49x09 - Determined: Fighting Alzheimer's

[bunniefuu]

KIMBERLY:
I'm going to say more numbers.

After I say them,
I want you to put them backward.

Two, eight, five, one, six.

Six, one, five, eight, two.

Four, one, six, four, three.

Three, four, six...
One, four, two?

♪♪

Hi, Mama.

[laughing]

BARB:
I think I have probably
a little greater

than 50% chance of getting it.

I have lately thought,

"You know, you got about another
ten years of memory left

before you hit
your mom's stage."

♪♪

I absolutely am terrified of it.

♪♪

KIMBERLY:
I'm going to read you
a list of words.

I want you to tell me as many
words as you can remember.

Okay.
All right.

Flute, dress, alarm,

juice, office,

mother, pond.

Flute, dress, juice, alarm,
office, mother...

Draw on the hands
at 20 minutes after 7:00.

KAREN:
I knew it was too late
for my mom.

But I have to think
about my son.

Hopefully, if not in my
lifetime, in his lifetime,

they can find a cure.

It takes generations, sometimes,
to find a cure.

♪♪

SIGRID:
I'm noticing in my journey
through memory

that when you give
a really long list,

then things start to get
really confused,

and I can't track it anymore.

Mm-hmm.

SIGRID:
I read that

if you were a daughter
of someone with Alzheimer's,

that you had a much higher
chance of having it.

My mother had passed away
from Alzheimer's.

I had three daughters,

and that's when they told me
about the study.

And I said, "Oh, sign me up!"

NARRATOR:
An estimated 50 million people
worldwide

live with Alzheimer's disease
or other dementias.

Having a parent with Alzheimer's

more than doubles a person's
risk of getting it.

Now, some are joining a
groundbreaking medical study

to try to find out what,

if anything,
could make a difference

for future generations.

"Determined:
Fighting Alzheimer’s,"

right now, on "NOVA."

♪♪

♪♪

STERLING JOHNSON:
This study is about
adult children

of people who have
Alzheimer's disease.

We bring our participants in

in mid-life, and we follow
them as they age.

We want to know who goes on
to develop dementia

and who doesn't.

We want to be able
to prevent this disease.

In order to do that,

we have to identify it as early
as we possibly can.

We also want to know
if there's a drug

or a lifestyle intervention

that will slow the rate
of cognitive decline.

Ultimately,
we want to prevent dementia.

So we call our study

the Wisconsin Registry
for Alzheimer's Prevention,

or WRAP.

WRAP, to me,
is super-groundbreaking,

because when it was started,
it was one of the first

to actually look at
the adult caregiver,

um, the adult child.

♪♪

[birds chirping]

MARK SAGER:
My wife and I were sitting
in the backyard,

and it was a summer evening in
Madison,

and we were having
a drink before supper.

I was commenting
that at the time,

there was almost no Alzheimer's
disease research here on campus.

And my wife said,

"You need to study someone
like me."

[inhales]

[voice trembling]:
And her mother had developed
Alzheimer's disease.

[sniffs]:
And I said, "Well, it sounds
like, you know,

it's a good idea," and actually,
it was a very good idea.

Alzheimer's disease
is defined by two things,

amyloid plaques
and neurofibrillary tangles.

These things show up
in the brain

in our 50s and 60s,
and eventually,

they become toxic to the cells

that are vital
for brain function.

After so long,
symptoms of dementia develop.

KAREN:
My mom didn't think
it could happen to her.

She read, she was active.

And she didn't think it would
hit her, and it did.

She couldn't escape.

♪♪

My mom always made things fun.

She would go outside,
play kickball with me.

She even made housework fun.

Until I got smart enough
and realized,

"No, I shouldn't
be enjoying this!"

[laughing]

She always kept us laughing.

But I started noticing,

she just didn't seem herself.

She wasn't reading as much.

She wasn't laughing as much.

And she had mentioned that
she thought

she was losing her memory.

Her sisters and her brother
had Alzheimer's,

and I was kind of worried
that was going on.

And if it wasn't Alzheimer's,

I wanted to find out what
it was to get her treatment,

to get her help.

And, uh...

[crying]:
Unfortunately,
it was Alzheimer's.

♪♪

And she would become angry when
you would try to help her.

And I tried to explain,

"I'm not trying to treat you
like a child.

I'm just trying to help you."

Imagine seeing someone
wither away

to where they don't know when
to go to the bathroom.

How to walk.

How to move their arms,
their head.

It got to a point where
I couldn't keep her at home.

I had to start giving it thought

to her being placed
in a nursing home.

It was the toughest decision
I ever had to make in my life.

♪♪

My son was three
when she was diagnosed.

XAVIER:
She loved me.

Like, she would never get mad
at me at all.

She'll get mad at other people.

But not me, for some reason.

We was like twins.

KAREN:
Had my son in daycare,

working full-time, now having
to worry about her safety.

Stress was...

You know, just, part of my life,
everyday life.

Up until she died.

XAVIER:
It doesn't feel the same
without my grandma being alive.

The person who loved me the,
really the, really the most,

passed away.

KAREN:
I want him

to graduate from high school,
go to college.

Find a career, have a family.

I want us to rekindle
our relationship.

I missed a lot of time
as he grew up

taking care of my mother.

I always thought,
"There'll be more time."

Always, "We'll do this later."

Xavier!

KAREN:
We'll have the fun later.

And later turned
into 12 years later.

♪♪

If by some chance
you lose capacity

when you're in this study,

do you want to continue doing
this study,

or do you want to withdraw?

Yes, continue.

Okay, could you initial there?

And then we ask for a name of
someone who can speak for you

if that's the case...
If you lose capacity.

KAREN:
I don't care what test it is.

I don't care if it's
a lumbar puncture, a MRI,

blood work.

I don't care, I'll do it.

Only part I don't like
is the cognitive testing.

Chicken, orange, pond.

KAREN:
That, although it's painless,

it does make you feel stupid,
and, uh,

I just wonder why I'm able
to roam around free

after I take those tests.

♪♪

CYNTHIA CARLSSON:
Take a breath and hold it.

[Sigrid inhales]

Okay, take a breath again.

[inhales]
And then hold it.

SIGRID:
My mother was just

such a very talented person.

Plus, she was also very bright.

But I can remember being
at my mother's one time.

She held her head and she said,

"Oh, I think I'm going crazy,
I just think I'm going crazy!

I can't remember anything!"

And we said, "Oh, Mother!

We can't remember where our
car keys are, either."

You know, "Nothing's wrong,"
we just sort of blew her off.

[sighs]:
I think even when you,

you do understand
intellectually...

[sniffles]:
it's very hard to experience
someone with Alzheimer's

up front and close.

She followed me around like a,
like a toddler,

or a, a, like a dog.

[voice trembling]:
I remember turning around,

and really just shouting at her,
"Stop following me around!"

[crying]

And I'm so sorry for that.
[sniffles]

♪♪

CARLSSON:
You doing okay still?

SIGRID:
I'm fine.

CARLSSON:
If you're trying to diagnose
someone

at risk for Alzheimer's,
you want to go back

before they're ever
having memory symptoms.

CARLSSON:
Okay, the needle's out, you can
lift your head and relax.

NURSE:
Lift your head.
You feeling okay?

SIGRID: Yeah, and I don't have
a headache yet.
Good!

There you go.

And I'll go get
a warm blanket, okay?

BARBARA BENDLIN:
At the very earliest stages,

people actually can have normal
cognitive function.

We're looking
at a silent process.

So we're really trying to map
out those early changes

in fine detail,
using sensitive methods.

CARLSSON:
There are two main proteins
that we focus in on.

So one is amyloid protein.

Amyloid that's in the
spinal fluid

gives us an idea about how much
is in the brain.

And then I'll have you
lie down here.

Watch your head so you don't
hit the coil.
Right.

[MRI scanner whirring]

JOHNSON:
Traditionally,

the way to diagnose
Alzheimer's disease

was with neuropathology
examinations

after a person has died.

Now, that's really still the way

to get a definitive diagnosis
of Alzheimer's disease.

But brain imaging is now a
window

into the living brain.

JOHNSON:
Let's look at
that hippocampus, Ron.

Here's the hippocampus
right here.

So we're able to observe
very subtle changes

in the hippocampus, the
structure that's very important

in forming new memories.

This is really interesting,

because this individual
is only 64 years old

and is cognitively normal.

But they happen to have a parent
with Alzheimer's disease.

So the question that we're
trying to address

is whether this kind of profile,

where you've got normal
metabolism,

but you're already seeing
budding signs

of Alzheimer's disease,

will this person go on
to get symptoms?

Or will they remain stable
for their entire adulthood?

DAVID:
What?

SIGRID:
Did you find your glasses?

DAVID:
They're the old-style glasses.

They are just someplace very,
you know,

like, out, laying somewhere.

I don't know what to do.

Other than, other than try
and find them.

Oh, dear.

Dear, oh, dear.

DAVID:
I guess I am slipping.

A lot of things I do forget.

Sigrid says I'm always

having a fresh new experience
every day,

even though it,
I may have actually done it

some time recently.
[chuckles]

I don't have the sense of being
confused or in a fog.

It's just, I don't, uh, can't
keep track of things as well.

When we started the study in


it was just people who have
a family history

of Alzheimer's disease.

But we soon became aware

that having that kind of
a focused group

may not be representative
of the general population,

and so we developed
a control group.

NURSE:
And...
[scale beeps]

Okay.

And you can bring your
head forward...

Up, nope, just head,
there you go, just like that.

Now bring this down,

and try not to crush you there.

Does that feel tight?



Five...
Five-eight.

Just a hair under five-nine.

I know.
I used to be five-ten-
and-a-half, so...

Did you?
Yeah.

DAVID:
Well, uh, we do the same tests

that everybody else does in the
program.

We have the blood test

and, like, a three-hour
cognitive inventory.

So they are doing everything,
I think,

that they're doing with
the regular group

with us.

I'm feeling like if
I'm gonna have memory problems,

then you're not gonna
have my assistance,

and you're going to be left
with all this stuff behind.

Yup.

Of course, obviously,
we gotta throw away stuff.

Would you say that louder?

We gotta throw away stuff,
but I, I...

Having saved it for ten years...

Ten years?
To look at.

You have college,

you have college course notes.

Yup.

SIGRID:
Throw them out.

I want some peace.

♪♪

Put that one on top.

Good load.

Put the other one on top.

BARB:
You like your maple
and brown sugar, Dad says.

BARB:
Take your warm blanket
off you?

[Irene moaning lightly]

I'm going to hold it up around
her arms while you change her.

Just 'cause she gets so cold.

It's okay, Mama.
[Irene moaning]

[Irene moaning]

Here we go.

Down we go.

DOREN:
If she made a little noise,

they'd give her Ativan,
knock her out,

so she wouldn't make any noise.

And, uh, I just fought all,
all seven months up there.

♪ Ay, ay, ay, ay ♪

♪ My little señorita ♪

[chanting wordlessly]

BARB:
She's gonna get you singing.

[laughs]
She's trying to copy you.

CRICKET:
I know, she usually does.

BARB:
She knows his voice.

He walks in the room and speaks,
and she's listening.

Oh, there.

Oh, there...
[babbling]

BARB:
I live five hours away from
my parents.

I try to get up there as
frequently as I can,

at least every few weeks, um,

but it's hard when you get
a call that there's a crisis

and you can't be there.

He would always stress, "Well,
I can take care of her myself."

But we said, "No,"
I told him right out,

I would not let her come home if

he wouldn't agree to having help
come into the home.

Ready to have a sip?

[whistles]

SUE:
Part of this disease is that
eventually

they will get so that
they can't swallow.

That's why I'm concerned about

how fast she's given things
to drink.

Feeding her slow is okay.

CRICKET:
I was giving her a drink of
water one day,

and she choked.

We all panicked.

And I know if I'm feeding
my mom something,

and she choked
and didn't recover from it,

I know my dad would hold it
against me.

The girls, they all said,

"Well, Dad, how are you gonna,

"how are you going
to take care of her?

"How are you going
to take care of her?

How are you going change her?"

And I said, "Just let Dad do it.

I'll show you I can do it."

I guess I feel the same
about her

that I did back then.

♪♪

Well, we've had 59 years
of very good marriage.

We worked hard together, she was
always right by me, and...

You just got to keep
on loving her

and taking care of her.

[Irene murmurs]

You okay? Hm?

All right.
I guess so.

[car signal beeping]

KAREN:
For the last several years
of our marriage,

I felt a strain.

In my mother's last six months
of life,

the one thing I always felt
was, I was alone.

I would be there 23 hours,
a day.

I'm trying to deal with my mom,

trying to get my son to
school...

Whatever.
[alarm chirps]

KAREN:
raising a teenager,
and trying to adapt life

to meet my mother's needs.

When I think about the lack
of support,

there's a lot of hurt
and a lot of anger.

[basketball bouncing]

I do not like school at all.

It is stressful.

KAREN:
My son can't go back to school
because of his grades.

[chuckling]

[sighs and sniffles]

♪♪

DIANE:
I'm going to show you a sheet
that has six figures on it,

and I want you to study the
figures so that you can remember

as many of them as possible.

You'll have ten seconds
to study the entire display.

♪♪

When I take it away,
that's when you start drawing.

Now draw as many
of the figures as you can.

Can't do it.
All right.

Well, that was fine.

I'd like to see whether
you can remember more

if I give you another chance.

That's all I could think of.

Try not to forget this display,

because I may ask you about
the figures again later.

Okay.
Okay.

DIANE:
I'll present the display again
for ten seconds.

Try to remember as many of the
figures as you can this time,

including the ones you
remembered in your last attempt.

[stopwatch clicks]

Now draw as many of the figures
as you can.

[chuckling]

I was going to really remember
that one, but I don't.

Okay, that was fine.

When you took it, did you feel

like you did better
two years ago?

I mean, do you feel...
Oh, I'm sure I did better...

You did, so you feel like you're
failing a little bit, too.

Absolutely, absolutely.
Absolutely.

I always feel badly about
myself.

When I do this.
Yeah.

'Cause I think it's kinda
startling

to really have to face
your memory gaps

and what that means.

Yeah, it is.

It's hard to take...
It's hard to take.

Well, I guess my question...
And I realized,

I summed it up...
My question to you is this,

is, did you at any point really
feel taken aback or shaken?

Today?
Yes.

No.
No, see?

I did, so,
there's a message in that.

Yeah.

Right?
Yeah.

Well, I know.

I know that you're worried,
I know.

So now, what you know about
Alzheimer's?

I gotta ask you, you know I do.

WOMAN:
Oh, my momma's getting a touch
of some sort of dementia.

GREEN-HARRIS:
Dementia is the loss of this
cognitive function.

Thinking, remembering,
reasoning.

It really is that broad-brush
definition.

Alzheimer's disease, this is the
umbrella for dementia.

If we were to have a spoke,

Alzheimer's disease would be
a spoke.

It is a type of dementia.

Alzheimer's disease,
or dementia,

can be in the brain for years
and not show.

Does it affect us differently?

CELENA:
Well, we're two times more
likely

with getting this disease,
and being a woman,

we're also two times more likely

with getting Alzheimer's
disease.

Have you ever thought about
getting part of research?

Can I at least talk to you
about it?
[laughs]

So if I were to ask you to be
a part of our research study,

what would your,
what would your thoughts be?

What would some of your
challenges be?

I would, I would say,
I probably wouldn't be.

MAN:
You know, we,
as African Americans,

are skeptical about research.

GREEN-HARRIS:
Mm-hmm.

We haven't had any past history
of good fortune in research.

And we feel apprehensive about
people experimenting on us.
GREEN-HARRIS: Yeah.

GREEN-HARRIS:
Even though we know folks don't
want to be involved,

we know we have to be involved,

because we're two times more
likely

to develop some kind of dementia

in the Black community.
MAN:
Yeah.

Why is that?
Why is that?

It has a lot to do with
our health.
[inaudible]

It has a lot to do with our
social determinants of health.

Stress, and we're trying to,
but you know what?

The biggest thing is the
question mark,

that's why we need you to be
involved in our research study.

So we can find out.
So we can find out.

I don't think it was
intentional,

but there was just a lapse of
recruitment of African Americans

in the beginning of the study.

Over time, it obviously
became recognizable

that there was the absence
of folks of color.

So in 2006, they started trying
to recruit African Americans,

but it was fairly unsuccessful.

And I think the original thought
was that,

"Oh, we just haven't asked."

But there was the
misunderstanding of how to ask.

Often time,
you have Caucasian investigators

coming into Black communities
and saying,

"Okay, I'm here
in my white coat,

"I'm here as the white knight,
I'm coming to save you,

and I've got all these ideas."

And never asking the community
for their ideas.

MAN:
I've noticed in our community
there's a lot of stigma.

And a lot of information that
has been old information

that people are continuing
to recycle over and over again.

Is there any materials

that we're able
to actually have to be able

to talk to these individuals?

'Cause there's not a lot of
education

that's going out there.

GREEN-HARRIS:
We still have the issue around
Tuskegee.

The level of offensiveness
that occurred with Tuskegee

has also continued to happen
over the years.

And so that is also in the
forefronts of our mind.

♪♪

DAVID d*ck:
For 40 years,

the general public in Tuskegee
and Macon County, Alabama,

was unaware the federal
government

was experimenting
with 430 local Black men

who had contracted syphilis.

They were used
as human guinea pigs

to determine the effects
of the disease.


of the untreated syphilis.

When the program became
public knowledge last year,

it was halted.

But so far, a citizens' panel
has been unable to force H.E.W.

to help those who survived.

I want to see the citizens
of Macon County and Tuskegee

who were utilized in this study
receive adequate compensation.

GREEN-HARRIS:
Any investigator that does not
understand the impact

of how communities of color
have been unfairly treated

when it comes to research,

they're doing themselves
a disservice.

We had to actually convince
the community,

and we had to say what made
us different.

So what made us different?

We didn't just go out and say,

"Hey, can you be a part of
our research?"

We actually started by
developing

our community advisory board

to talk about,
how do we address this thing

called Alzheimer's and dementia
in the Black community

so that we can build this
new research model?

The question is: what do you do
with all that data?

And how come we never see it
after you get this information?

We curate this data and share it
with people all over the world.

We're part of a consortium of,
of other cohorts

like the WRAP study.

But we share our data with
any investigator

throughout the world who has
a question

that we can answer.

All right,
we have one more consent form.

We do have permission now
to give you some

more results about
your memory testing.

So are you somebody
who would want to know...

Yes.
Some more information

if there was some cognitive
changes or not? Okay.

So how this is going to work
is, Dr. Sager and the scientists

will review your memory testing.

If they see anything,

they'll give you an overview
of the concerns.

SIGRID:
When I failed

to be able to reproduce these
figures on my piece of paper,

and couldn't do it three times
and broke down and cried,

I was convinced it had to be
Alzheimer's.

This was the beginning,

this was the beginning
of, of the end.

And so when he called
and said to me,

um, "I don't see any signs
of early Alzheimer's,

"but are there other things

in your life that might be
causing this?"

And I said, "Well,

"my 46-year-old daughter
died of heart arrhythmia

"very, you know, very suddenly
and unexpectedly,

and it was such a shock,
and yes, I'm depressed."

I'm trying to get to her,
the depression scores.

Yeah, here we are.

Depression and low mood,

even anxiety and stress,
those things affect memory.

Depressed mood can cause memory
dysfunction to such a degree

that it can fool some physicians
into thinking

it's Alzheimer's disease.

SIGRID:
And I thought, "Okay,
I gotta get depression

off the table if I can."

And also, you know, up my game,
so to speak, on exercise

and things that I know might
delay Alzheimer's.

TRAINER:
Good, bend the elbows
a little bit,

just like you had it.

SIGRID:
Bend the elbows a little bit.

TRAINER:
There we go.
Good. Bring them up. Good.

TRAINER:
Fine, chin up.

Three.

Nicely done!

Are these light for you?

I don't want to say that,

because then you'll,
you'll make it harder.
Yeah, I know. [laughs]

Right there.
Good! Good!

Right there. Perfect.

Right where the forearm
and the bicep touch. Good!

SIGRID:
The thing that's going to make
me the most determined is this

scare of becoming the next
in my family

to come down with Alzheimer's.

♪♪

NEWS REPORTER [on TV]:
Reporting live from Milwaukee,

Crystal Gantner, Fox 6 News.

Teachers are here, and again,

everyone will be coming
very shortly,

because in
just about 20 minutes,

that's when that bell-ringing
ceremony is scheduled...

KAREN:
Come on, people.

Move, move.

I better get my Boo-Boo
to school.

Don't call me that.

What, Boo-Boo?

No. Don't call me that.

KAREN:
He's at that age, being 16,

where, you know, they try to act
all tough.

But here he's starting off
at a new school.

He, I don't think, knows what
to expect.

I don't know.

He wasn't really clueing me in
this morning.

XAVIER:
All right. See you.

KAREN:
All right.
I'll see you at 4:00.

You're my baby.

[calling]:
Bye, Boo-Boo!

I know you hear me.

[talking in background]

WOMAN:
Although the research
is important,

there's still reaching out
to the caregivers.

Because when you go down,
who helps her?
WOMAN: That's right.

GREEN-HARRIS:
The caregiver is the
great denominator, right?

And that's why we have
the relationships

with the folks around
this table.

Let's start talking about
what we're learning

from that research.

We do know that lifestyle

and behavior changes,
eating modifications,

we know that has some impact.

With my mom, her diet changed
as her dementia progressed.

Has someone looked at
that difference?

BENDLIN:
That's a really good question,

and it's part of the reason
why we want to look at

people who are healthier,
as well,

and may not have diet changes.

KAREN:
Being part of this board is

super-important for me.

It gives me a sense of purpose.

I'm not just, you know,
being a test subject,

but having a voice.

I believe that there will be
an intervention.

There will also, at some point,
be a cure.

And I often liken what will
happen if we're not

participating
to what happened with things

such as hypertension.

Hypertension was studied
in, primarily, white males.

When an intervention
for hypertension

was initially found,
it worked in white males.

We want to be sure that
when there is something there,

we have been in the numbers and
we will definitely be able to

benefit from whatever
intervention, cure

comes from this research.

OZIOMA OKONKWO:
With advance in age,
the amount of atrophy

that you see in the hippocampus
actually is minimal.

Whereas when you look at those
individuals who do not meet

the guidelines for being
physically active,

that is when you tend to see
the most shrinkage

in hippocampal volume over time.

SAGER:
The data is really compelling.

If you remember, about 33%

of the population are considered

physically inactive.

And so, this is a huge
reversible, you know,

risk factor.
BENDLIN:
Right, and so,

what are the instructions?

OKONKWO:
So for this, you put someone
on a treadmill

and have them walk or run
until they

are exhausted, you know,
pretty much.

SAGER:
It takes about six to eight
minutes to do.

And it requires a
blood pressure, a pulse,

and a stopwatch.

That's it.
And that's it.

And two cones.

And some cones.

[all laughing]

♪♪

OKONKWO:
This morning, we're going to be
working you

real hard to see
how hard and how far

you can get before you...

Pass out?

Well, hopefully not!
[laughing]

During the exercise test,
you'll be wearing a mask

that's kind of a blue,
rubbery mask.

SCHULTZ:
And what that does
is, when you breathe in air,

all the air that you exhale
will be captured

and transmitted to
a gas analyzer.

JEAN:
Ten percent,
three-and-a-half.

SCHULTZ:
And that gives us a really good

indication of overall
physical fitness.

JEAN:


SCHULTZ:
Then we can use this data
to relate it to

some of your other measures that
you've been collected in.

So we can relate
physical fitness to cognition.

BARB:
Whew!

Good job!

Five percent,
three miles an hour.

OKONKWO:
Physical inactivity is
well known to be

a modifiable risk factor

for all kinds of cognitive
changes in late life.

Okay, we're going to go up
another hill.

Nice, even, big breaths.

Nice work.

OKONKWO:
And the measurement

of the highest oxygen inhalation
that we were able to record

has been shown to correlate
with a slower rate

of cognitive change
in late life.

There you go!

Excellent work!

Whoo!

You k*lled that, that test.
You k*lled it.

[Sigrid chuckling]

That, that is one of the best
tests we've ever had here.

Absolutely, it was.

You k*lled it.

You're very kind.
You k*lled it.

You went as high up
as one could possibly go.

♪♪

DAVID:
You!

You are a frenzy of activity.

SIGRID:
I think you really do need
to think about exercising.

DAVID:
Mm-hmm. Yeah, that's true.

But the more time you exercise,

and then you're tired
at the end of it.

And so your, that...

That moment of mental...

SIGRID:
I'm not tired.

I, I just exercised.

DAVID: I get tired
at the end of it.
SIGRID: I know.

I just exercised,

and what it does
is, it boosts my energy.

What it does to me is,
I want to take a nap.

[laughs]
But maybe if you
exercise more...

I want to move around mentally.

That's, I mean...

No, you still have to
physically move around.

You have to physically
move around.

And circulate, you know,

the blood throughout
your whole body.

Studies are showing you
shouldn't sit more than for,

for, you know, 30 minutes
or something,

and you're supposed to
get up and move around.

CHORUS:
♪ Jingle bells, jingle bells ♪

♪ Jingle all the way ♪

♪ Oh, what fun it is to ride ♪

♪ In a one-horse open sleigh ♪

♪ Hey ♪

♪ Jingle bells, jingle bells ♪

♪ Jingle all the way ♪

♪ Oh, what fun it is to ride ♪

♪ In a one-horse open sleigh ♪

[cheers and applause]

GREEN-HARRIS:
A diagnosis of
Alzheimer's disease

does not mean a death sentence.

You can still have
quality of life!

And caregivers need support.

We're here to support that.

If I see somebody in need,
I want to be there for 'em.

'Cause I would want somebody
to be there for me.

♪♪

BARB:
Come see Auntie Barb!

Come see Auntie Barb!

[gasps]

Peeks! Peeks!

BARB:
We were trying to count

great-grandchildren last night.

I ran out at 15.

No, Nana-Banana!

She's putting something
on top of Gavin's head,

and he's saying,
"Look at my head."

[chuckles]

Okay, there it is, Mama.

[child shrieking, laughing]

Sippy.

DOREN:
Hey, hey, hey...

Quiet down a little bit.

Sue and I always make the
appointment at the same time.

And then we go and have
our brains tested.

That's what I call it.

We play games.

BARB:
Okay, everybody smile.

Ada Potato,
are you showing your biceps?

[all laughing]
You got muscles there?

[laughing]

Oooh!
Look at those pretty eyes!

BARB:
Well, look at that!
Yeah!

She is in there after all.

You've pretty eyes, ain't you,
honey?

Yeah.

Yeah. Daddy's sweetheart,
aren't ya?

[babbling]

[wind blowing, birds twittering]

♪♪

[birds twittering]

DOREN:
I knew it was coming.

Yup, the last four days...

It was terrible.

[smacks lips]

[speaks softly]
Okay.

Dust to dust, ashes to ashes.

[weeping]

It's okay.

[weeping]

MAN:
Would you like me to walk her
out for you, Doren,

or would you like to take Irene?

No, I'll carry her out.

I'll take her.

You let me know
when you're ready. Okay?

BARB:
Monday morning, when we brought
hospice in,

you could see a grimace
on her face.

So you could tell that
she was having pain

and she wasn't able to eat.

Yeah, look it.
Isn't it beautiful?

Oh, wow, that is very beautiful.

BARB:
Oh, I've never seen that one.

DOREN:
We both put on
a little weight there.

BARB:
Look at how curly her hair was.

DOREN:
Ah, she, she was curly-headed.

[Barb chuckles]
DOREN:
That's a cutie.

BARB:
I love her smile.

[laughing]:
That's you!

Oh, I know it.



CONGREGATION:
♪ And He walks ♪

♪ With me
and He talks with me ♪

♪ And He tells me I am His own ♪

♪ And the joy we share ♪

♪ As we tarry there ♪

♪ None other has ever known ♪

[song ends]

[birds twittering]

ADAM GONZALES:
The setting is the annex.

When they say an "annex,"

it means a secret hiding place.

GIRL:
That's Anne?

That is Anne.
That's Anne Frank.

Anne Frank had something in her

that not a lot of
people today have:

a positive outlook on everybody
and everything.

KAREN:
He's never been a behavior
issue.

Just, teachers are concerned

because he wouldn't talk.

He's actually tried to
answer questions in class.

Raise his hand a little bit
more.

Say some things.

It's not...
We can still go further.

But I can clearly see
that he has been trying.

And that's a good start.

♪♪

She weighed 40 kilograms.

She's appearing older than
the stated age of 73 years.

"The hippocampal sections
of left and right

"[C and R, respectively]
are remarkable

for attenuation
of the fornix..."

♪♪

SIGRID:
Oh, good,
it's not too busy.

[exhaling]

DAVID:
Some people just get a buzz
out of the whole thing, and

I've never been a gym person.
[laughs]

♪♪

DAVID [breathing heavily]:
Well, you're still
standing, so...

SIGRID [breathing heavily]:
Well, yeah, I'm still standing.

How is your heart rate now?


Good!

♪♪

[birds twittering]

So this person was 61
when they started with WRAP.

They're 73 now.

Ton of amyloid.

The participant doesn't report
any memory problems.

There may be some opportunities
here to study

what is it that makes a person

steady over time
in the presence of disease.

It's very interesting seeing
how some of the things

that people do every day

are actually very critical.

Do you read newspapers?

Or play games?

Puzzles, checkers?

The findings have been
compelling that

the things that you do
to keep your brain engaged

actually do kind of help you

push back against what one
might have expected.

It will be curious to see
how all of this

pans out in the WRAP
sample over time.

♪♪

Draw the lines
as fast as you can.

Ready... Begin.

♪♪

MAN:
I'm wondering if any of you can
touch on any

evidence we have of the
reversibility

or at least the ability to slow
the onset or progression.

Let's say we have a biomarker
or we identify people at risk.

What can we do if they then,
as a 55-year-old,

improve those?

JOHNSON:
We've seen that people who have

certain healthy
lifestyle patterns...

Sleeping well,

keeping cognitively and
physically fit and active,

modifiable things like
hypertension, diabetes...

And it may be that if we can
treat these things effectively,

that may slow the progression
of Alzheimer's pathology.

This is tremendously important,
because it tells us

that there may be an avenue
of slowing down this disease

in midlife, or in fact,
preventing it entirely.

BENDLIN:
In our studies,
we've seen effects on the brain

of a lot of different
modifiable factors.

That said, you can do all those
things right and

you might still develop
dementia.

DAVID:
Let us get onto breakfast.

[Sigrid laughs]
Bring me my breakfast!

Frozen kale from our garden.

[blender whirring]

So today,

as I understand it,
they're going to inject...

It's not like, it's not like a
dye, it's actually...

She explained sort of
like radiation?

Some form of, you know,
radiation?

CARLSSON:
What we're doing today is,

Sigrid's coming in to be
evaluated for participation

in a clinical drug trial.

If she has any amyloid build-up
in her brain,

then she'll be eligible
to receive this medicine

that'll help clear out some of
that amyloid.

And then we'll see if the
medicine not only clears out

the amyloid,
but more importantly,

if it helps protect her thinking
abilities over time.

♪♪

WOMAN:
It's a good reminder...
Mm-hmm.

That when you speak, not to...

move your head.

And Sigrid, I am now injecting
very slowly.

And Sandy has started
the scanner, so we're

starting the imaging right now.

SIGRID [voiceover]:
It's going to be physical
evidence.

They are gonna sit down with me
and they'll go over the results.

That will be very difficult.

This is one of the most
important studies being done

worldwide right now for
Alzheimer's prevention.

I think it's going to be
a critical point in time

for us to see, if we get rid of
amyloid,

does it really help prevent
Alzheimer's disease?

And if we get rid of the amyloid

and it doesn't help thinking
abilities,

and doesn't help people,
then that's going to give us

a kick start to go look in a
different direction.

Hi! Good to see you!

Hi, good to see you.
[speaks softly]

CARLSSON:
These are two separate people.

So this is one single individual
at one point in time.

And this another individual.

And both of these people
have Alzheimer's disease.

They've had memory symptoms
for probably years.

They've had amyloid build-up in
the brain for probably decades.

The warmer colors...
So yellow, oranges,

and especially the reds...

Those are the areas where
there's some amyloid build-up.

Now, these two people
are both healthy older adults.

This person has some amyloid
build-up, though.

You can see that there are
some areas that have some red.

Some warmer colors.

But they don't have
any memory problems.

And they do not have
Alzheimer's disease.

So, at this point, again,

you are in this category.

SIGRID:
You're kidding!

CARLSSON:
No, I'm not.

Am I ever happy.

[laughing]:
We can go out for fish tonight
and drink double Manhattans!

All right,
but you'll miss all the fun.
Oh!

That is huge.

Huge!

Sigrid is rejected.
Yeah.

Sigrid is rejected!

Huge.

Yes. Very good.
Good to see you.

Enjoyed it.
Okay. Yes. Good news.

Enjoyed it. Yeah.
Enjoyed it.

[laughing]

Something to enjoy.
CARLSSON:
That's right.

All right. You take care.

I'll send Ben back in.

GLORIA GAYNOR:
♪ I could never live
without you by my side ♪

Give me a kiss.

♪ But then I spent
so many nights ♪

Good job, Sigrid!

Who knows what's lurking
in my brain?

I know!

♪ But now you're back ♪

♪ From outer space ♪

♪ I just walked in
to find you here ♪

♪ With that sad look
upon your face ♪

♪ I should have changed
that stupid lock ♪

♪ I should have made you leave
your key ♪

♪ If I'd have known
for just one second ♪

♪ You'd be back to bother me ♪

Well, I guess the question is,
where's the car?

[laughing]:
Yeah.

You sure you've got the ticket?

I've missed ya.

Thought about you lots.

Oh?
Think about calling you
at 5:30 in the morning.

Well, I'm probably
laying there awake.
And then I figure,

"I think he's sleeping."
No.

WOMAN:
One, two, three.

SUE:
Irene's Sunbeams.

CRICKET:
Thanks.

[laughing]

BARB:
Whoo!

Keep going, right?

Speed up?

[car horn honks]

GIRL:
Hi, Grandpa!

DOREN:
We got quite a family.

[shrieking, laughing]

["Pomp and Circumstance"
playing]

[people talking in background]

[cheering, whistling]

All right.

Now it's time.

The NOVA, NOVA Tech graduates!

[cheers and applause]

Keanu Avery.

[cheers and applause]

Kevin McCall!

[cheers and applause]

And our salutatorian,

number two in the class,

Xavier McElwee Lloyd!

[cheers and applause]

[cheering and yelling
in background]

[people talking in background]

I'm so very proud of you.

I love you.

KAREN:
He's my Boo-Boo.

He's my Boo-Boo.

He's my Boo-Boo.
I'm a man. I'm a man.

I ain't no Boo-Boo.

Mama, I made it.

Yes, you made it.

[cheers and applause]

If it hits my mom,
I just want to have that cure

that I could just
give it to her.

I'm actually glad that
she's trying to help

people with Alzheimer's.

I'm proud of it.

♪♪

To think that this disease
was first described in 1906

and we didn't even have a
diagnostic criteria till 1984.

Like, how to actually say that
someone has Alzheimer's

took almost 100 years.

And then to think of all
we've learned,

this is quantum leaps.

♪♪

♪♪

♪♪