GLOBAL HEALTH AGING

Alzheimer’s is a scary disease. The thought of losing one’s mind while still alive is unsettling and it doesn’t get easier as cognitive and physical decline are closely related. Research has shown that all types of dementia experience mobility decline, even those progressing to Alzheimer’s disease (AD). As dementia progresses, decline in mobility is evident especially as gait and balance become impaired. Alzheimer’s is the 6^th leading cause of death in the United States and an estimated 5.4 million Americans currently suffer from AD. Unlike other major diseases, it seems there is little or no solution to preventing or treating Alzheimer’s. HIV, Stroke and Heart disease have decreased significantly in the number of deaths but Alzheimer’s has greatly increased with devastating statistics. Clearly, the US has a crisis on its hands.

“People with Alzheimer’s disease live a long time, but require constant and very expensive care. They are prevented from working due to the debilitating nature of the illness and those who leave the workforce to care for a family member with Alzheimer’s impact economic productivity.”

While strong research investment is important, advocacy is even more crucial as it gets more people interested in putting an end to Alzheimer’s. In the past few years, millennials have also become strong advocates for issues concerning this disease. Organizations such as Hilarity for Charity and The Purple Elephant focus on the millennial generation and some of these organizations are even managed by millennials, a trend that is changing the face of AD. One millennial who is presenting a fresh take on Alzheimer’s is Max Lugavere. This 32-year-old filmmaker is working on a project that explores the impact of diets and lifestyles on brain health in a documentary called Bread Head. The trailer is fascinating especially as Max asks new questions about Alzheimer’s including the possibility of preventing the disease based on the choices we make.

Global Health Aging was pleased to interview Max Lugavere on his documentary as well as why millennials are starting to get interested in aging and health issues affecting older adults. We hope you find the interview informative.

Global Health Aging: BREAD HEAD asks new questions about Alzheimer’s disease. Do you think people can avoid Alzheimer’s even if they are predisposed to it (family history, heredity, etc)?
Max Lugavere: One thing is for sure—you can do everything “right” in accordance with the current science, and still get it, the same way that you can wear your seat belt all the time but still end up in a fatal car accident thanks to some fluke of bad luck. Science hasn’t provided us with a silver bullet just yet. HOWEVER, you can also greatly minimize your risk—quite easily in fact. My goal is to make people aware of the fact that Alzheimer’s is only determined by your genes for a VERY small number of cases. Less than 5%. For the rest of us, it’s the interplay between our genes and our lifestyles that determine our chances, for Alzheimer’s and for any number of other ailments. Our health is largely in our control—genes are not destiny!

Global Health Aging: The idea that Alzheimer’s is type 3 diabetes is groundbreaking! How does this change everything we know including the beta amyloid proteins that may cause Alzheimer’s?
Max Lugavere: The “type 3 diabetes” moniker is a hypothesis, and diabetes doesn’t cause Alzheimer’s, but it does greatly increase the risk. It does seem that they may be more like cousins, with a similar underlying pathology—meaning the mechanics behind the disease. The thing about type 2 diabetes (a biological disaster which has reached epidemic proportions in the States as well as in India, China, and throughout many emerging economies) is that it’s characterized by decreased sensitivity to insulin, and it’s diagnosed when you have too much blood sugar as a result of your cells not able to use glucose properly. But you can show decreased sensitivity in various organs, places of the body, before crossing the threshold where a full-blown T2D diagnosis is made; your brain being one of them. And this precedes the buildup of the plaques that clog Alzheimer’s brains by decades.

Global Health Aging: In the BREAD HEAD trailer, you pose the question about Alzheimer’s being inevitable or avoidable based on the choices we make. How did you come to exploring this idea?
Max Lugavere: I picked Alzheimer’s because it’s the most common form of dementia, but my interest and research goes beyond Alzheimer’s. I am concerned with not only preventing neurodegeneration, which begins in the brain decades before the first symptom, but also optimization. We live in a time where attention is the new limited resource; distraction is constant. It’s sort of like a kind of obesity of the mind. So I think anything we can do to maximize our cognitive health, the better and more enriched our lives will be.

Global Health Aging: Millennials are starting to get interested in aging and health issues affecting older adults. How can this trend affect the way society views aging and older adults?
Max Lugavere: I think it’s in part because the oldest millennial is now 35. Unlike previous generations, we were brought up with the tools of the internet. Information has been set free. We’ve also invested in human capital more than any previous generation. So I think we are more proactive about holding onto our health and even optimizing it. We’re the generation, after all, that’s ushering in the quantified self movement. It’s awesome to not only witness but to be a part of.

Global Health Aging: BREAD HEAD is innovative! What would you tell people who think nothing can be done to prevent Alzheimer’s as research has shown?
Max Lugavere: I’d tell them they need to get with the times. We’re finally at the end of the era of “diagnose and adios”. That said, we still have a long way to go, so in that sense, it’s imperative to support scientists that are continuing to do this incredibly vital research, both towards a cure and for prevention. It’s also important to look to technologies like my friends at Neurotrack that are devising brilliant ways of early diagnosis, which is key.

Acknowledgements and Further Information

I would like to thank Max Lugavere for taking the time to answer our questions. If you want more information on Max Lugavere, visit his website here.

Sophie Okolo is the Editor-in-Chief of Global Health Aging.