August 9, 2024 • 10 mins
Watch Carol and Tim LIVE every day on YouTube: http://bit.ly/3vTiACF.
Dr. Ian Lustbader, Clinical Professor of Medicine at NYU Langone, talks about new treatment approaches for Alzheimer’s and Dementia.
Hosts: Carol Massar and Matt Miller. Producer: Paul Brennan and Sebastian Escobar
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Bloomberg Audio Studios, Podcasts, radio news. This is Bloomberg Business
Wait inside from the reporters and editors who bring you
America's most trusted business magazine, plus global business, finance and
tech news. The Bloomberg Business Week Podcast With Carol Messer
(00:23):
and Tim Stenebeck from Bloomberg Radio, We're.
Speaker 2 (00:27):
Going to switch gears a little bit. Alzheimer's.
Speaker 3 (00:30):
The disease is among the world's most pressing healthcare challenge,
is affecting more than six point nine million people in
the United States and forty million global, in numbers that
are expected to double by twenty forty. Meantime, dementia is
the seventh leading global cause of death among older people,
and the number of people affected is expected to almost
triple by twenty fifty, with annual costs upwards of one
(00:50):
trillion dollars. We all probably know someone, often family members, friends,
who've had to deal with one or the other. So
we're going to dig into this with doctor Ian las
Bader back with us, his clinical professor of medicine at
n YU Lango Medical Center, joining us right here in
our studio.
Speaker 2 (01:05):
So good to have you back.
Speaker 3 (01:06):
We were just saying over a year or so right
that you've been in the studio some zoom.
Speaker 4 (01:11):
You've done a lot of zoom interviews, but yeah, COVID
kind of separated everybody and then. But it's nice to
be back in studio. Everyone looks great.
Speaker 5 (01:18):
I don't know if I've told you this, but I
studied at Tubingan University in Germany, which is where Alzheimer
did his research and did his work. So there's that connection. Also,
my father unfortunately has Alzheimer's, and so I have a
million questions for you about this. I find one of
(01:39):
the biggest problems in terms of treatment is getting the patient,
who is almost always, you know, a responsible adult with
his own sort of legal autonomy. Is getting the patient
to accept the diagnosis and start to move towards treatment.
Because my dad for years has denied that there's anything
(02:01):
wrong with him and doesn't remember, you know, last month
when the doctor told him he has Alzheimer's.
Speaker 4 (02:07):
Because the onset is really can be slow and insidious.
Patients really are often in some denial about what's happening,
although family members may be worried. But you're exactly right
that as typically as people get older, often they have
normal signs of aging which may be memory issues, but
dementia which is sort of a group of syndrome of
(02:30):
a number of different diseases, like Alzheimer's which is about
sixty or seventy percent of dementia's Louis body dementia, which
often presents with personality change, the fronto temporal dementia that
some of our stars I don't know if I can
mention who are well known, Bruce Willis and others where
they really have significant personality changes. So it's more than
(02:52):
just subtle memory. Many patients say, you know, I forget names,
I can't remember people, I forget where my keys are,
and they get panicky. But really there's a broad spectrum
of how dementia can present walking difficulties, and the problem
is making a diagnosis early. It can be anything from
metabolic problems, thyroid problems, brain tumors increase pressure on the brain,
(03:18):
viral diseases, HIV, Parkinson's, and we even see it in
some of our fearless leaders who seem to have some
cognitive change. So whenever someone has neurocognitive changes, memory typically,
but problem solving, getting lost things like that, you have
to think about the diagnosis and then figure out through
(03:40):
various tests. Do they have it and if so, what
kind they have?
Speaker 5 (03:43):
But how can you I mean, as a spinal tap
the only surefire away, how can you make conclusive diagnosis,
you know, just with sort of cognitive testing.
Speaker 4 (03:53):
Right, So typically we do cognitive testing and sometimes you
can make a clinical diagnosis. We often do brain image,
so either a CT or a PET scan, which is
positron emission to look for decreased uptakes, so like in
front or temporal dementias, they'll be decreased activity in the
frontal and temporal part of the brain. Alzheimer's, you actually
(04:14):
see brain shrinkage and a lot of this is caused
by these deposition of tau protein or beta amyloid. The
normal proteins in the brain become a dysfunctional and result
in a lot of abnormalities, and some of the drugs
are trying to target that. Unfortunately, dementia is probably more
(04:35):
complicated just than tau protein, because you can give these
monoclonal antibodies and sometimes they can help, but it's not
a cure.
Speaker 2 (04:44):
Is it just a matter of time?
Speaker 3 (04:46):
Doctor les Beta that because we're living longer, that we're
all going to have some form of dementia.
Speaker 4 (04:52):
So we do have patients in their nineties who are
sharp as attack. They do not even though memory to
some degree, and obviously walking problem solving can slow down
a little bit. There are many older people, some perhaps
here at Bloomberg, who are really sharp, and that brings
to mind the Lanced article recently they talked about modifiable factors.
(05:14):
So yes, you have to make a diagnosis, but there
are many things that are simple. Lifestyle change, blood pressure control,
weight control, cholesterol control. The Lances Sidy showed lowering the LDL,
stopping smoking, weight reduction, exercise, and working later keeping your
brain engaged. So a lot of people and we.
Speaker 5 (05:35):
Know that exactly. You know, Fit is a fiddle in
the brain until the very end. I think he was
ninety nine or one hundred. Winny did Warren Buffett obviously
is in fantastic shape cognitively, and he's ninety three years old.
So I mean we have a lot of guests I
can think of a come on Bloomberg Television, Blueberratio in
(05:55):
their nineties and they still can run circles around me.
Speaker 4 (05:59):
That's here is genetics, yes, so definitely we see families
and genetic issues that play a role. Lifestyle can play
a role, and we talked about obesently blood pressure, vascular issues.
Where you live plays a role. Your sex plays a role,
slightly more common in women. Air pollution. There's a host
(06:21):
of different associations, let's put it that way, that seem
to be modifiable. But the underlying sort of cause, why,
for example, in Alzheimer's do we see this TAEL protein?
You know, why are we seeing these actual brain changes?
The baseline cause of that isn't clear, but there are
(06:41):
many associations that clearly slow things down a little bit,
and they're otherwise healthy lifestyle changes that should be considered,
and certainly people should see a neurologist. Often the primary
care doct may say, well, you're exaggerating, It doesn't hurt
to see a neurologist. Get some studies to make sure
there are no simple readable cluses like you know, an
underactive thyroid.
Speaker 5 (07:02):
Well, I have to say I've heard something a little
contrary that. Recently with another patient who's diagnosed as I
follow in Canada, his neurologist was much more concerned about
sort of the theoretical study of what was going on
with him, and not as concerned with necessarily fixing the
lifestyle issues that he had. It wasn't until he saw
(07:24):
a psychiatrist. And this is Alzeimer's patient I'm talking about
that he was prescribed drugs that really helped him live
a slightly better life.
Speaker 4 (07:32):
Right, we do see one of what personality change psychiatric issues, agitation, confusion,
inappropriate speech and behavior can be seen in a variety
of these dementias. And some of the pills, uh, you know,
like you mentioned then Nepa, zilar A, aircept as well
(07:53):
and others you know, can certainly slow things down, slow
the decline, reverse and cure that do not have yet.
And that's the big you know, billion dollar or trillion
dollar because as we age in more and more people,
as you say, six point nine million, probably going to
get much higher as we get older. But it's the
other costs, right, who's going to care for people nursing homes.
(08:15):
People can't care for themselves. They become really very dependent
and we don't have the resources to care for them.
Speaker 3 (08:22):
Do you ever think about the GLP one drugs in
terms of that seem to be the miracle cure for everything,
but you know, we are finding out that losing weight
and being healthier. Like obviously this leads to so many
other health benefits. It's rather basic, but here we are right.
Speaker 4 (08:37):
I'm not aware of any specific studies, but for sure
we see lower cardiovascular risk outcomes. The golps are great
for weight. There are some obvious risks and complications, but
it definitely helps diabetes, It helps weight, cardiovascuer outcomes, and
may well reduced dementia. Dementia is sort of the usually
(08:58):
a somewhat slow process. I think we need more studies
for that, but you'll have people argue against glps too.
Speaker 3 (09:04):
I do feel like the pharmaceutical company it's kind of
the holy grail of finding something for Alzheimer's or dementia.
But is it likely that we will find something that
once it's diagnosed, you slow it.
Speaker 2 (09:15):
I don't know.
Speaker 4 (09:15):
I think we have so much concern about it that
there's a big effort in research and IH and the
drug companies who have all depopulously are motivated to really
have a breakthrough. So they're doing a lot of studies
and there are some encouraging results, but there are no
at this point amazing breakthroughs like Wow, this has made
(09:36):
a big, big difference. Probably at part because there are
many causes and we're really looking more at the outcome,
which is these neurofibrillary intell deposition in the brain, but
the underlying reason why that happens is not yet clear.
Speaker 2 (09:50):
Do you have any other questions?
Speaker 5 (09:51):
I have a lot more. My mom sent me a
whole list of questions I'm to ask. They're in the
commercial break we have to run.
Speaker 2 (09:57):
I'm always good, come back here.
Speaker 4 (09:59):
Thanks so much.
Speaker 3 (10:00):
Yeah, I feel always feel like we learn a lot.
It's just information that all of us can use. Well.
Have a great weekend, look forward to next time. Doctor Ianlospator,
Clinical Professor of Medicine at NYU Landgoing Medical Center.
Speaker 1 (10:11):
This is the Bloomberg Business Week podcast. Avail little on Apple, Spotify,
and anywhere else you get your podcasts. Listen live weekday
afternoons from two to five pm Eastern on Bloomberg dot Com,
the iHeartRadio app, tune In, and the Bloomberg Business App.
You can also watch us live every weekday on YouTube
and always on the Bloomberg Terminale.
Bloomberg Audio Studios, Podcasts, radio news. This is Bloomberg Business
Wait inside from the reporters and editors who bring you
America's most trusted business magazine, plus global business, finance and
tech news. The Bloomberg Business Week Podcast With Carol Messer
(00:23):
and Tim Stenebeck from Bloomberg Radio, We're.
Speaker 2 (00:27):
Going to switch gears a little bit. Alzheimer's.
Speaker 3 (00:30):
The disease is among the world's most pressing healthcare challenge,
is affecting more than six point nine million people in
the United States and forty million global, in numbers that
are expected to double by twenty forty. Meantime, dementia is
the seventh leading global cause of death among older people,
and the number of people affected is expected to almost
triple by twenty fifty, with annual costs upwards of one
(00:50):
trillion dollars. We all probably know someone, often family members, friends,
who've had to deal with one or the other. So
we're going to dig into this with doctor Ian las
Bader back with us, his clinical professor of medicine at
n YU Lango Medical Center, joining us right here in
our studio.
Speaker 2 (01:05):
So good to have you back.
Speaker 3 (01:06):
We were just saying over a year or so right
that you've been in the studio some zoom.
Speaker 4 (01:11):
You've done a lot of zoom interviews, but yeah, COVID
kind of separated everybody and then. But it's nice to
be back in studio. Everyone looks great.
Speaker 5 (01:18):
I don't know if I've told you this, but I
studied at Tubingan University in Germany, which is where Alzheimer
did his research and did his work. So there's that connection. Also,
my father unfortunately has Alzheimer's, and so I have a
million questions for you about this. I find one of
(01:39):
the biggest problems in terms of treatment is getting the patient,
who is almost always, you know, a responsible adult with
his own sort of legal autonomy. Is getting the patient
to accept the diagnosis and start to move towards treatment.
Because my dad for years has denied that there's anything
(02:01):
wrong with him and doesn't remember, you know, last month
when the doctor told him he has Alzheimer's.
Speaker 4 (02:07):
Because the onset is really can be slow and insidious.
Patients really are often in some denial about what's happening,
although family members may be worried. But you're exactly right
that as typically as people get older, often they have
normal signs of aging which may be memory issues, but
dementia which is sort of a group of syndrome of
(02:30):
a number of different diseases, like Alzheimer's which is about
sixty or seventy percent of dementia's Louis body dementia, which
often presents with personality change, the fronto temporal dementia that
some of our stars I don't know if I can
mention who are well known, Bruce Willis and others where
they really have significant personality changes. So it's more than
(02:52):
just subtle memory. Many patients say, you know, I forget names,
I can't remember people, I forget where my keys are,
and they get panicky. But really there's a broad spectrum
of how dementia can present walking difficulties, and the problem
is making a diagnosis early. It can be anything from
metabolic problems, thyroid problems, brain tumors increase pressure on the brain,
(03:18):
viral diseases, HIV, Parkinson's, and we even see it in
some of our fearless leaders who seem to have some
cognitive change. So whenever someone has neurocognitive changes, memory typically,
but problem solving, getting lost things like that, you have
to think about the diagnosis and then figure out through
(03:40):
various tests. Do they have it and if so, what
kind they have?
Speaker 5 (03:43):
But how can you I mean, as a spinal tap
the only surefire away, how can you make conclusive diagnosis,
you know, just with sort of cognitive testing.
Speaker 4 (03:53):
Right, So typically we do cognitive testing and sometimes you
can make a clinical diagnosis. We often do brain image,
so either a CT or a PET scan, which is
positron emission to look for decreased uptakes, so like in
front or temporal dementias, they'll be decreased activity in the
frontal and temporal part of the brain. Alzheimer's, you actually
(04:14):
see brain shrinkage and a lot of this is caused
by these deposition of tau protein or beta amyloid. The
normal proteins in the brain become a dysfunctional and result
in a lot of abnormalities, and some of the drugs
are trying to target that. Unfortunately, dementia is probably more
(04:35):
complicated just than tau protein, because you can give these
monoclonal antibodies and sometimes they can help, but it's not
a cure.
Speaker 2 (04:44):
Is it just a matter of time?
Speaker 3 (04:46):
Doctor les Beta that because we're living longer, that we're
all going to have some form of dementia.
Speaker 4 (04:52):
So we do have patients in their nineties who are
sharp as attack. They do not even though memory to
some degree, and obviously walking problem solving can slow down
a little bit. There are many older people, some perhaps
here at Bloomberg, who are really sharp, and that brings
to mind the Lanced article recently they talked about modifiable factors.
(05:14):
So yes, you have to make a diagnosis, but there
are many things that are simple. Lifestyle change, blood pressure control,
weight control, cholesterol control. The Lances Sidy showed lowering the LDL,
stopping smoking, weight reduction, exercise, and working later keeping your
brain engaged. So a lot of people and we.
Speaker 5 (05:35):
Know that exactly. You know, Fit is a fiddle in
the brain until the very end. I think he was
ninety nine or one hundred. Winny did Warren Buffett obviously
is in fantastic shape cognitively, and he's ninety three years old.
So I mean we have a lot of guests I
can think of a come on Bloomberg Television, Blueberratio in
(05:55):
their nineties and they still can run circles around me.
Speaker 4 (05:59):
That's here is genetics, yes, so definitely we see families
and genetic issues that play a role. Lifestyle can play
a role, and we talked about obesently blood pressure, vascular issues.
Where you live plays a role. Your sex plays a role,
slightly more common in women. Air pollution. There's a host
(06:21):
of different associations, let's put it that way, that seem
to be modifiable. But the underlying sort of cause, why,
for example, in Alzheimer's do we see this TAEL protein?
You know, why are we seeing these actual brain changes?
The baseline cause of that isn't clear, but there are
(06:41):
many associations that clearly slow things down a little bit,
and they're otherwise healthy lifestyle changes that should be considered,
and certainly people should see a neurologist. Often the primary
care doct may say, well, you're exaggerating, It doesn't hurt
to see a neurologist. Get some studies to make sure
there are no simple readable cluses like you know, an
underactive thyroid.
Speaker 5 (07:02):
Well, I have to say I've heard something a little
contrary that. Recently with another patient who's diagnosed as I
follow in Canada, his neurologist was much more concerned about
sort of the theoretical study of what was going on
with him, and not as concerned with necessarily fixing the
lifestyle issues that he had. It wasn't until he saw
(07:24):
a psychiatrist. And this is Alzeimer's patient I'm talking about
that he was prescribed drugs that really helped him live
a slightly better life.
Speaker 4 (07:32):
Right, we do see one of what personality change psychiatric issues, agitation, confusion,
inappropriate speech and behavior can be seen in a variety
of these dementias. And some of the pills, uh, you know,
like you mentioned then Nepa, zilar A, aircept as well
(07:53):
and others you know, can certainly slow things down, slow
the decline, reverse and cure that do not have yet.
And that's the big you know, billion dollar or trillion
dollar because as we age in more and more people,
as you say, six point nine million, probably going to
get much higher as we get older. But it's the
other costs, right, who's going to care for people nursing homes.
(08:15):
People can't care for themselves. They become really very dependent
and we don't have the resources to care for them.
Speaker 3 (08:22):
Do you ever think about the GLP one drugs in
terms of that seem to be the miracle cure for everything,
but you know, we are finding out that losing weight
and being healthier. Like obviously this leads to so many
other health benefits. It's rather basic, but here we are right.
Speaker 4 (08:37):
I'm not aware of any specific studies, but for sure
we see lower cardiovascular risk outcomes. The golps are great
for weight. There are some obvious risks and complications, but
it definitely helps diabetes, It helps weight, cardiovascuer outcomes, and
may well reduced dementia. Dementia is sort of the usually
(08:58):
a somewhat slow process. I think we need more studies
for that, but you'll have people argue against glps too.
Speaker 3 (09:04):
I do feel like the pharmaceutical company it's kind of
the holy grail of finding something for Alzheimer's or dementia.
But is it likely that we will find something that
once it's diagnosed, you slow it.
Speaker 2 (09:15):
I don't know.
Speaker 4 (09:15):
I think we have so much concern about it that
there's a big effort in research and IH and the
drug companies who have all depopulously are motivated to really
have a breakthrough. So they're doing a lot of studies
and there are some encouraging results, but there are no
at this point amazing breakthroughs like Wow, this has made
(09:36):
a big, big difference. Probably at part because there are
many causes and we're really looking more at the outcome,
which is these neurofibrillary intell deposition in the brain, but
the underlying reason why that happens is not yet clear.
Speaker 2 (09:50):
Do you have any other questions?
Speaker 5 (09:51):
I have a lot more. My mom sent me a
whole list of questions I'm to ask. They're in the
commercial break we have to run.
Speaker 2 (09:57):
I'm always good, come back here.
Speaker 4 (09:59):
Thanks so much.
Speaker 3 (10:00):
Yeah, I feel always feel like we learn a lot.
It's just information that all of us can use. Well.
Have a great weekend, look forward to next time. Doctor Ianlospator,
Clinical Professor of Medicine at NYU Landgoing Medical Center.
Speaker 1 (10:11):
This is the Bloomberg Business Week podcast. Avail little on Apple, Spotify,
and anywhere else you get your podcasts. Listen live weekday
afternoons from two to five pm Eastern on Bloomberg dot Com,
the iHeartRadio app, tune In, and the Bloomberg Business App.
You can also watch us live every weekday on YouTube
and always on the Bloomberg Terminale.
Hosts And Creators
Tim Stenovec
Carol Massar
Popular Podcasts
Law & Order: Criminal Justice System - Season 1 & Season 2
Season Two Out Now! Law & Order: Criminal Justice System tells the real stories behind the landmark cases that have shaped how the most dangerous and influential criminals in America are prosecuted. In its second season, the series tackles the threat of terrorism in the United States. From the rise of extremist political groups in the 60s to domestic lone wolves in the modern day, we explore how organizations like the FBI and Joint Terrorism Take Force have evolved to fight back against a multitude of terrorist threats.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
NFL Daily with Gregg Rosenthal
Gregg Rosenthal and a rotating crew of elite NFL Media co-hosts, including Patrick Claybon, Colleen Wolfe, Steve Wyche, Nick Shook and Jourdan Rodrigue of The Athletic get you caught up daily on all the NFL news and analysis you need to be smarter and funnier than your friends.