An internationally known physician and researcher, Agus shares the latest research concerning Alzheimer’s disease.
Dr. David B. Agus
Tavis: Is prevention the best medicine for many diseases? That’s a question that continues to vex many in the medical profession, particularly when it comes to Alzheimer’s, a disease that will affect some 16 million baby boomers over the next three decades and one for which there is no cure at the moment.
Joining me to talk about it, Dr. David Agus who, of course, is head of USC’s Westside Cancer Center and the Center for Applied Molecular Medicine. Dr. Agus, as always, good to have you back on this set.
Dr. David Agus: Great to be here, Tavis. Thank you.
Tavis: When I last saw you, you were actually headed out of here. You were last here for your annual fundraising event for the work that you do and it made all kinds of national news because of that – I’m trying to find a word for it – that massive contribution by Mr. Ellison of Oracle.
Agus: Listen, I am just so honored that the technology and the entertainment community step up and they’re helping fight this horrible disease called cancer. They really are putting in. So Larry got up there and said, “How much did you raise the evening?” They said $4.5 million. Larry said, “I’ll double it.”
And it’s such a privilege that they get it. You know, we spend more in our country on vitamins and supplements than in all of medical research. We spend more on potato chips than on cancer research. That has to change if we’re going to make a difference.
Tavis: What do you make of that, that we spend more on vitamins and supplements? I mean, that just shook me to my core. More on vitamins and supplements than research?
Agus: Than all of medical research. More potato chips than on cancer research in our country. I think our priorities are wrong. We all want that quick fix. Take a pill to make you better. That’s what a vitamin or a supplement is. Or take a potato chip. Eat potato chips. Makes you feel better.
We need to focus and say, listen, we spend today, it’ll pay off tomorrow. Research, new drugs, new ways of treatment, new ways of thinking, are what’s going to stop the suffering of disease.
Tavis: But why does it feel to me then like cancer is the one disease that gets all of the medical attention, that gets all of the money that is directed toward research? Why does it feel that way to me?
Agus: Well, I think a lot of money is spent on cancer and you’re right. There’s a lot spent on cancer research. And the progress with all that money has not been like we hoped. So we certainly need to do things better.
But still, the fraction of every dollar in our country that goes to medical research is minute. It’s less than a penny. So we need to change that and we need to say we invest today, it’ll pay off tomorrow.
Tavis: So we know how massive this baby boom generation is in terms of size. How frightened should we be by the numbers we just shared that 16 million in that generation alone will be suffering from Alzheimer’s?
Agus: Listen, as we can start to prevent many diseases, we can delay cancers, we can prevent heart disease and delay it, other diseases of aging happen. Alzheimer’s is one of them. We need to really focus so we can prevent and then hopefully treat this.
So get a load of this experiment. It came out two weeks ago. So three of the top medical journals. So the original experiment was done in 1956 where this remarkable woman in New York took two mice, an old mouse and a young mouse, and sewed their skin together, kind of Frankensteinish.
And the blood supplies mixed and when the blood of the young mouse went to the old mouse, all of a sudden new brain’s neuron connections happening, the muscles got stronger, the heart got better and the young mouse aged. She was able to reverse aging in an old mouse with the blood of a young mouse.
Well, three separate labs at Harvard, UCSF and Stanford did the same thing now where they were able to take the proteins from a young mouse and turn on stem cells in an old mouse and let new neuron connections happen so new muscles grow. And they isolated it down to one protein, reversing aging.
So when I talk about prevention, it’s out of optimism because of what’s in the future. The clinical trials in people with Alzheimer’s with this protein are going to start the end of the year.
Tavis: Reversing aging – you’re the expert here, not me. It seems to me, though, that reversing aging is one thing. Attacking how this disease works on the brain is another. Are they one and the same?
Agus: They’re probably connected. You know, with this disease, it turns out proteins start to glom in the brain and block it up. So if we can get those stem cells to turn back on, maybe we can reconnect the neurons that we’re losing.
Agus: But you’re right. At the same time, we have to understand the fundamental notion to disease and that’s happening. There is a lot going on now in animal models of Alzheimer’s. So it turns out you give a mouse Alzheimer’s, it sits in a corner like this. You drop in a piece of paper; normally it rips it up and makes a nest called nesting.
The Alzheimer’s mouse sits there like this, does nothing to the paper. You can then give a protein that’s – FDA approved a drug for lymphoma that reverses some of the protein-folding issues in the mouse. And then two weeks later, it’s ripping up the napkin again.
So there’s a lot of hope out there and it’s early on in this testing of these drugs, but there is hope. That’s why we have to focus on prevention and delaying as much as we can because those magic pills are out there.
Tavis: For all the research, all the attention, all the money that has been directed toward Alzheimer’s research, why are we not – I mean, this is promising. But why are we not farther along at this point?
Agus: Well, I think it’s a very difficult disease, right? The patients themselves can’t be advocates. When you have Alzheimer’s, you can’t get out there and march on Congress and push for money there and it’s been difficult. Most patients, when they die, they say use my body for an autopsy, but not my brain. So we haven’t been able to study that many brains, so it’s been difficult.
But there’s a study that came out earlier this year that really is profound. And what is showed is the largest study ever done in the elderly population. Every year you delay retirement, you reduce Alzheimer’s by 3%. So if you retire at 85 instead of 65, that’s a dramatic 60% reduction in Alzheimer’s.
So the old adage, you don’t use it, you lose it. So we need to look at these tidbits of data, these stories, and start to act on them if we want to make a difference today.
Tavis: So everybody who’s had the honor of being treated by you likes you not just because your research is so brilliant, but I am told – although I haven’t had this experience personally except to sit across from you on this set – that you have a wonderful bedside manner. And we all want a physician that has a good bedside manner.
I raise that only because it seems to me that it’s not just the Alzheimer’s patients that we have to be concerned about in this baby boom generation, but those persons who are going to have to care for these Alzheimer’s patients, which means if you got 16 million people suffering, that means there are millions more Americans who are taking care of their mothers and their fathers and their grandparents.
And that creates a whole other conversation about how we look out for these people who are now giving care at an age in their life, at a point in their life, where they didn’t expect to be burdened in that way. Does that concern you?
Agus: Oh, no question about it. You know, they are the unsung heroes or the caregivers. And there’s no network for them, there’s no support system for them. What website can they go to to figure out what to do and how to do it? We need to address that today.
You know, the aging population is an issue, right? The baby boomers now are turning to the late 60s and they’re going to start to get all those diseases of aging, cancer, Alzheimer’s, heart disease.
You know, it’s going to burden the system dramatically. We need to figure out a way to address it. Care at home is fantastic, but we got to worry about those caregivers and develop a support network for them.
At the same time, we have to work on our infrastructure. Look what happened in the last couple of weeks in the Veterans Administration hospital system. We ain’t good at our support network here in healthcare in our United States and we need to change that.
Tavis: I’m glad you said that ’cause I wanted to ask you about that, but I didn’t want to put you on the spot because it is such a huge issue and we’re trying to figure this out now with whoever the new, you know, Secretary of Veterans Affairs will be.
And I think it’s a much bigger job than just one person being appointed by Obama to run that department. But I think you’re right that the system seems to be burdened.
I tried to make the point that the more wars you fight, the more veterans you’re going to have coming home. And some of these wars are quite frankly, my own assessment, military excursions that we shouldn’t have been engaged in in the first place. That’s me, not you.
But the point is, whether you agree or disagree with these wars, the more wars you fight, the more veterans you’re going to have coming home. If you have more veterans coming home with a system that is ill-equipped to handle their needs, this problem isn’t just going to go away. It’s going to get worse.
So what’s your sense of whether or not we have a system for veterans or for everyday Americans that has the capacity to handle what Alzheimer’s with 60 million patients and these other diseases are about to do to overload that system even more so?
Agus: Our system is designed to treat and doctors, hospitals, are incentivized to treat, right? A surgeon gets paid to operate. A doctor gets paid for doing something. We need to change it and reverse it so you’re getting paid and incentivized to prevent and to really change the structure of healthcare so we can address it early on where we can make an intervention.
The best way to treat any disease is to actually prevent it. When you look at how our Veterans Administration is set up, most people they’re older, they have Medicare. They go to the Veterans Administration because they get free drugs, so their care is fractured. Fractured care isn’t good.
The care for our veterans should be one of our top priorities. It should be aspirational. I want to be like them and get that kind of care rather than what it is now, which is an abomination. And that needs to change.
We need to rethink it and design it from the ground up. Whether it be a voucher system, whether it be restructuring totally, incentivizing for prevention or developing ways in a support network for them, I’m not sure what the real answer is. But we need to start to bring in our think tanks and do it right away.
Tavis: Are you in any way hopeful that the politics that are so connected to the healthcare debate in this country are ever going to change? Do you see the optics changing?
I ask that because, I mean, so much of this, again, whether one agrees or disagrees, there is a sentiment in this country that the optics on this have been the way they are in part because Barack Obama has been the president pushing it. Of course, the Clintons, you know, had their own come-uppance when it came to this issue.
I’m just trying to get at whether or not you see any way politically where the optics on this change so that we can have some advances that aren’t always so fraught with partisan politics.
Agus: It doesn’t look like it. You know, there’s X bandwidth for health in Washington. And for the last decade, it’s been about healthcare finance. We need to change it back to health. But the problem is, health is a 10, 20, 30-year affair and politics is a four-year affair.
So what politician is going to say, “Let’s spend now to benefit later”? It just doesn’t happen. Our political cycles and our health cycle just don’t mix and somebody needs to change that. In order to get normative behavior, you need leadership. And I challenge you to name a healthcare leader in our country today.
When the greatest healthcare leader over the last decade is the Mayor of New York City, you know there’s a problem there. I applaud what Mayor Bloomberg did, but we need real leadership so we can get normative change and that just doesn’t happen in healthcare. Healthcare finance that are leaders, but I want leaders on health.
Tavis: Let me circle back before I let you go here to the brain. We were talking about Alzheimer’s…
Agus: I’m pro brain [laugh].
Tavis: So am I. I’d like to have more of it, but I’m pro. What most excites you? What makes you most hopeful about what we are learning about the brain?
Agus: Well, it’s at it’s what we call plastic. We thought as we get older, our brain is static and just worse and worse. So an amazing experiment was done at UCSF where they designed a videogame, and the videogame had you do two things at once that actually connected parts of the brain.
So if somebody over 75 did this for 30 hours, what happened is they thought better. They functioned better and it lasted for several years. So we can retrain the brain. It’s not just a downhill. It’s actually going to be uphill.
So as you get older, focus on what you’re not good at it and try to get better and realize that there’s hope around the corner. We just need to prevent or delay these diseases because there really is hope to reverse things. The plasticity of the brain is astounding.
Tavis: I love this guy. I always appreciate having him on to hear his profound and innovative insights. His name, of course, Dr. David B. Agus.
His latest text which I love is called “A Short Guide to a Long Life”, “A Short Guide to a Long Life”. I’ve been digging into this every day and I highly recommend it. Dr. Agus, good to have you back.
Agus: Tavis, thank you. It’s an absolute privilege.
Tavis: Good to see you.
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