Who Will Get Alzheimer's?

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When I first started working at Alzheimer's back in the early 80's, and no one was working on it. Alzheimer's is really become much more popular as a research topic over the last two, or three decades because we're growing older. Lifespan increased from 50 in 1900 to 75 at the end of the 20th Century, and now it's already up to almost 80.

We might be able to expect lifespan to go up to over 100 by the end of this century. So, all of modern medicine is letting us grow older, but the dead end is Alzheimer's, because the brain, in everyone, the brain is accumulating pathological lesions, pathology that will cause Alzheimer's disease.

No one is escaping this pathology. So, when we think of Alzheimer's we think about when you're going to get it, not whether. And some people might take up to 120 years old, and they'll never get that far, and others we have families where they get it at 20 years old. At the personal level, it's really hard to come about a disease worse than Alzheimer's disease, because Alzheimer's robs you of yourself.

It's a thief of personality, so if you think about your life, from day one, you're accumulating experiences in memories. Every single day as you take in information, you're associating it with what you've already learnt, and what you've already experienced. So, everything about who you are, your personhood, how people think about you, your behavior is based on your experiences and memories.

Experiences and memories that Alzheimer's disease just robs you of. The disease robs you of yourself, you're still in there, you're still conscious, you're still having mental activity, but the person you are and the person who people know slowly is eroded. The reason for it is that you develop two particular pathological features in the brain that involve very sticky clumps of protein.

One is called a plaque, it's outside the nerve cells. The other is called a tangle, it's inside the nerve cells. You have to have both to get the disease, and overtime the parts of your brain that define who you are go away. Our big question about genetics of the disease is which genes determine when you're going to get the disease.

So, this is a part of life, it's a part of ageing. But I and my colleagues believe it does not have to be.