But, for me, this way of thinking has long stopped when it came to Alzheimer's disease, a progressive mental deterioration that can occur in middle or old age, due to generalized degeneration of the brain, and affects an estimated 5.8 million Americans. In my mind, Alzheimer's was a chronic, progressive disease with no cure. Why would I want to know my biomarkers or calculate how at risk I am? Better to turn a blind eye than live in dread for the future, I thought. What could really be done?
But Alzheimer's is hardly a hopeless disease. Sarah Pillemer, PhD, a neuropsychologist who specializes in dementia, says that Alzheimer's is heterogeneous disease, which means it's caused by multiple factors. Some, she explains are completely out of your control (like aging and genetics), but there are actually a lot of other factors you can control, that when addressed, can stop Alzheimer's from progressing as quickly or severely. The important part is knowing what you can change.
That's where a new artificial intelligence technology is coming in. Created by uMethod, which brings personalized medical technology that addresses chronic conditions to market, Extnd Method is a new methodology using AI technology that creates a personalized prevention plan for Alzheimer's. The AI is used to interpret data from someone’s blood and urine tests, their demographics, medical history, lifestyle, and more to fit the person’s data against the latest scientific research on Alzheimer's disease. Alzheimer's prevention is getting personal—really personal.
What Alzheimer's prevention currently looks like
While, yes, Alzheimer's is a disease with no cure, Dr. Pillemer says that this doesn't mean that those who are given a diagnosis—or are told they are high-risk for it—are sent on their way with no plan of action. "It depends on the stage of Alzheimer's, as there is more you can do at a mild stage than a severe stage," Dr. Pillemer says. Something that's recommended to all patients is a healthy diet (the Mediterranean diet is often recommended, given the wealth of scientific studies showing its benefits for cognition) and regular exercise (which helps increase blood flow to the brain). Dr. Pillemer says continuing to learn new skills (brain exercise, if you will) and having strong social relationships are also recommended to patients with Alzheimer's or to those who are at risk for it.
UMethod CEO Vik Chandra says that lifestyle changes in all these ways is helpful, and most helpful when said changes are personalized. "One of the key places for Alzheimer's research is Weill Cornell Medical Center Prevention Clinic, which is run by Richard Isaacson, MD," Chandra says. "When a patient comes to Dr. Isaacson, he collects all their medical history, does lots of medical tests, genetic tests, and tests assessing the patient's cognitive function and so on. Then, every patient is given a treatment plan personalized to them." Chandra explains that, for example, some medications may help mitigate other health conditions that are putting them at risk of cognitive decline, or they may be told to make lifestyle and dietary changes, such as drinking less coffee or doing more aerobic exercise.
The point is that the personalized treatment plan highlights areas in one's life that can can be changed. Sure, general advice about sticking to the Med diet and exercising are great, but knowing where you personally could improve is even better.
What AI tech adds to prevention options
Of course not everyone has access to a doctor like Dr. Isaacson who can create a personalized plan for them. This, Chandra says, is where Extnd Method helps. A doctor can use Extnd's AI software to analyze everything a patient provides—blood work, urine tests, medical history, demographics, lifestyle habits, etc—and then cross-reference that data to known scientific risks and preventive measures connected to Alzheimer's. It then uses that data to recommend a treatment or prevention plan customized to that patient's individual biomarkers and health—which the doctor can then prescribe to the patient in question.
Chandra gives a few examples of how it works. "The blood tests may show low levels of iron or vitamin D, and low levels are linked to a greater risk of Alzheimer's. Or, the data may show a thyroid condition that can be managed through medication, which will also be part of the treatment. There are literally hundreds of [factors] the AI technology can pick up on."
It's important to acknowledge that Extnd Method is exactly that: a prevention plan. Chandra says it's recommended to people in their 40s and 50s, as treatment is most effective before signs of Alzheimer's start to manifest. (Something Dr. Pillemer also says is true.) For those who are symptomatic of Alzheimer's, Extnd Method will be covered by insurance, Chandra says. (The plan came out June 18, 2020 and is currently being rolled out to doctors who specialize in Alzheimer's prevention and treatment.)
Dr. Pillemer—who is unaffiliated with Extnd Method—says she's hopeful about what it can offer. "One of the reasons why there isn't an effective Alzheimer's drug is that there are so many factors that can cause it," she says. "This is why the best treatment plan is an individualized treatment plan. One person may need to focus on improving their heart health, because heart health and brain health are linked, while someone else may need to prioritize managing anxiety and getting better sleep. So I think these tailor-made plans will be very beneficial."
Knowing that while, yes, there are some risk factors for Alzheimer's you can't control, but there is actually quite a bit you can, has changed my mind about maintaining an "ignorance is bliss" mentality. When I shared this with Chandra, he reiterated that people aren't powerless against Alzheimer's. "There is real hope based on concrete scientific evidence in terms of real steps people can take," he says. "We want this to be something that's accessible to everyone and we're working hard to do that. This is a pivotal time in Alzheimer's research and people should be very hopeful. You don't have to wait for some drug to show up. There is something you can do today."
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