Living with Alzheimer's disease

Dr. Janice Knebl has cared for residents at the James L. West Alzheimer Center since it opened 16 years ago in Fort Worth, Texas. Knebl, a geriatrician, is also a prominent researcher in the field of Alzheimer's and dementia. Here she discusses the disease, its treatment and prevention.

Q: Are we close to a cure for Alzheimer's?

A: I'm not as optimistic about a cure. I view this disease at the same complexity level as diabetes. We do not have a cure for diabetes, but we have great approaches, prevention, treatment and management. If we can do what we've done with diabetes, that could be awesome. It would have a major impact.

Q: How much do we know about the causes of Alzheimer's?

A: We don't know the cause, but we know a lot more than we did. (Proteins called plaques) are like gum interfering with the way cells talk to each other. Also, another kind of protein (tangles) actually gets in the nucleus and causes cell death. The brain actually degenerates and shrinks.

There is just a huge amount of research at many different levels. One is looking at those plaques and tangles and trying to understand how they're made. Can we stop them from being produced or can we eliminate them once they are produced? Another area we look at is what's called neurochemicals. It's how the brain cells talk to each other. Research is being done, trying to alter the amounts of those chemicals in the brain to help people function better. But those drugs do not alter the course of the disease.

Q: Can anything be done to reduce the odds of developing Alzheimer's?

A: People need to be physically active because the brain is attached to the rest of the body. Walking is great. Diet is really important. If you have high blood pressure, you need to get that treated because high blood pressure is not good for the brain. Smoking is another one. Drinking in moderation. Those practical things.

If people are under undue amounts of stress and suffer from depression, it's got to get treated. People with late-life development of depression have a higher risk of developing dementia. We don't understand the connection, but it's clearly there.

The other thing is just keeping your brain active. There are all kinds of games now. Nintendo has come out with them, and Dr. Gary Small at UCLA has his own kind of brain game. Something simple to do is to not drive home the same way every day. Change it up, because you get into a rote mode. You get home and you don't even remember how.