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Alzheimer's can be 'detected 20 years before first symptoms': ADDF researchers

Alzheimer’s Drug Discovery Foundation CEO Mark Roithmayr and Co-Founder and Chief Science Officer Dr. Howard Fillit sit down with Yahoo Finance to discuss the progress in Alzheimer's research ad the prominence of the neurological disorder.

Video Transcript

[AUDIO LOGO]

DAVE BRIGGS: Anyone who's watched a loved one suffer with Alzheimer's disease knows all too well there's simply nothing more painful than watching someone you care about lose their memories of accomplishments, let alone their loved ones. An estimated six million Americans are currently living with a neurological disorder, half are undiagnosed.

And while there's no known cure, there are glimmers of hope today. Bill Gates, Jeff Bezos, the NFL Players Association, part of a big group throwing $100 million into early detection. Here to discuss are Dr. Howard Fillit, the CEO of the Alzheimer's Drug Discovery Foundation and the co-founder and Chief Science Officer Mark Roithmayr. Nice to see you both. Thanks for being here.

MARK ROITHMAYR: Good to be here.

DAVE BRIGGS: And this is National Brain Health Day, so it's an important day for you to be here. Mark, what does that round of venture philanthropy mean for progress? And how would you characterize this moment? Is there hope?

MARK ROITHMAYR: There really is hope, and I think there's a false narrative that's out there that's leading people to believe there's not. But let's just start with that $100 million. You pointed out, six million people in the United States, 57 million worldwide, in the next 50 years that's going to triple. So everybody knows somebody who's being touched by this, right.

Think about it. If we're going to get new treatments, and we're on the cusp of new treatment, we have to have better tools, tools to diagnose. Those half the people that aren't diagnosed, if you can catch it early, we know we can do something about it. Here comes along philanthropists like Leonard Lauder, Bill Gates, Jeff Bezos.

They put in $50 million three years ago, another $50 million now, because there's new diagnostic tools we're right on the brink of. Blood tests, eye tests, apps for your Apple 14 if you want that are just ahead of us now. So hope around diagnostics, but there's also hope around treatment.

DAVE BRIGGS: How important, Dr. Fillet is early detection?

HOWARD FILLIT: Well, it's very important for a number of reasons. One is, we know a lot about prevention for the first time, and there have been randomized study showing that prevention works. And it's been estimated by the Lancet Commission in the UK that up to 40% of cases could be delayed by five years, which would have an enormous impact.

But the other thing about early detection is, with these new blood tests and brain scans that are on the market that we helped to develop, we can detect the onset of Alzheimer's disease 20 years before the first symptoms.

DAVE BRIGGS: Wow.

HOWARD FILLIT: So it's like measuring cholesterol in middle aged people to prevent a heart attack when they're in their 70s and starting a statin. And so the model here is that we can detect this disease in the preclinical phase, and there are clinical trials now of anti amyloid drugs, for example, that are in people who are pre-symptomatic. They're not symptomatic, but they have the disease based solely on the biomarkers.

DAVE BRIGGS: Some clinical trials as of late have been controversial, as with the Biogen drug that cost $56,000. They have now cut that price tag in half. Again, a lot of controversy to this process. Is there still optimism that can provide some answers and help?

HOWARD FILLIT: There's still optimism because we have Genentech, we have Lilly, and we have Eisai Biogen has a partnership, developing new anti amyloid drugs that in the next quarter and the next two or three quarters, we're going to hear about the results. And we're probably going to see, I think, some modest benefit clinically, which is really where the controversy lies.

But the thing that I think we've learned about this whole amyloid business is, that whether or not these drugs actually work, the era has changed. And 75% of all drugs now in development are non amyloid, non-tau drugs, which means that for the, I've been doing this 40 years. We started attacking the pathology. Now we're attacking the biology of the disease. And aging is the leading risk factor for Alzheimer's. And we're starting to learn and apply and translate knowledge from 100 years of research on aging into new therapeutics for Alzheimer's. And that's what I'm really excited about.

DAVE BRIGGS: Mark, the cost was a big focus of that controversy. Do you think we'll ever begin to bring those costs down?

MARK ROITHMAYR: Oh, I certainly think we're going to bring those costs down. And when you listen to what Howard said, the overwhelming majority of new treatments that are out there are not to do with amyloid. Amyloid's only a part of it. But this biology of aging approach brings hope, of course, things like inflammation, vascular, genetics. And the more of these investments get spread out, we expect to see, and here's where the real kind of breakthroughs are going to come, prevention, combined therapies, precision medicine.

This is the story that's not being told. While everybody gets caught up in this controversy, oh, it's the price or it's this drug or it's that drug, so a lot of hope, a lot of new treatments that are going to come, and it's going to be personalized to you based on how you're aging. As we all sit here, we're all aging, but we age differently.

DAVE BRIGGS: Will we live to see a cure for Alzheimer's?

MARK ROITHMAYR: We will live to see treatments for Alzheimer's in the next five to 10 years. The first new breakthroughs on treatments, I say this all the time, you might not believe this, but I'm 61 years old. If I would be diagnosed with cognitive issues tomorrow, I could work with Dr. Fillit, work with the Alzheimer's Drug Discovery Foundation, I would have options.

I have children in their early 30s. They will have prescriptions. I have a 17-month-old grandson and a four-month-old grandson. They will have protocols to follow. This is right in front of us right now. We can thank the Alzheimer's Drug Discovery Foundation, we can thank Bill Gates, we can thank Jeff Bezos, we can thank Bill Gates. And it's interesting if you think about it. Why are all these big philanthropists turning to us right now? Because they see this hope.

DAVE BRIGGS: Yeah. What should people look out for? Often I hear people say, my mom, my dad, my grandpa had this. What are the signs they should be looking out for?

HOWARD FILLIT: Well, in terms of family risk, we've known for many decades, and I've been doing this over 40 years, that family history, like having a parent, for example, with the disease, increases a person's risk. About 30 years ago, a gene was discovered called APOE-e4, APOE-e. And about 20% of people in the community have an APOE-e4 gene. But 60% of people with Alzheimer's disease have the APOE-e4 gene.

So we know that, for example, if a person gets the APOE-e4 gene from mom and dad, so they have two of them, their risk of getting Alzheimer's is about 15 times the average. Now we've known about this for over, almost 30 years, but we haven't been able to drug it. Our foundation has taken a gene therapy approach to fixing APOE-e4. And it would have, it will have a big impact.

And the way we're doing it is, there's a gene called APOE-e2, and we know from epidemiological studies that APOE-e2 offsets the risk of APOE-e4. So we're delivering gene therapy, giving people through a company we spun out of Weill Cornell here in New York named LEXEO, giving people APOE-e2 in their brains through a viral vector. And we know that this could really change the world.

DAVE BRIGGS: Let's end this with some news people can use. Exercise, diet, what are the things people can do to curb?

HOWARD FILLIT: The most important I think risk factor right now that we can manage is exercise, and diet, Mediterranean diet, sleep, avoid alcohol, avoid smoking. Manage your diabetes and hypertension. And those are the main things. Hearing loss, these are the main risk factors that we can control and delay the onset of the disease.

DAVE BRIGGS: Dr. Fillit, Mark Roithmayr, great to see you both. Really appreciate the work you're doing. Very personal to me and to a lot of our audience.

MARK ROITHMAYR: Happy Brain Health Day.

DAVE BRIGGS: Brain Health Day, put it out there, people. Thank you both.