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Interview
Neil Stokes - 6 November 2016 2.00 h

Alzheimer's on the ropes

Dr. Jordi Camí Every Monday at 7.20 pm, El Punt Avui TV's English Hour airs the interview series Going Native. This time Neil talks to Dr. Jordi Camí, director of the Pasqual Maragall Foundation.
- Neil Stokes
What is Alzheimer's dis­ease ex­actly?
Alzheimer's is a neu­rode­gen­er­a­tive dis­ease that ap­pears late in life, from 60 to 65 years old on. We now live longer, so there are more cases of Alzheimer's. It's a dev­as­tat­ing dis­ease be­cause it shows it­self as a pro­gres­sive de­te­ri­o­ra­tion of the cog­ni­tive func­tion; you lose your mem­ory.
That sounds like some peo­ples' worst night­mare.
Yes, it's the worst be­cause in a wheel­chair, for ex­am­ple, you can still move around. But when you have Alzheimer's dis­ease you need other peo­ple to take care of you, and you can't do any­thing about it.
How does it de­velop?
As far as we know, the dis­ease con­sists of an ac­cu­mu­la­tion of a par­tic­u­lar pro­tein. This pro­tein is a reg­u­lar pro­tein, but for rea­sons we don't un­der­stand very well, there is an ac­cu­mu­la­tion that even­tu­ally be­gins to kill neu­rons. And at pre­sent this is a dis­ease we can­not cure.
Why is it so dif­fi­cult?
Right now we have no drugs to slow, stop or re­verse the neu­rode­gen­er­a­tion. When the clin­i­cal symp­toms of the dis­ease ap­pear, the brain is al­ready very de­te­ri­o­rated and we are not able to re­verse this. We do have drugs that can im­prove the qual­ity of life of these ill peo­ple, so we can man­age de­pres­sion and so on, but these drugs do not mod­ify the cause of the dis­ease. How­ever, there are new facts that tell us that bi­o­log­i­cal signs of this dis­ease ap­pear 20 years be­fore the clin­i­cal symp­toms. This is some­thing new and we think that for Alzheimer's these ob­ser­va­tions are the key to tackle the dis­ease. So, we now need to know the nat­ural his­tory of the dis­ease, to un­der­stand how it be­gins, when it be­gins, what fac­tors speed it up or slow down, its bi­o­log­i­cal evo­lu­tion. And so we think we will be able to pre­vent or slow the bi­o­log­i­cal pro­gres­sion of the dis­ease when we are still ap­par­ently healthy.
Are drugs the only way, or can lifestyle help?
We are look­ing for drugs for when you al­ready have the dis­ease, but there is room for other prac­tices. We have very lit­tle in­for­ma­tion but there are new ob­ser­va­tions that sug­gest that every­thing good for our health is good for our brains. In coun­tries where peo­ple do things that are good against car­dio­vas­cu­lar dis­ease there are fewer cases of de­men­tia. We are be­gin­ning to work with these ap­proaches and I am con­vinced that if you lead a healthy life and have the best so­cial re­la­tion­ships pos­si­ble it must be ben­e­fi­cial.
Is it just liv­ing longer that is caus­ing more cases, or is it also our mod­ern lifestyles?
What is clear is that thanks to med­i­cine and bio­med­ical dis­cov­er­ies, we are now able to delay all the crit­i­cal prob­lems. Sev­enty years ago, when peo­ple reached 60 they had the same ill­nesses as peo­ple do now when they are 90. So thanks to bio­med­ical changes and so­cial im­prove­ments, we have been able to put off these prob­lems to the later stages of life. So, the ob­jec­tive is healthy age­ing, to mod­ify our ac­tiv­i­ties to delay the prob­lems for as long as pos­si­ble. Peo­ple are now liv­ing longer all over the planet. And this is some­thing new and we have no ex­pe­ri­ence with this.
Tell us about the Pasqual Mara­gall Foun­da­tion?
Pasqual Mara­gall is an un­com­mon per­son and he de­cided when he was rel­a­tively well that he wanted to do some­thing to help sci­en­tific re­search into this dis­ease. The name Pasqual Mara­gall is very strong and he of­fered us an op­por­tu­nity eight or nine years ago to form the Pasqual Mara­gall Foun­da­tion. It is a small foun­da­tion de­voted to sci­en­tific re­search and we even­tu­ally de­cided to focus on pre­ven­tion. This is very im­por­tant for us be­cause we are con­vinced that we will be able to re­duce the num­ber of peo­ple who end up with the dis­ease. That is why our strat­egy is to focus on pre­ven­tion, and we are very op­ti­mistic. We need a lot of money, of course, but the foun­da­tion has grown, de­spite this very deep cri­sis in Cat­alo­nia and Spain.
What is the pub­lic per­cep­tion of Alzheimer's?
Fif­teen years ago no one was talk­ing about Alzheimer's dis­ease, in part be­cause it is a very bad dis­ease and no one wanted to talk about it. How­ever, the Pasqual Mara­gall Foun­da­tion has helped clear the air. We are con­tribut­ing to putting this dis­ease on the agenda, not only of politi­cians, but so­ci­ety in gen­eral. Be­cause of the cri­sis we have not re­ceived pub­lic funds, so we de­pend on al­tru­ism. To be suc­cess­ful we need to in­vest in com­mu­ni­ca­tion, to make it clear that Alzheimer's dis­ease ex­ists and that there are no short­cuts; only new knowl­edge will fa­cil­i­tate a rad­i­cal so­lu­tion for this dis­ease. So we are in­vest­ing in com­mu­ni­ca­tion be­cause we need to ask peo­ple to be part of our foun­da­tion, and now there are nearly 7,000 mem­bers, three times what there was two years ago.
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