Open Forum in The Villages, Florida

Decoding Alzheimer's: Dr. Craig Curtis on Pioneering Research and the MIND Diet Connection

February 23, 2024 Mike Roth & Dr. Craig Curtis Season 5 Episode 9
Open Forum in The Villages, Florida
Decoding Alzheimer's: Dr. Craig Curtis on Pioneering Research and the MIND Diet Connection
Open Forum in The Villages, Florida
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Unlock the mysteries of the mind with Dr. Craig Curtis as we journey through the latest innovations in Alzheimer's research and the promise of novel treatments that have the power to alter the trajectory of this devastating disease. With America's silver generation growing by the minute, Dr. Curtis enlightens us on a breakthrough blood test that could signal the presence of Alzheimer's plaques early on, and Aducanumab, an FDA-approved drug that's slowing the disease's progression. We're not just talking science; we're discussing hope, the future of medical care, and how Medicare plays a pivotal role in bringing these advancements from the lab to the lives they're meant to change.

Feast your brain on the MIND diet episode segment, where we break down the brain-boosting benefits of this innovative eating plan. Dr. Curtis guides us on how to marry the Mediterranean diet with an American twist, revealing how even a moderate adherence can keep our grey matter in prime condition. And if you've ever wondered about the effects of fasting on your cognitive fortress, tune in for a compelling look at how taking a break from eating could fuel inflammation reduction and cellular rejuvenation. Prepare to be inspired to take proactive steps towards safeguarding your cognitive future.

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Open Forum in The Villages, Florida is Produced & Directed by Mike Roth
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Emily:

Welcome to the Open Forum in the Villages Florida podcast. In this show we talk to leaders in the community, leaders of clubs and interesting folks who live here in the villages to give perspectives of what is happening here in the villages Florida. We hope to add a new episode most Fridays at 9am. We are a listener supported podcast. There will be shoutouts for supporters and episodes. As a supporter you will get a direct email link to Mike. In season 5 we are making significant improvements and changes on an ongoing basis.

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Emily:

If you have a book that you would like to turn into an audiobook, let us know via email to mikeatrothvoicecom. Hope you enjoy today's show.

Mike Roth:

This is Mike Roth on Open Forum in the Villages, florida. I'm here today with Dr Craig Curtis. Thanks for joining us, craig. Thank you for having me, mike Good. Dr Curtis, you've been on the show before and you're a long-term supporter of the show. I want to ask you a couple of questions today about Alzheimer's disease epidemic in America. Would I be right when I characterize it as an epidemic?

Dr. Craig Curtis:

You would be very close.

Mike Roth:

Yeah, it seems to affect older people first. That's right.

Dr. Craig Curtis:

And one of the most important, I guess, aspects to the academic is that we currently have 60 million people in the United States over the age of 65. And in the next 30 years we will have approximately 90 million people in the United States over the age of 65. So the incidence of Alzheimer's disease will indeed be rising.

Mike Roth:

So there have been a couple of updates or advances in Alzheimer's research and treatment since we last spoke. First, could you tell our listeners a little bit about the blood test that's been announced for Alzheimer's?

Dr. Craig Curtis:

Sure. So in 2020, we had the world's first blood test, cleared by the FDA, to detect what we call plaques, which are made up of this protein called amyloid that builds up in the brain, which causes Alzheimer's disease. So that first blood test detected those plaques. But I would say it's accurate, but it's not accurate enough, and so scientists have been searching for better ways or better blood tests, and just in the last month, they published some data showing a new blood test that is no-transcript, possibly more accurate, and not only that, but it detects these problems prior to symptoms, it looks like, which will be very, very important for prevention.

Mike Roth:

On the treatment side of Alzheimer's, the new drug that was proved by the FDA that you talked about the last time you were here. Can you tell us where we are on that drug?

Dr. Craig Curtis:

Sure, so that drug is called the can be and it was approved last July in 2023, and it was the world's first drug to show, in over 18 months, in approximately 2000 people, that it slowed the progression of Alzheimer's disease by approximately 25% over those 18 months, so can you translate 25% into time.

Dr. Craig Curtis:

Roughly five months gained in 18 months. So the theory is and we don't know this is worth we're continuing to test is that, while if someone takes it for a longer period, does that mean they'll gain even more time? So those are answers still yet to be determined, although the data is pointing in that direction.

Mike Roth:

So it could be something like insulin, where once someone is on it, they really can't get off it and it does no no, we actually what.

Dr. Craig Curtis:

We think, that we're only going to need to treat patients for a limited time. So if they need a limited amount of time to remove the amyloid, remove the plaque, then they should start to slow the memory loss. So we feel like we need to get to that amyloid early and clear it out quickly because the changes in cognition or the retaining of memory. There's a delay of approximately one year from when you clear out the plaque to when we start seeing actual slowing of the disease.

Mike Roth:

So we're going to be on the drug for about a year.

Dr. Craig Curtis:

Well, sometimes, based on dosing, we might need to go a little longer. There are some newer medicines coming that looks like we might be able to clear out the plaque in as short as six months.

Mike Roth:

And those are going to be expensive, not covered by insurance.

Dr. Craig Curtis:

Medicare has said they're going to start covering those medications. We hopefully by the end of this year. The first thing they just announced a few months ago is they're going to start covering the cost of the PET scans. But the PET scans to detect amyloid are still very, very expensive and I think Medicare is really hoping the blood test turns out to be what we think it can be. And we should note matter of fact, there's a new blood test coming on the market in a few weeks. That seems very, very accurate.

Mike Roth:

Is there a name to that new blood test? There is a name.

Dr. Craig Curtis:

Well, the company is called ALSPATH A-L-Z-P-A-T-H.

Mike Roth:

So you'll be able to go into your local quest diagnostics for a blood test that they do once a year with your family physician and have that test added on.

Dr. Craig Curtis:

Well, there's a couple of really important points. You just brought up Number one family physician and number two can you just walk into quest and get it? So they did just run a study where they showed that if we don't move these blood tests into primary care in a couple of years, it could take four years to get a diagnosis and get treatment. Wow, if we're leaving this only to the specialists. So, therefore, it was a study done by the RAND Corporation and they said that if we can get these blood tests into the hands of primary care physicians, then we can cut that weight by many years.

Mike Roth:

And then the outcomes would be better if treatment is thoughts earlier, exactly.

Dr. Craig Curtis:

We absolutely know that starting treatment earlier is better.

Mike Roth:

Okay, let's talk for a few minutes about some of the things that people can do on their own to get better. I understand there have been some studies that talk about exercise and how that helps in brain health.

Dr. Craig Curtis:

That's right, some really fascinating research recently. So there was an article published in the Journal of Alzheimer's Disease in January so one month ago, january 2024,. It was researched on at UCLA and Washington University where they looked at 10,000 people. They looked at the brain volume on MRI scans.

Mike Roth:

So 10,000 is a significantly large sample.

Dr. Craig Curtis:

That is a very large sample, exactly Good research. So they looked at brain volume in those aged 18 to 97 and correlated that with how much exercise those people performed over the prior couple of weeks. And those with greater than 25 minutes a week of moderate exercise had larger brain volumes.

Mike Roth:

So you don't need to go to the gym every day for an hour or even three days a week. You need to exercise at least 25 minutes per week and it was moderate exercise.

Dr. Craig Curtis:

That's right. According to this study, the moderate exercisers did the best, and those are people that essentially, are able to huff and puff while they work out. So get the heart rate up a little bit, get the breathing a little heavy, sort of like a brisk walk. You didn't need to go to the hop on your bike and ride as fast as you can.

Mike Roth:

For 25 minutes every other day.

Dr. Craig Curtis:

That's right, and you didn't need to jump in the pool and swim laps as fast as you can and you didn't need to go for a run.

Mike Roth:

So if I just jumped in the pool and swam laps for 10 minutes a day, three days a week, that would probably cover me. You would have a larger brain at the end of it. Yes, and larger brain means from a brain's health perspective.

Dr. Craig Curtis:

It means a healthier brain. Just like if Arnold Schwarzenegger walked through this store and took you to the gym every day for the next six months and you lifted weights, your muscles would probably get a little bigger.

Mike Roth:

Yeah Well, if you exercise, I have a lot of aches and pains.

Dr. Craig Curtis:

Right, but you would have bigger muscles and if you do this moderate exercise for 25 minutes a week, you will have a larger brain, according to this study.

Mike Roth:

And larger brain means a lower likelihood that Alzheimer's or dementia will set in on you.

Dr. Craig Curtis:

Well, we don't know that for sure, but what we can say is that a larger brain probably indicates that your brain is healthier, and those people tend to live longer.

Mike Roth:

Okay, so even people who like to read a lot in a very sedimentary, if they get out and exercise for 25 minutes a week in a moderate level, will benefit from just that. That's right.

Dr. Craig Curtis:

The study. Primarily you need at least 10 minute blocks of exercise. So 10 minutes. Don't take 25 minutes and divide it by seven days and get four minutes a day. That won't work, but in 10 minute blocks. So generally, like you said at the beginning of this, that three 10 minute sessions a week appears to give you a larger brain.

Mike Roth:

Okay, so if you're in the villages, we can tell people to walk around a couple of blocks twice or three times a week and that will dramatically help. That's right.

Dr. Craig Curtis:

Not a stroll, though you don't want to go and look at the birds and you want to move and get your heart rate up and get your breathing rate up as well.

Mike Roth:

Okay, so not quite at the race walk speed level, but just moderate race walking will do it for you.

Dr. Craig Curtis:

I say a brisk walk is what I like to say.

Mike Roth:

Okay, good. The other thing that people might be able to do is modify their diet. Can you tell us what the latest research is on diet and Alzheimer's?

Dr. Craig Curtis:

Yes, so there's been a lot of talk about diet and Alzheimer's disease. There's a lot of data published that those that follow a Mediterranean type diet or a mind diet which I'll cover here in a minute essentially have larger brain volumes, have slower rates of memory loss as they age and might have more resistance to developing Alzheimer's disease and other forms of dementia.

Mike Roth:

Okay, so many of us are familiar with a Mediterranean diet and what that means. The other term you used was a mind diet.

Dr. Craig Curtis:

Right. So the Mediterranean diet traditionally is difficult to follow for Americans. It's based on whole grains, two or three servings a day, fresh fruits and vegetables, green leafy vegetables, multiple servings a day, beans, berries, nuts, legumes, obtaining protein from fish and eggs and chicken, and only having red meat once a month and very little sweets, right.

Mike Roth:

Once a month.

Dr. Craig Curtis:

Exactly so. That's a traditional.

Mike Roth:

I feel like I'm in trouble now.

Dr. Craig Curtis:

No, don't be so. There's some good news here. So approximately 15 years ago, researchers at Rush University in Chicago and Harvard University looked at the Mediterranean diet and said, well, how can we make this more for Americans? What can we do? And so they came up with the mind diet M-I-N-D for Mediterranean interventional neurodegenerative delay diet. Let's stick with mind diet.

Mike Roth:

Yeah, that's what you used to say.

Dr. Craig Curtis:

And it's not a diet, it's really more of a lifestyle and essentially it converts the Mediterranean diet into a much more accessible diet for Americans. So you're allowed some pastries and some more sweets and some more red meat, but they really, really still attempt to get you to follow the fresh fruits and vegetables and berries and beans, nuts, legumes, et cetera.

Dr. Craig Curtis:

And as much chicken as you can and fish and eggs for protein. And they really want you to avoid fried foods, foods fried in oil. Specifically, they want you to avoid heavy use of alcohol. One to two drinks a day, we'll talk about in a few minutes seems to provide some benefit in a couple of areas, but we'll talk about that in a minute. And so the mind diet is much easier to follow for Americans and for what we're used to eating.

Dr. Craig Curtis:

And then the other thing is that mind diet, that eating, that type of eating can be. You can eat other foods from other, I would say, ethnic foods. For example, you can eat Mexican food and still follow a mind type lifestyle. You can eat Turkish food and still follow the mind lifestyle. You can still eat American food and follow a mind type diet or lifestyle. So there's a lot of different. There's a lot of flexibility to it as well.

Mike Roth:

You kind of indicated that the mind diet includes sugar.

Dr. Craig Curtis:

Well, there is a little bit of sugar. We don't want you to take in extra sugar, but there will be sugar in natural sugar in a lot of the fruits that you eat and you said pastries. Well, good pickup. So it allows you to. We know that if we try to put people on this restrictive diet, they're essentially not going. They're going to fail or they're not going to do well when they attempt to do that. So, yes, we're being a little more generous and we don't want to live forever.

Mike Roth:

Or do you? Well, that's a heck of a good question, and I've always answered it for myself. I want to live as long as I'm healthy, right Okay? I don't like the idea of becoming a vegetable someplace.

Dr. Craig Curtis:

Well then, eat your vegetables. Oh, I love the vegetables, okay.

Mike Roth:

I'm lucky because my wife hates cooking with oil. She she always burns herself, and when we were first married she told me no fried foods.

Dr. Craig Curtis:

Smart wife, although one of my favorite foods in the world is fried chicken, so I can't, but I just don't do it that often. I try to, maybe once every three or four months.

Mike Roth:

That's something I used to love as a kid, and I just can't eat it now. I'd rather have an eggplant, and I think that's a wonderful food.

Dr. Craig Curtis:

And you know what, as you sort of start to follow these types of lifestyles, you do start to sort of forget what you used to love and you can find new things that you love, just like what you said about eggplant.

Dr. Craig Curtis:

And I do wanna point out that the data, the studies that have been done using the mind diet, are significant studies, meaning that one of the recent studies just published a few months ago actually looked at autopsy data from people that follow the mind diet and the beautiful thing was so. Let's say, for example, there are 21 meals in a week breakfast, lunch and dinner. If you were able to change about half of those, so 10 of those meals a week, let's say you chose to eat salads and more green leafy vegetables and olive oil and whole wheat toast, et cetera.

Dr. Craig Curtis:

If you did that, with about 10 of those meals a week, you can increase the size of your brain. Autopsy proven so. Otherwise these people had bigger brains. So once again we're kind of back to the bigger brain topic.

Mike Roth:

That's a good idea.

Dr. Craig Curtis:

But this was autopsy proven. I believe in approximately 500 autopsy so you don't need to follow it with 21 meals a week like religiously every day. This was people that just followed the diet to what we call moderate adherence of approximately half the meals a week.

Mike Roth:

Has there any research been done about fasting diets, where they say don't eat anything for 16 hours?

Dr. Craig Curtis:

Yeah, so that's been really popularized over the last couple of years. So a lot of the data comes from animals, not from humans at this point, and so we knew. The world really first found out about it when they took mice and they calorie restricted mice and this was for their whole life.

Dr. Craig Curtis:

This was just calorie restriction on a daily basis, and those mice outlived their peers approximately double, and this was, I think, around 20 years ago. They figured this out and so then they started to look at fasting and 16 hour fast, et cetera, where you just eat regular one day and then you might skip breakfast and lunch the next day and only eat dinner. So the theory is that promotes. It promotes a reduction in inflammation in the body. We're constantly fighting inflammation, whether it's in the body or the brain. It promotes autophagy, which is the removal of old cells.

Dr. Craig Curtis:

So we have these old cells in our body that we want to get rid of, and some of that is true in animal data, but I don't think we know enough about in humans yet how helpful it may be. I think it's okay if you want to follow fasting I don't have any problem with it when my patients talk about it but I do think that you should do it once again in moderation.

Mike Roth:

I heard it helped in lowering your resistance to insulin, because every time you eat something, your body produces insulin, and if you don't eat it fast, that insulin is not produced, so that it helps you in prevention of diabetes.

Dr. Craig Curtis:

That is true so far in animal studies and in humans. We think it's true because people that fast do tend to have a lower weight so therefore, overall, they're putting less stress on their body as far as insulin and diabetes.

Mike Roth:

So in the time we have left, dr Curtis, can you tell our listeners a little bit about what you do over K2 research?

Dr. Craig Curtis:

We're clinical researchers, which means we study Alzheimer's disease and prevention of Alzheimer's disease. Matter of fact, one of the big studies we're involved in right now is one of the country's largest prevention studies. So this is a study partially funded by the NIH, the US government, and it's being coordinated through at Harvard University and University of Southern California. They're the coordinating centers and there are approximately 80 research sites around the country, and what we're looking for are people over the age of 60 that would like to have a PET scan to see if they're developing amyloid. And these are people that have no symptoms of Alzheimer's disease. They don't have any memory loss, no cognitive complaints at this time, and if we find amyloid in their brain, that is the number one risk factor for the development of Alzheimer's disease. That's what we find in the brains of patients with Alzheimer's disease, and so the study will run four years where they can get the medicine that was just FDA approved. They get that or a placebo, and we're going to follow them for four years to see if removing that amyloid before they get dementia will actually halt the progression or stop people from developing Alzheimer's disease.

Dr. Craig Curtis:

So that is a really, really important study and a really, really one of our main focuses at K2, at my research center. And then we're also looking for patients that have memory problems. We're doing, we're performing regular research, what I would say regular research trials on patients that have memory problems. We're trying to investigate what's causing that memory problem if it is indeed amyloid, which would indicate that the patient probably has early Alzheimer's disease and we're trying different medications to try to remove that amyloid and slow the progression of Alzheimer's disease. And once again, we've already had one home run in the field and we're looking at newer, more advanced medications that we think might be much better.

Mike Roth:

So, dr Curtis, what do you think the future looks like? Alzheimer's treatment here in America.

Dr. Craig Curtis:

I think the future looks very good. I think that these blood tests are going to make a significant difference in our ability to detect someone who's developing Alzheimer's disease before symptoms. And let me take a step back and just cover that for a second. So we know that a person who develops memory loss due to Alzheimer's disease, we know that that disease actually started approximately two decades or 20 years prior. We know that amyloid starts building up for approximately 20 years 15 to 20 years which then initiates other brain cells or to die off, essentially, which leads to Alzheimer's disease. So we're trying to remove that amyloid prior to that so we can prevent Alzheimer's disease.

Dr. Craig Curtis:

And we're also attempting to want. Somebody already has the cognitive changes or memory symptoms. We're trying to figure out if we, if reducing that amyloid really slows the disease. So we now have, of course, the world's first medicine on the market that is slowing Alzheimer's disease by removing amyloid from the brain, and we're looking at newer, more advanced forms of those medications that remove the amyloid much more quickly, in a matter of months. So that's very exciting.

Mike Roth:

So if one of our listeners wants to go to one of your seminars that you put on regularly, how do they make a reservation to do that?

Dr. Craig Curtis:

The easiest way is to go to our website, which is wwwCraigCurtisMD. com, or call our office at 352-500-5252. Thanks, dr Curtis. Thank you, mike.

Emily:

Remember our next episode will be released next Friday at 9 am. Should you want to become a major supporter of the show or have questions, please contact us at mikeatrothvoice. com. This is a shout out for supporters Tweet Coleman, ed Williams and major supporter Dr Craig Curtis at K2 in The Villages. We will be hearing more from Dr Curtis with short Alzheimer's tips each week. If you know someone who should be on the show, contact us at mikeatrothvoice. com. We thank everyone for listening to the show. The content of the show is copyrighted by Rothvoice 2024, all rights reserved.

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