How Duke is closing in on Alzheimer’s

As Americans live longer and baby boomers reach their 70s, there is an increasingly urgent need for treatments to prevent Alzheimer’s disease or slow the progression of symptoms.

Duke researchers have been attacking the disease on several fronts. One promising direction seeks to understand how the disease develops and progresses, and why some people’s brains are more resistant to the disease than others.

Dr. Heather Whitson, professor of medicine and ophthalmology and director of Duke’s Center for Aging and Human Development, has seen many patients who maintain their cognitive abilities despite evidence of significant brain pathology. She wonders, “What is the secret? What are their brains doing that we could try to get other people’s brains to do?”

Whitson, a geriatrician, seeks to help people keep their minds and bodies resilient as they age. To that end, she studies lifestyle and environmental factors as well as molecular and cellular processes in the body and brain. She co-directs the Duke-UNC Alzheimer’s Disease Research Collaborative, which brings together Duke and University of North Carolina researchers from multiple disciplines to find ways to prevent or slow the disease, with a special focus on reducing health disparities.

“At the molecular and cellular level, we’ve advanced so much in the past 20 years that I’m hopeful,” she says. “We have the opportunity to unlock the resilience of youth,” Whitson says. “And Duke is a really enviable place to be able to do that because of strong programs across our schools of medicine, nursing, and engineering, and our basic sciences. If you look at our peers, you don’t see many that have all of those really highly ranked schools within walking distance. We really benefit from the proximity because it spurs collaboration and promotes team science.”

We have the opportunity to unlock the resilience of youth, and Duke is a really enviable place to be able to do that because of strong programs across our schools of medicine, nursing, and engineering, and our basic sciences. ”

Heather Whitson

Director, Duke Center for Aging and Human Development

Whitson also sees great potential in understanding triggers, particularly those related to sensory loss, that may play a role in how Alzheimer’s is diagnosed and how its symptoms progress. As people lose the ability to see, hear or smell, they become more at risk for developing cognitive impairments. “It’s a major stressor to your brain to have less input from your senses,” she says. “I’m trying to understand how the aging brain copes with that.”

Other Duke investigators are looking into additional potential Alzheimer’s triggers, including stressors like metabolic changes, infections and cardiovascular disease—sharing their ideas and insights with others. “It may be a combination of all of these things,” Whitson says.

Stephen Lisberger, Ph.D., the George Barth Geller Distinguished Professor for Research in Neurobiology and chair of Duke’s neurobiology department, shares Whitson’s optimism about future Alzheimer’s treatments and prevention.

Lisberger studies the very fundamental question of how the brain learns, and he believes that understanding how the brain compensates could point to promising pathways for treatment.

He values being at a university that encourages collaborations among scientists and across disciplines. “If you take people at the beginning of their careers and bring them into an environment where collaboration happens and is valued and the expectation is that they will be part of a broader community rather than a silo, then that becomes their culture,” he says. “The kind of collaborative effort we have at Duke is very powerful.”

Lisberger doesn’t know when or how or which research insights will lead to treatment for Alzheimer’s, but he has no doubt it will happen. “I am sure that we will succeed, and the best evidence of that is history,” he says. “Almost every treatment for human disease has come from a serendipitous discovery about how the body works that was made by a basic scientist who was pursuing knowledge for its own sake.”