Exploring Alzheimer's Prevention with Dr. Craig Curtis

Exploring Alzheimer's Prevention with Dr. Craig Curtis

In this episode of the Open Forum in The Villages, Florida, host Mike Roth is joined by Dr. Craig Curtis to discuss Alzheimer's disease and ongoing research. Dr. Curtis highlights the development and impact of FDA-approved drugs Licanumab and Denanumab, which aim to slow Alzheimer's progression by removing amyloid protein from the brain. They discuss preventative studies, including the U.S. Government's Ahead study, and examine factors like nutrition, exercise, and overall health that may influence the onset of Alzheimer's. The episode concludes with information on how listeners can participate in clinical trials and support Alzheimer's research.

00:00 Welcome to the Open Forum in The Villages

00:58 Support the Podcast

01:39 Introduction to Dr. Craig Curtis

01:57 Understanding Alzheimer's Disease

03:05 FDA Approved Drugs for Alzheimer's

05:04 The Role of Amyloid and Tau in Alzheimer's

10:17 Prevention Studies and Lifestyle Changes

15:24 The Importance of Research Participation

20:09 Data Security and Privacy in Research

24:43 Final Thoughts and Contact Information

Transcript

Nancy: 0:08

Welcome to the Open Forum in The Villages, Florida. In this show, we talk to leaders of clubs and interesting folks who live here in The Villages to get perspectives of what is happening here in The Villages, Florida. We are a listener supported podcast. There will be shout outs for supporters in episodes.

Mike Roth: 0:26

This is Mike Roth. I'm thrilled to share with you this podcast, which is my passion project for you. This podcast brings you knowledge, inspiration, and a lot of things that people need to know About the villages and the people living here. Be sure to hit the follow button to get the newest episode each week. Creating this podcast is a labor of love. Even though it demands more time, I can easily spare. Now, here's where you come in. You can help us keep the podcast alive and thriving. How? By becoming a supporter. The easy way for you to support us is to visit our podcast webpage. OpenForumInTheVillagesFlorida.Com and click on the supporter button at the top of the page or the purple supporter box. Even a small donation of three to ten dollars a month makes a big difference and you can cancel your subscription at any time. Your support means the world to us. Stay curious, stay inspired, and keep those headphones on. I hope everyone enjoys today's show. This is Mike Roth today, I'm here with Dr. Craig Curtis. Thanks for joining me, Dr. Curtis.

Dr. Craig Curtis: 1:45

Thank you,

Mike Roth: 1:45

Today, Craig, why don't you tell our listeners a little bit about the types of studies for Alzheimer's that you're doing now at K2.

Dr. Craig Curtis: 1:53

Sure. I'd love to highlight our prevention studies. We now know that Alzheimer's disease starts about 20 years before the symptoms, with the buildup of a toxic protein called amyloid. And so scientists have been on a quest to remove amyloid to see how it affects the disease. the medicine that was recently FDA approved to slow down symptoms in people with Alzheimer's disease memory problems works by removing this substance called amyloid out of the brain. And now we're attempting to use those medicines to actually remove amyloid before someone develops symptoms of Alzheimer's disease, such as memory loss and forgetfulness.

Mike Roth: 2:38

So that's in that 20 year period before the disease is obvious?

Dr. Craig Curtis: 2:43

That's right. Scientists now call it alzheimer's pathologic change versus Alzheimer's disease. And we're saving the term Alzheimer's disease for when someone is actually experiencing symptoms due to Alzheimer's disease, which we would know as memory loss, forgetfulness, problems thinking, lapses in judgment, etc.

Mike Roth: 3:05

I thought there were two drugs that were approved by the FDA for helping delay the symptoms in Alzheimer's. Did I get that right?

Dr. Craig Curtis: 3:13

Not exactly. We're not delaying the symptoms yet. So those medicines are only FDA approved for people that are actually experiencing memory loss due to Alzheimer's disease. And other symptoms of Alzheimer's disease. those medicines work by removing amyloid out of the brain and slowing the progression of symptoms. Currently, we cannot halt the progression of symptoms nor reverse the progression of symptoms. But we can slow the progression of Alzheimer's disease About how much? Approximately 25%, which some scientists are debating whether or not that's even worth the expense of the medication and the potential side effects of the medication. although it appears to be an important slowing, it's actually more of a minor slowing, but we do have better medicines on the way.

Mike Roth: 4:08

Could you, Tell our listeners what the names of the two approved drugs are.

Dr. Craig Curtis: 4:12

Yes. The first one is called Licanumab, and it was approved in 2023. And the second one is called Denanumab, and that was approved in late 2024. They both work the same way. The medicines are antibodies that only attach to amyloid in the brain. So when we give these antibodies, they actually attach to the amyloid, stimulating the immune system to come along and gobble up or remove that amyloid. They're very successful at removing amyloid. But we think that we're just getting to patients a little too late by the time we give them those medicines. Because by the time someone has symptoms, otherwise memory loss and judgment issues and other symptoms of Alzheimer's disease, they already have quite amount of amyloid in their brain.

Mike Roth: 5:04

What about the tau that happens after the amyloid?

Dr. Craig Curtis: 5:07

What we now know is that amyloid builds up over 20 years and then initiates Tau, a second protein inside the cells that starts breaking down. we have amyloid building up outside and around the cells and Tau breaking down inside the cells when Tau starts to break down brain cells, die off and we start to have symptoms of Alzheimer's disease. Amyloid is the spark and tau is the fire. we have this spark sparking for 20 years, without symptoms once the spark causes the fire, the breakdown of tau inside the cell, we start to see symptoms. We are actively researching ways to stop tau as well.

Mike Roth: 5:49

Is it possible to regrow new brain cells? To replace the ones Tao has killed.

Dr. Craig Curtis: 5:56

That's a hot topic. Scientists, for the most part, do not believe that we can regenerate any brain cells. There have been a few research papers published in the last four or five years that hint that there might be some brain cell regeneration, specifically in a part of the brain called the hippocampus, which, ironically, is where Alzheimer's disease starts, but it's really hard to prove that in humans.

Mike Roth: 6:22

And there are. No studies now that would involve the tau?

Dr. Craig Curtis: 6:26

Scientists have been studying amyloid for about the last 30 years, and it has become clear in the last probably 8 to 9 years that amyloid is the spark and tau might be the fire. So scientists have started looking at ways to stop Tau from progressing, because if you think about the disease, it starts very mild with an occasional senior moment or an occasional you can't think of someone's name Or you can't remember directions to a place or you walk into a room and you can't remember why. Those senior moments can be just normal, but they can also be the first warning sign of impending Alzheimer's disease. Now it starts there. And as we know, it does progress. Little small senior moments become bigger. A person starts to forget that someone has called or what they had for breakfast. And that progresses into other problems such as. making poor judgment or poor decisions, other symptoms such as what we call orientation problems or getting lost, driving to familiar places. scientists wanted to know why it progresses and what is going on as it starts very mild and gets worse over time? It turns out that's due to Tau actually spreads from cell to cell. And into other parts of the brain, causing other parts of the brain to become dysfunctional.

Mike Roth: 7:51

If you have a drug that removes the amyloid from the brain, won't that stop the progression of Alzheimer's disease?

Dr. Craig Curtis: 8:01

So that's a great question. And right now we know that removing amyloid once the symptoms have already begun. Does slow the progression of the disease, yet it still continues because tau, once that fire gets lit, you can remove the amyloid, yet the fire continues. As we look at the natural progression of Alzheimer's disease. amyloid builds up for about 20 years, hits a peak, and then it initiates this tau problem, and the tau, as it spreads through the brain, actually causes the symptoms. So even if you removed 100 percent of the amyloid, that would not cure Alzheimer's. That is true in patients with symptoms. You can remove all the amyloid, yet the symptoms will continue to progress. So what we're doing now in these prevention studies is we're trying to see if removing amyloid Prior to symptoms beginning, if removing all the amyloid out of your brain, whether or not that actually halts the progression into actual symptoms and Alzheimer's disease. In fact, there's a very large study funded by the U S government called the Ahead study that I'm a part of. we're not looking for more patients for that study. It started around four years ago, and we recruited around 12, 000 Americans between the ages of 65 and 80, if they reported they did not have any symptoms of memory loss we asked them essentially Would you like a free scan to see if you have amyloid building up in your brain? I think approximately 5, 000 Americans received that scan and around 1, 500 of those have entered into the trial. Half of that group is receiving one of those FDA approved medicines to remove amyloid. The other half is getting a placebo. over the next four years. We will have some answers about removing amyloid in people without symptoms, who have significant amyloid, We will know if removing that amyloid before symptoms begin, can actually stop. That spark from creating the fire. in about four or five years, we could be having a very different discussion.

Mike Roth: 10:17

Is there anything they can do in terms of health or diet that could delay the onset of Alzheimer's?

Dr. Craig Curtis: 10:25

Actually, We're not 100 percent sure that we can delay the onset of Alzheimer's disease, but there's some promising science looking at nutrition, sleep, and exercise. Let's go over each one Let's start with Nutrition. there's a diet called the Mediterranean diet rich in high fiber foods, whole grains, fresh fruits and vegetables, beans, nuts, legumes, and olive oil. Olive oil is critical to the Mediterranean diet. they get their protein primarily from fish eggs or chicken. for Americans, you're not allowed butter, fried foods, or much red meat, maybe once a month for red meat in a true Mediterranean diet.

Mike Roth: 11:05

In the past you talked about something called the Mind Diet. What is the Mind Diet relative to the Mediterranean Diet?

Dr. Craig Curtis: 11:11

That's right. Approximately 25 years ago, scientists realized that the Mediterranean Diet was rather good at helping people age well and retain a lot of vitality as they age. A Western scientist started wondering, is there a way to modify the Mediterranean diet into a little more of an American version or a European version that would still allow us to eat some of the foods we enjoy, yet still receive the health benefits of something like the Mediterranean diet? And sure enough, the MIND diet, which stands for Mediterranean Interventional Neurodegenerative Delay diet, has been shown to slow brain shrinking. Our brains shrink as we age, and it's been shown to actually help people remember better and perform better on cognitive testing. It's been shown in some autopsy studies that it actually reduces the amount of amyloid and Tau in the brain. Yes, there are some very concrete nutritional ways that can make your brain healthier and possibly slow down or prevent Alzheimer's disease to some degree.

Mike Roth: 12:23

Now, from a health and exercise perspective, what can people do?

Dr. Craig Curtis: 12:27

So it turns out that exercise is equally important and crucial to brain health. We know that in people that get regular exercise, that they actually have a slightly larger brain. And it's a good thing to have a brain, but we also know that, there's a lot of benefits to having a brain. And there's a lot of things that you can do to improve your brain health.

Mike Roth: 12:57

And Now, I'm going to Ask you to break exercise up into Two portions when people are younger, they're building muscle by doing this exercise when people get into their 60s 70s or even 80s I understand it's extremely hard to build muscles.

Dr. Craig Curtis: 13:13

It is hard to build muscle yet you can build muscle as you age. you can absolutely strengthen your muscles resistance training, or working out with weights, there was a study out of MIT in Boston, published back in November, that showed that muscles, when they undergo exercise, release a hormone that stimulates neuron growth or brain neuron growth. That study was done in animals, but it's a fascinating look at how resistance training can help the brain as well.

Mike Roth: 13:45

That's good.

Dr. Craig Curtis: 13:46

Mike, can I talk about some of the other prevention studies briefly?

Mike Roth: 13:49

Sure. Let's talk about prevention studies. Everyone wants to prevent Alzheimer's. It's the most feared disease in America. More than heart attacks.

Dr. Craig Curtis: 13:57

It's a very feared disease.

Mike Roth: 13:59

Heart attacks and strokes kill more people.

Dr. Craig Curtis: 14:01

That is true. It's the number one killer of men and women in the United States. Alzheimer's disease is also the only one of the top 10 killers of Americans that we currently don't have a way of modifying significantly. But through these prevention studies, we're hoping we can find some more answers. We're also looking at removing this amyloid before someone gets symptoms. we talked about tau and that protein, how it spreads through the brain. We currently have a research trial where we're testing a vaccine to see if we can halt the spread of Tau. It's a worldwide study and we're doing it right here in The Villages. And we're really hopeful that things like this in the future can provide us some help. That study might be able to stop the progression of Tau, if it works.

Mike Roth: 14:50

Why don't you share with our listeners how they can become involved with you at K2.

Dr. Craig Curtis: 14:55

Sure. So our phone number is 352 500 5252 or they can just go to our website CraigCurtisMD. com or K2Med com. There are many ways to reach us and they can leave some information and we're happy to get back to them and schedule an appointment. I noticed you have a lot of newspaper ads for seminars. Why don't you tell our listeners why you're doing the seminars? The number one problem with Alzheimer's research in the United States, is we don't have enough people volunteering to participate.

Mike Roth: 15:33

Unbelievable.

Dr. Craig Curtis: 15:34

It really is, but the numbers are staggering. A few years ago they published data showing that there are approximately 25, 000 openings for research participants in Alzheimer's disease in the United States, and we fill on average about 7, 000 of those positions. if we could fill 25, 000 a year across the United States, that would be amazing. The pace of Alzheimer's research would pick up threefold. right now, one of our largest problems is finding people that want to participate in research. researchers around the country, whether it's at a university setting a major academic center or research such as ours in The Villages, spend a lot of time in outreach and community events, trying to make people aware of what we do. In fact, most people probably don't realize the research that's happening right here in The Villages in Alzheimer's disease. Yes, and it's our major problem. If you ask me, what's the major problem in Alzheimer's research today? It's not lack of companies attempting to find a treatment or cure. It's not lack of funding from whether it's government funding or whether it's private funding. It's lack of finding qualified participants because when someone comes in for a research study, we do a health exam and we do some blood work, just basic things, making sure they're healthy enough.

Mike Roth: 17:02

Your screening exam would put out a certain percentage of the elder population in which Alzheimer's is likely to occur.

Dr. Craig Curtis: 17:12

That is very true. probably the best example is that government funded study where we're actually looking at removing amyloid ahead of time. It's called the AHEAD study, We started out with approximately 12, 000 people that were interested. Approximately 5, 000 people made it to actually getting the PET scan, they didn't pass the basic screening. or had other health conditions that would not allow them to participate. out of those people, the final people that actually are getting the medicine are around 1,500. So we start with 12, 000 to whittle that down to around 1, 500 They come in every month getting the medicine or placebo and we follow them for four years that's spread across Approximately 75 research centers in the United States. A small percentage actually decide not to move forward on their own. The majority of people that do not move forward, we unfortunately find something in their blood work, EKG, MRI of the brain, or even their PET scan, and we tell them I'm sorry, but we found this, and so you should see your doctor and get this checked out, but you don't qualify right now for the study.

Mike Roth: 18:23

Are you looking for people who are pretty healthy

Dr. Craig Curtis: 18:25

Actually, no, they can have a fair amount of medical problems. They can be on multiple medications. Yes, absolutely. But if we find something, we have to pause and they have to go back to their doctor and that condition has to stabilize. So then they could come back maybe six months to a year later. But overall, I would say over 95 percent of our patients take medicines, sometimes multiple medications, and they have many different health problems, high blood pressure diabetes problems with their intestines, normal things, osteoarthritis, et cetera. But all of those patients can usually qualify for a study.

Mike Roth: 19:04

What about someone who had a stroke?

Dr. Craig Curtis: 19:07

It all depends on how big that stroke was, where that stroke is located. So we would evaluate that on the MRI. Sometimes patients think they had a stroke and we do an MRI and realize there's no damage. we can't find any signs of a stroke. We usually want to do the workup to see if we find anything, even if they have something in their medical history that might exclude them.

Mike Roth: 19:29

it's important for people to volunteer to be part of a study.

Dr. Craig Curtis: 19:34

It is. They're all volunteers, in fact. We tell them that from the beginning. They do get compensated for their time and travel. Some studies pay a few thousand dollars over the life of the study. we don't take insurance because everything is funded. You don't need insurance. We don't charge anybody. Actually we compensate. The participant for participating in the study. So we don't need insurance. there's none of that hassle. one of the major reasons is this is research and we don't want an insurance company to look at results of research when we really don't know what that research means yet. So we don't want that being used against anyone. We take privacy very seriously.

Mike Roth: 20:11

I was talking to some of your people about that and the anonymization of the data from an individual subject seems to be very extreme. The only place it seems that you keep their name is in your paper file.

Dr. Craig Curtis: 20:25

That's right. So the good news is that it's very well protected, all of that information, because once you come in, essentially you get converted to just a number. And that's the kind of data that gets transmitted as we do cognitive testing over time and other tests over time. It's always done via our participant number. So we take that very seriously.

Mike Roth: 20:46

Data security is much better than it is at your Health insurance company

Dr. Craig Curtis: 20:54

I think so.

Mike Roth: 20:55

What is the most important thing for people to know who are slightly younger, say, from 50 to 60?

Dr. Craig Curtis: 21:02

You can make lifestyle changes now that could possibly delay or prevent the onset of Alzheimer's disease. we know there are things you can do engaging in exercise, nutrition, and getting enough sleep every night that seem to really alter the course of aging in positive ways.

Mike Roth: 21:23

Help prevent Or delay Alzheimer's?

Dr. Craig Curtis: 21:27

That is a great question. We know that people that do mental exercises do seem to do better on cognitive testing. Yet we do not have proof or research that it actually alters the course of a disease such as Alzheimer's disease. But all scientists feel, all doctors feel, that you should definitely engage your brain and get involved in crossword puzzles, Sudoku whatever types of brain stimulation you enjoy, and do it on a regular basis.

Mike Roth AI 9-11-24: 21:54

Sure. Here in The Villages, there's a company that advocates using hyperbaric oxygen over a three month period of time to rejuvenate your brain. Have there been any double blind studies that prove that this Therapy is effective.

Dr. Craig Curtis: 22:12

So I'm not familiar with any double blind studies that have shown that it's effective. However, hyperbaric oxygen as a therapy is effective in certain conditions, certain medical conditions, such as a diabetic wound. It can help oxygenate the tissue around a wound and help a wound heal more quickly.

Mike Roth: 22:32

Specifically about Alzheimer's disease.

Dr. Craig Curtis: 22:35

So if you extrapolate that from a wound to a brain that might be damaged due to Alzheimer's disease, it makes sense that something like that could definitely work. I'm not sure I've seen a double blind, placebo controlled study on whether or not that works. But I definitely think all avenues, anything you can do, I definitely agree that it's not harmful, so therefore I would say, why not try it?

Mike Roth: 23:02

It takes 10 years and, it's not like spending a hundred bucks on pills,

Dr. Craig Curtis: 23:05

And I'd love to see, as soon as they put out a double blind placebo to control trial with biologically diagnosed Alzheimer's disease. In order for us to show that a drug works, it takes an average of about 10 years and multiple phases of studies. in approximately 2, 000 people.

Mike Roth: 23:26

2, 000 participants in the study, based on the numbers you just gave us, they would probably need to put 25, 000 people into the sample.

Dr. Craig Curtis: 23:36

I'm sure they could design a study a little differently but generally if they could produce a study with 750 patients or so on each side, one group gets placebo, one group gets the therapy that would probably be sufficient. I'm not a statistician and I'm not the FDA, but I think you would need those types of numbers in order to prove a therapy might work. if it were me. Or my wife, I would definitely try it. I don't feel there's any harm to something like that, that i am aware of.

Mike Roth: 24:07

I think you're right. there could be no harm.

Dr. Craig Curtis: 24:10

Yes, I would definitely have no problem trying it. that's my official stance on it. if a patient asks me if they should try it, and they have the means, I have absolutely no problem with them trying it.

Mike Roth: 24:22

Even if they're in one of your studies?

Dr. Craig Curtis: 24:24

Generally, we would say, please try it before you enter a trial or wait till after it's done, because we wouldn't want to affect the outcome of a trial. Let's say hyperbaric oxygen really works well. That patient could throw the study out of whack by doing so well. The truth is we'd prefer them to do it before or after one of our research studies. Mike, I appreciate you having me on today and I hope your listeners enjoyed this.

Nancy: 24:48

Remember, our next episode will be released next Friday at 9 a. m. Should you want to become a major supporter of the show or have questions, please contact us at mike at rothvoice dot com. This is a shout out for supporters Ed Williams, Duane Roemmich, Paul Sorgen, Kathy Loving, and 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 mike at rothvoice dot com. The way our show grows is with your help. Text your friends about this show if you enjoyed listening, or just tell your friends about the show. We thank everyone for listening to the show. The content of the show is copyrighted by Rothvoice 2025. All rights reserved.