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Earlier this month, Bloomberg reported out on how researchers have uncovered how the body's own immune system may be driving the progression of ALS, a breakthrough that could reshape treatment of the fatal disease. But what's key in a big broader way, the findings could lead to therapies that target the immune system and may have implications for the treatment of other neurodegenerative diseases, and that includes things like Alzheimer's
and Parkinson's. So let's get to our weekly BusinessWeek Women's Health segment. We focus on key issues and developing technologies impacting the present and future of women's health around the world. Our focus today is on Alzheimer's, which affects over seven million Americans today. By twenty fifty, that number is projected to rise to nearly thirteen million, according to the Alzheimer's
Association with US is doctor Fanny Allah. She's Associate Professor of Neurology and Neuroscience at the Icon School of Medicine at Mount Sinai, and she joins us right here in New York City. Doctor Lahie, thank you so much for being with us. I am curious when it comes to neurological problems, what are the difference in what affects women versus men.
It's a pleasure to join you. The short answer to that is that we know the statistics of what are the diseases that afflict women at a higher prevalence than men, and one of them is Alzheimer's disease. But to say that we would not be correct to say that we
understand the why. And I think this is exactly why we need to be doing research, because getting the answer to why are women's brains more vulnerable to Alzheimer's disease and other kinds of neurodegenerative disorders may hold the key to understanding how these diseases strike the vulnerable brain, and so that knowledge will definitely help women. But I think beyond that would help us understand what are the key factors that make the aging brains vulnerable to Alzheimer's disease.
At this point, do we know what? Do we know? What are the clues or what are the hypotheses that medical professionals have established.
A central hypothesis that we and others are following is that in women's lives there is a huge physiological transition in midlife due to menopause. That shift in hormones that the brain and other organs see is unique to women. It happens in men, but at a much later stage
in their life. And so what we are doing at Mount Sinai is to specifically query the impact that lower levels of sugen may have on the cells that form the vasculature of the brain, the protective barriers of the brain, and other cells within the brain.
So is a fix and easy fix just keeping the hormone levels higher, and I know that there are consequences to doing that potentially, how do we think about it? How do you guys think about R and D and what can be done to help women since they are certainly it sounds like more vulnerable as a result when it comes to Alzheimer's.
Absolutely, we certainly hope that for those who can get hormone replacement therapy that may diminish their risk to a certain extent. But the question is when do those hormones need to be started? And we think it needs to be perimenopause, you cannot wait too long before starting them. The second question is how long do you keep those hormones as you may As you alluded to it, those hormones also increase the risk of other things such as cancers,
and those risks increase as women age. So how long do you keep someone on hormones in order to decrease their risk for Alzheimer's disease, which is a late life phenomenon. And then the third question is for the many women who actually cannot be on those hormones, what can we discover about what those hormones do and just go ahead and develop drugs and interventions that activate or deactivate those pathways.
What about genetic components if somebody else in the family has had Alzheimer's, that trade being passed down, does that happen?
That's an excellent question, and in fact, one of the most prevalent genetic risk factors for Alzheimer's disease, the APO E four illele, we think interacts with hormones in exerting its effect on Alzheimer's disease. Now, the question of heritability of Alzheimer's goes beyond just a point four and that in of itself is a really big area of research. There are other components of the disease, such as metabolism and mitochondria that we inherit from the maternal side, for instance,
that could be contributing to this heritability. But even beyond that, there are aspects of our ancestry that continue within us informs that we currently don't fully grasp and I hope we will understand in the future to again contribute to better therapeutic developments.
So talk to us little bit about You've done a lot of work when it comes to blood biomarkers. Why might this be important here?
Blood biomarkers are very exciting because, similar to other disorders such as cardiovascular disease, cancer, kidney liver disease, you really to detect disease before individuals have prominent symptoms that bring them to the medical attention. And in the case of Alzheimer's and other kinds of neurodegenative disorders, those are cognitive impairment and ultimately dementia. At the point that someone has very significant cognitive changes, we think we could potentially slow
down disease progression. But to say that we can stall it or have game changing treatments completely change someone's brain trajectory would be not realistic. So these blood biomarkers can detect risk of future symptoms with increasingly better predictive ability. One thing that I should mention is that we don't think that the pathologies that eventually lead to dementia start at the time that symptoms present. They really start decades before.
And these blood BUYO markers for Alzheimer's disease are detecting that. My lab works on expanding that panel because right now we are detecting only a few aspects of the disease. We think a key component of Alzheimer's and other neurodegenerative diseases are the changes that happen to the blood vessels of the brain, and at the moment, we have no biomarkers that detect vascular pathologies with great precision.
Doctor Lolly, we just have about thirty seconds left. Are you optimistic that during your career we will see a major breakthrough and either treatment or prevention of Alzheimer's.
Absolutely, I'm going to go further and seeing that, I hope that it's not at the end of my career. I have great hope for the decade that is to come. We already have two FD approved treatments that slow down disease progression, and many other game changing treatments are in the pipeline.
Well, we so appreciate getting a chance to talk to you, and you really like laying it out so clearly and specifically, Doctor Fannie Alaki. She's Associate Professor of Neurology and Neuroscience at the Icon School of Medicine at Mount Sinai.