October 1, 2018

Diseases

#18 – Richard Isaacson, M.D.: Alzheimer’s prevention

“Anyone with a brain is at risk for Alzheimer’s.” —Richard Isaacson

Read Time 17 minutes

In this episode, Richard Isaacson, a neurologist and director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and New York-Presbyterian, discusses strategies for staving off Alzheimer’s disease. Richard shares a wealth of insight for people who want to know more about Alzheimer’s and what you can do to help yourself and your loved ones — starting today and continuing throughout the entire lifespan.

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We discuss:

  • Richard’s fun-facts (and alter egos): “bling” phones, Doogie Howser, and DJ Rush [8:00];
  • Richard’s impetus to focus on Alzheimer’s disease: Uncle Bob [18:20];
  • Starting an Alzheimer’s Prevention Clinic [27:00];
  • How Alzheimer’s is diagnosed [30:00];
  • Short-term memory, processing speed, executive function, and how they’re tested [35:45];
  • Prevention vs reduction of Alzheimer’s [44:00];
  • What is the prevalence of Alzheimer’s in America? [49:30];
  • How do people actually die from Alzheimer’s or dementia? [51:30];
  • How can people do everything right and still get Alzheimer’s? It’s all about AGE [55:15];
  • The APOE gene [58:15];
  • Why is the risk of Alzheimer’s higher for women? [1:13:00];
  • How many different paths lead to Alzheimer’s? [1:15:45];
  • What role does MTHFR play in Alzheimer’s? [1:19:45];
  • What are the “ABCs” of Alzheimer’s prevention? [1:26:45];
  • Baptists, Tauists, Syners, and Apostates [1:36:30];
  • Concerns with statin use for high-risk patients [1:45:00];
  • The use of Theracurmin [1:48:45];
  • What are the five actionable things one can do to reduce the risk for Alzheimer’s today? [1:54:30];
  • The cognitive reserve [2:14:15]; and
  • More.
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Richard Isaacson, M.D.

Richard S. Isaacson, M.D. currently serves as Director of the Alzheimer’s Prevention Clinic, Weill Cornell Memory Disorders Program, and Director of the Neurology Residency Training Program at Weill Cornell Medical College/NewYork-Presbyterian Hospital. He previously served as Associate Professor of Clinical Neurology, Vice Chair of Education, and Education Director of the McKnight Brain Institute in the Department of Neurology at the University of Miami (UM) Miller School of Medicine. He completed his residency in Neurology at Beth Israel Deaconess Medical Center/Harvard Medical School, and his medical internship at Mount Sinai Medical Center in Miami Beach, FL. Prior to joining UM, he served as Associate Medical Director of the Wien Center for Alzheimer’s disease and Memory Disorders at Mount Sinai.

A graduate of the accelerated 6-year B.A./M.D. program at the University of Missouri – Kansas City School of Medicine, Dr. Isaacson now specializes exclusively in Alzheimer’s disease (AD) risk reduction and treatment, mild cognitive impairment due to AD and pre-clinical AD. His AD research focuses on nutrition and the implementation and longitudinal assessment of dietary interventions for AD management. Dr. Isaacson has a family history of AD, including his Uncle Bob (diagnosed while he was in high school) and his Dad’s Cousin (diagnosed six years ago) and passionately believes in a comprehensive, multi-modal approach toward both AD treatment and prevention. He is the author of two best-selling books geared for patients and caregivers, Alzheimer’s Treatment Alzheimer’s Prevention: A Patient & Family Guide (2012 Edition) and most recently, The Alzheimer’s Prevention & Treatment Diet.

Dr. Isaacson’s career in education spans undergraduate (student), graduate (resident/fellow), and continuing (faculty) medical education, as well as patient, caregiver and community education/outreach. His recent efforts have focused on the development of Alzheimer’s Universe (www.AlzU.org) a vast online educational portal on AD, with results published in the Journal of the Prevention of Alzheimer’s disease. He has chaired the AAN Undergraduate Education Subcommittee working group in dementia and received the AAN Education Research Grant for “Evaluating the effectiveness of Continuum: Dementia as a teaching tool for medical students” published in Neurology. He recently led a collaborative education and health information technology research initiative at Weill Cornell, Harvard, UM, U. Pennsylvania, U. Rochester published in Neurology. He is the author of numerous publications, his research in neurology and medical education has been presented at scientific meetings nationally and internationally, and was awarded the 2009 AAN A.B. Baker Teacher Recognition Award. He is also a member of the Alpha Omega Alpha Medical Honor Society. [weillcornell.org]

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  1. fantastic podcast. surprising there was no mention of glymphatics? seems there may be some interesting interplay between cognitive load, HRV and intracranial fluid dynamics.

  2. Hey Craig and everyone! I also would love a human readout on glymphatic clearance combined with autophagy. I am a PhD and researcher in this field and in humans this is still very new as far as finding 1) a readout; 2) confirmation of modulating it through interventions; 3) observing real behavioral and/or disease modifying changes as a result.
    Of course, from animal models, we are aware that, in theory, this should help with reducing the cognitive impairment through clearing the damage, etc. [for instance Ehrnhoefer et al., 2018 demonstrated that in a disease with dysfunction in the clearance of aggregate, treatment could induce autophagy and lower the burden in the brain, stating “our findings imply that … clearance could be enhanced.”] But in practice, AD and other neurodegenerative conditions in humans are complex. It is coming!

  3. I’m interested in the Theracurmin discussion but got a bit confused by the reference to the brand that they use. Peter said he uses “Jarrow ” brand and that they have a “combined lozenge thats methyl folate and methyl B12”.
    Well a search for “Jarrow Theracurmin” led to their Curcumin 95, no mention there of Theracurmin and a search for “Jarrow Methyl B-12 & Methyl Folate” located this but no mention there of Theracumin either.
    A search on “Theracurmin” found several brands but not Jarrow, Could you please clarify which Theracumin you use?

  4. I listen to the The Drive religiously – this is the weakest episode – when it first came out I just couldn’t listen to the end. Last week – having forgotten why I hadn’t listened to the whole episode – I tried again. This time I forced myself to listen to the end! What have I learned from this guy with the impressive CV? That he advises things because others, “people more intelligent than him”, have told him they work. Peter, this was a disappointing episode! Most of your guests shine through their knowledge of the literature and their ability to disseminate that knowledge. Not this guy!

  5. I really enjoyed this episode and just signed up for the healthcare provider course. I’m a dietitian specializing in nutrigenetics/nutrigenomics and functional nutrition so this podcast gave me insight on what testing to add so I can deep dive with my AD risk patients. AD triggers such an emotional reaction with people that have a family history, I’m just so thankful that there are people like Richard focusing on functional tools for prevention! Peter, your podcast rocks. In this field, I feel like it is irresponsible to not be learning something new everyday, and your podcast definitely helps me do that on such a variety of topics. Thank you for all that you do!

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