According to the Alzheimer’s Association, an estimated 7.4 million Americans are living with Alzheimer’s dementia in 2026.
Researchers around the U.S. are constantly learning more about dementia — how to diagnose it, what causes it, and ways to help lower the risk.
But major cuts to federal funding and scientific research grants in recent years have stalled or blocked important progress.
For the latest on where we stand in understanding Alzheimer’s and dementia, GBH’s Morning Edition spoke with Ryan Mace, an assistant professor of psychology at Harvard Medical School, and clinical psychologist at Mass General Brigham; along with Olivia Okereke, chief of the Division of Geriatric Psychiatry and Aging at Mass General Brigham and an associate professor of psychiatry at Harvard Medical School and associate professor of epidemiology for the Harvard T.H. Chan School of Public Health. This transcript has been lightly edited for clarity.
Tori Bedford: Let’s first talk about some of the medical advances that we’ve been able to make in this field. We’ve seen controversial, very early drugs to slow progression. What kinds of progress have we seen in recent years and months?
Olivia Okereke: Well, the major progress that we’ve seen the last few years is related to what we call the anti-amyloid antibody-based drugs. So you may have heard of lecanemab (sold under the brand name Leqembi) or donanemab (sold as Kisunla): these are medications that are given via infusions, and they are targeted at the protein that we believe is responsible for the pathology that happens with an Alzheimer’s disease called amyloid beta.
And I think that is probably the most newsworthy of some of the recent developments. There has been some controversy you alluded to — mostly to do with how effective in the long term we’re going to see these medications be. So for example, how much improvement or slowing down of cognitive decline will we ultimately see? But it’s early days. The other thing that we know about these medications is that they really are geared toward people who have the biomarkers of Alzheimer’s. So people who have identified biomarker is either in blood, or in imaging scans that tell us that amyloid is present.
Bedford: And there have also been advances showing that behavioral changes can have an impact?
Ryan Mace Yes, that’s right. There was a recent study that came out — it was called the U.S. Pointer Trial. It was funded by the Alzheimer’s Association, and what they did is they enrolled a large group of older adults with early risk factors for dementia, like having a sedentary lifestyle.
And they encouraged a combination of different lifestyle changes, such as engaging in physical activity that raises the heart rate through cardiovascular activity, as well as some weight training, following the Mediterranean, or sometimes called the mind diet for brain health — as well becoming more mentally engaged and socially engaged as well. And they followed them over a two-year period and they found that both a very regimented approach to making those lifestyle changes, as well a self-guided or self-directed approach was associated with protected cognitive performance over a long period of time, but that the more regimented period intervention was a little bit more beneficial.
Bedford: All of this research has been able to happen because of funding. In the last few years we’ve seen this federal administration making drastic cuts to research grants and to agencies like the National Institutes of Health. How do these cuts impact ongoing work and what progress can and is continuing?
Okereke: There can be dramatic impacts on the work, and that has to do with the fact that federal funding will either accelerate or in some cases, the absence of federal funding might slow down the progress. The progress we had discussed about the anti-amyloid drugs, for example, was heavily fueled by years of basic and translational research and clinical research to develop these treatments. And, in particular, in the last several years there had been an increase targeting Alzheimer’s disease research specifically at the National Institutes of Health. And what that did is it not only funded the projects, it fueled the introduction of new researchers into the field. It fueled new minds, new thoughts, new questions, really that are at the heart of how scientific progress gets made.
Bedford: We can remain hopeful that the work does continue. With the knowledge that we have from recent developments in research, what options does someone have if they’ve been recently diagnosed or found out that their loved one has been diagnosed with dementia or Alzheimer’s?
Mace: I think a lot of approaches can be beneficial. Ideally, if the diagnosis is caught or made early, there’s still a lot that you can do to prolong your health and lifespan. At the earliest stages, it’s never too late to work on improving your lifestyle. But as the disease progresses and as cognitive decline becomes more significant, the shift clinically with folks is often towards maintaining quality of life and independence as long as possible. And that does take a family approach, because dementia and cognitive decline and memory loss can really impact everybody in the family.
Bedford: And the mindset has changed as well, right? I think that’s one of the things that I’ve seen so dramatically change in the last few decades. Can you talk a little bit about that — how there’s more options now maybe, and how people are thinking about it differently?
Okereke: There was a time when people thought that Alzheimer’s disease either was just a normal part of aging, which of course it is not, or there was nothing that anyone could do to prevent it, especially if you had a family member, for example, who had it, then it meant, well, you would get it too. But neither of those things are true.
And in fact, we hear about so many of these modifiable lifestyle factors that have been powerful in reducing overall risk. And I think that is one of the things that is a take home that people should have — that there are things they can do to reduce risk, and the old myths about, ‘well, there’s nothing you can do’ — those don’t really apply.
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