy her mobility issues; no surgery was required.

Following his advice, Mom gained full use of her arm, rather than partial movement that surgery would have allowed. In my opinion, Healthnetwork saved her months of pain, rehabilitation, and risk of surgical complications. Most of all, it gave her continued quality of life and enabled her to leave a few weeks later for her winter home in Florida.

Four years ago, the shingles virus attacked my brother-in-law Tim’s heart, causing significant heart damage and resulted in him going in and out of AFib five times in those four years. On the fifth episode, Tim was in AFib for six weeks. Because he was frustrated, I asked if he’d like me to try my Healthnetwork connections. Cleveland Clinic offered the top heart specialists in the country.

Tim got an appointment with Dr. Amman Hussein, a specialist in cardiac electrophysiology. After spending 45 minutes reviewing test results with Tim, Dr. Hussein and Tim felt an ablation was the best course of action. Tim just completed his three-month check-up following the procedure. His heart is no longer enlarged, and ejection factor is back to normal. Tim says this is the best he has felt in years, and is grateful for Dr. Hussein.

My husband, Lee, had a triple bypass and two stents by a local cardiologist. He had great respect for his doctor; unfortunately, he was transitioning to a more administrative role, and Lee needed a new specialist. A call to Healthnetwork and we had an appointment. We are very pleased with a specialist in Interventional Cardiology that Cleveland Clinic has recommended. Lee’s appointment is approaching, and we are confident he’ll be in good hands.

I have witnessed two life-changing events facilitated by Healthnetwork. Fellow Legatus members should realize how easy it is to work with Healthnetwork. In my opinion, working through Healthnetwork guarantees a positive experience. We have become GOLD supporters because of the extraordinary care and attention we received from both Healthnetwork and Cleveland Clinic.

DIANE HUSS, (and her husband Lee) from LaSalle, Michigan, are Legates in the Genesis Chapter, as well as Healthnetwork GOLD supporters.

Addressing risky behavior that leads youth astray

In the cultural wars, Obria, a nonprofit chain of pro-life clinics offering a holistic health approach for women, just scored an amazing win. They were given a two-year Title V grant in the amount of $450,000 per year to teach sexual risk avoidance in the states of California and Washington. It is a significant step toward healing a culture steeped in ignorance, which has been critically wounding bodies and souls.

Operating on the assumption that young people engage in sex outside of marriage, public school sex education has become a promoter of it. It is a model destined for failure, focused on accommodating dangerous and immoral behavior rather than reversing it.

Last year, two scientific reviews made headlines concluding that abstinence-until-marriage programs fail to protect kids and also violate their human rights by not supporting their sexual activity. The premise of accommodating license over morality, however, is not only at odds with moral, healthy living, but at odds with numerous other studies reporting that “sexual-risk avoidance” programs reduce risky behaviors and even increase academic success in students.

Much-needed U-turn

The Planned Parenthood sex education model has dominated public schools while abstinence education is actually illegal in the state of California. But the comprehensive sex-risk avoidance model is gaining national acceptance and funding, according to Kathleen Eaton Bravo, an Orange Coast Legate and founder and CEO of Obria, a chain of pro-life medical clinics. Obria offers comprehensive life-centered health to women at 30 clinics in five states with the aim to reach 200 sites by 2021.

“To promote a culture of life, it is important to address the behaviors that lead young people astray by offering education in sexual risk avoidance,” Bravo explained. As the mother of three adult sons and as a post-abortive mom, Bravo understands first-hand that education is the key to making good decisions. Under the Trump administration, she said there is now a greater willingness to fund such programs.

Last October, Obria became the first California-based pro-life organization in 37 years to receive a grant from the Department of Health and Human Services under Title V to teach sex-risk avoidance. “All of our affiliate clinics are implementing the program,” Bravo said. “We expect to see 15,000 students in the first year.”

 Motivation over threat 

Obria Executive Director Mauricio Leone wrote the grant, to teach the curriculum created by the Center for Relationship Education – which bases everything on science supported by research – to promote healthy relationships. It uses the “whole person” approach, nurturing the body, mind, and heart, rather than only focusing only on sexual behavior. And instead of resorting to negativism and threats, it seeks to motivate young people to be their best by simply imparting the facts.

Leone, who is married with two young daughters, was initially impressed by Obria’s pro-life mission, and at first volunteered to write grant proposals. He was soon hired full time and became certified as a risk-avoidance specialist through Ascend – a national organization that represents the field of Sexual Risk Avoidance education as an optimal health strategy to improve opportunities.

“What is being taught now is much more comprehensive than just abstinence education,” Leone said. “It uses the latest scientific information to teach about sexual health and includes the emotional, psychological, relational, emotional, and physical. The main goal is to eliminate all risks associated with sexual activity.”

“While the typical sex education program teaches how to use condoms, we are presenting an entire picture of what a human being is,” Leone said. “Everything we teach is factual and science-based. We inform on the consequences of STDs, and relate methods of contraception— though we don’t normalize them— as we educate about the risks, and show that no contraception is 100 percent effective.”

Given that California does not allow such education in their schools, Leone said that they will train educators to implement the program in their clinics — for teaching patients directly — and in other settings such as churches, as well as Christian and Catholic schools. “I just heard that the Archdiocese of San Antonio is partnering with the University of Texas to implement this curriculum in Catholic schools in Texas,” he said.

In Washington, the program will be offered to the public schools since it is not illegal there. According to Bravo, since many parents in California are not aware that sexual risk avoidance education is not allowed in public schools, she hopes to inform and encourage them to support legislation to change that law.

“This grant was perfect for us, to empower young people to change their lives for such a time as this,” Bravo said. “Now the doors are open again, and committed to life-affirming education.”

PATTI ARMSTRONG is a Legatus magazine contributing writer

Palliative care: intensive caring when cure isn’t likely

The word “palliative” may seem an odd word to use in medicine, as the dictionary defines palliate as “to relieve or lessen without curing.” Yet, isn’t it the purpose of a physician to fix and to cure? Modern medical technology often excels at providing diagnoses and treatment possibilities, but of itself, it doesn’t provide the necessary conversations when ailments prove incurable or refractory to treatment. Palliative care provides ways to care even when cure is not possible.

The Center to Advance Palliative Care defines palliative care and the medical sub-specialty of palliative medicine as “specialized medical care for people living with serious illness…to improve quality of life for both the patient and the family.” Palliative care can be helpful and appropriate at any age, in any serious illness stage, and works to provide relief from stress, in whatever form it takes. It is team-based, often with representation from medicine, nursing, social work, and chaplaincy, because serious illness affects one physically, emotionally, mentally and spiritually. Palliative care teams can be found in hospitals, clinics, or embedded in other subspecialty practices, like oncology. There is palliative care for adults, for children, even perinatally, helping parents cope when their pre-born baby is found with serious diagnosis during pregnancy.

Many people possess misconceptions regarding palliative care. Some think palliative care means “giving up” when it actually adds an additional layer of support. Patients can continue with all their other medical care, like dialysis, chemotherapy, and hospital visits. Others believe palliative care is synonymous with hospice care, but hospice is a small subset within palliative care. Both focus on comfort and living the best life possible despite serious illness. Hospice is most appropriate when care and hospitalization directed at the disease are more burdensome than beneficial. With hospice, the focus is patient comfort, most often in the familiarity of the home, surrounded by loved ones. Patients can continue medications providing symptom-management and comfort. Hospice care, when consistent with patient goals, can be a very peaceful experience for patients and families.

It is also important to emphasize that hospice and palliative care should never do anything to prematurely hasten death. The field is created as the antidote to the suffering that may cause one to seek physician-assisted suicide. As Dame Cicely Saunders, the founder of the hospice movement, said to patients: “You matter because you are, and you matter to the last moment of your life. We will do all we can, not only to help you die peacefully, but also to live until you die.”

The word “palliative” derives from the Latin pallium, meaning “to cloak.” Cloaking patients and families with support and symptom management encourages living the best life possible despite chronic or incurable illness. Studies show that people live longer – and better – with palliative care than without. Palliative care physicians witness a beautiful awe caring for patients in intense and intimate times. They are like leaves in autumn, which are most lovely before they fall, because the autumn in physical life can be a true springtime for the soul.

NATALIE RODDEN runs the palliative medicine consultation service at St. Anthony North Health Campus in the Denver area. She also serves as co-chair of her hospital’s ethics committee and travels nationally providing education and advocacy for authentically Catholic end-of-life care and against physician-assisted suicide.

Reducing stress hinges on individual resilience

It’s 2019 – a New Year! A popular resolution made at this time of year is to “reduce the stress in my life.” The solution is not simple; stress or what is perceived as stressful varies from person to person

One’s ability to adapt to stressful situations and crises is often referred to as emotional resilience. Although it is thought that we are born with a certain degree of emotional resilience, it is also something that can be developed. The more emotional resilience you have, the better you can cope with the stress in your life.

Characteristics of emotional resilience:

Emotional awareness • the ability to understand what you are feeling and why you are feeling it
Perseverance • focus on being action oriented to move beyond stress
Internal locus of control • believe that you have the power to control events and outcomes, not external forces
Optimism • see positives in situations and believe in your strengths
Support • have a strong network and supportive friends and family members
Sense of humor • maintain levity amid life’s highs and lows
Perspective • learn from mistakes and see obstacles as challenges
Spirituality • often associated with stronger emotional resilience

The first step in stress management is to accept responsibility for the role you play in creating or maintaining it.

The 4 A’s of dealing with stressful situations

Avoid unnecessary stress

  • Learn to say “no”
  • Avoid people who stress you out
  • Take control of your environment
  • Shorten your to-do list
  • Prioritize – distinguish between must do and should do

Alter the situation

  • Express your feelings
  • Be willing to compromise
  • Be more assertive
  • Manage your time better

Adapt to the stressor

  • Reframe the problem
  • Look at the big picture
  • Adjust your standards – perfectionism is a major source of avoidable stress
  • Focus on the positives

Accept the things you cannot change

Remember to make time for fun and relaxation and adapt healthy lifestyles. Connect with others, exercise regularly, eat a healthy diet, reduce caffeine, sugar, and alcohol, avoid cigarettes and recreational drugs, and get enough sleep

Please visit Prescription for a Better Life by Susan Locke, M.D., at www.healthnetworkfoundation.org

If you would like more information about Healthnetwork Foundation and how we can advocate for you, please call or email us today.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

Protecting ‘power’ to the brain can fend off Alzheimer’s

For the first time in history, non-infectious chronic diseases (cancer, heart disease, diabetes and dementia) have replaced infectious diseases in the majority of deaths worldwide.

In the U.S., Alzheimer’s disease (AD) is second only to cancer as the most feared diagnosis. Alzheimer’s is a cruel disease; symptoms progress over a decade, slowly and relentlessly robbing people of their memories, ability to think, and remain independent. No one has ever survived Alzheimer’s disease and the current available treatments have very modest benefits. Sixteen million American caregiving families and friends last year accounted for $232 billion in free care during 18.4 billion hours.

The greatest risk factor for developing AD is age. AD affects 10 percent of people over 65 years, and 45 percent over 85 years. Nearly 50 million people worldwide have AD, and this number is expected to nearly triple over the next 30 years, due to the world’s aging population.

Sobering news, but there is hope.

Through current brain imaging capabilities and blood and spinal fluid testing, we know that AD typically starts ‘silently’ in midlife with the slow accumulation of two proteins — amyloid and tau— decades before the mildest symptoms appear. Disease gradually progresses to subtle memory problems and then worsens to involve additional thinking skill (reasoning, judgment, attention, and language). When these symptoms reduce a person’s ability to perform everyday activities, a diagnosis of Alzheimer’s “dementia” is made. Patients with AD often have a second form of dementia (vascular, Lewy body, etc.).

Treatment – medical and practical

What about treatment? First, there are non- modifiable risk factors, such as advancing age and genetic risk factors, such as a protein called ApoE4. About one-fourth of the population carries this protein, and people with one or two copies of ApoE4 have a threefold and twelvefold, respectively, increased risk of AD. Gene therapy advances may make it possible to either “silence” or alter ApoE4.

Modifiable risk factors include cardiovascular disease (e.g., diabetes, high blood pressure, heart disease) and social and cognitive disengagement. A healthy heart helps to maintain a healthy brain, and an active mind increases resilience to AD. Eating a healthy diet, avoiding mid-life weight gain, not smoking, modestly drinking alcohol, regularly exercising (even walking!), treating diabetes, high cholesterol and high blood pressure if diagnosed, maintaining strong social ties with your friends and family (don’t be too busy to visit, call, or e-mail), and keeping mentally active (reading, seeking challenging mental tasks, being the ‘eternal student’!) could reduce the cases of Alzheimer’s disease worldwide by as much as a third! The Alzheimer’s Association is a great first resource for those interested in learning more: https://www.alz.org.

On the scientific front, there are many clinical trials to reduce levels of abnormal amyloid and tau proteins, as well as trials focusing on the brain’s immune system, neurotransmitters, and improving brain cell survival. Gene therapies and adult stem cell approaches will likely impact the future course of AD.

MARTIN M. BEDNAR, M.D., PH.D. is vice president, Neuroscience Therapeutic Area Unit, Takeda Pharmaceuticals and a fellow of the American Association of Neurological Surgeons. Throughout his pharmaceutical career, he has focused on Alzheimer’s disease therapies. Dr. Bednar is president of the Providence, RI Legatus chapter and a frequent author on the interrelationship of science and religion, embracing the sanctity of life from conception to natural death.