As We See It

Memory screenings and ‘beautiful minds’ at the Lou Ruvo Center for Brain Health

The Cleveland Clinic Lou Ruvo Center for Brain Health.

In a few minutes, based on a few simple questions, I'm given a number. It's not a test score so much as a marker within a cognitive range. The assessor at the Lou Ruvo Center for Brain Health emphasizes that this memory screening is far too basic to be diagnostic, and besides, I'm young and without many risk factors. But I'm nervous. If my number doesn't fall within what’s considered “normal,” I will be advised to see my doctor or a neurologist here about a more in-depth determination of the health of my brain.

“We’re not saying that you have Alzheimer’s disease or dementia or mild cognitive impairment, but this test shows maybe you might be headed in that direction,” the assessor says, assuring me that a score outside of normal on the Brief Alzheimer’s Screening could be caused by other factors (a poor night’s sleep, test anxiety, vitamin B12 deficiency, thyroid problems, metabolic disorders such as diabetes, etc.). Then she reads the official interpretation of my number: “There is no significant cognitive impairment indicated. Further testing by a physician or other qualified health care professional is not recommended. Suggest repeating test in one year.” Had the results been different and my reaction severe, the Lou Ruvo Center has a social worker, a neuropsychologist and a psychologist ready to provide counseling and support—and that’s in addition to its regular staff of specialists devoted to caring for cognitive disorders and conducting research on the cutting edge of treatment and prevention.

I am “Participant No. 1,” getting a preview of the free public screenings that will take place at the Lou Ruvo Center on November 19. That’s National Memory Screening Day, an annual initiative of the Alzheimer’s Foundation of America. While the assessment can provide some rudimentary clues to brain health, the day of recognition is designed to raise awareness and spark discussion about cognitive disorders, so there’s less of a stigma and so people will be better equipped to plan for the future and seek treatment or focus on lifestyle changes that promote healthy aging.

While the slots have all been scheduled for this year’s National Memory Screening Day at the Lou Ruvo Center, it’s a year-round resource, from the free library to Lunch & Learn seminars. But one of the best ways to get a sense of its mission is to sit down with Dr. Kate Zhong, senior director of clinical research and development. After my assessment, we talked about the state of Alzheimer’s treatment and the disconnect some people have with thinking about health from the neck up.

“The overall direction [of an Alzheimer's diagnosis] will be that your memory is going to go downhill, your executive function is going to go down, your judgment is going to go down over the years. … So what can you do to plan for that, even if you are still relatively normal?” she says. “Having an early diagnosis brings up the whole issue of treatment at a very early stage. And the earlier you start the treatment, the better the prognosis.”

Dr. Zhong says there are five standard Alzheimer's medications that have been approved by the FDA, all of which address a deficiency of choline, a neurotransmitter associated with memory. While these drugs can slow the decline of a person’s brain function, they cannot reverse or “cure” the disease. So the Lou Ruvo Center is part of a national push to develop medications that have the potential to do just that. At any given time, Dr. Zhong’s team is engaged in 20-25 related clinical trails, including a new one blazing a trail nationally by focusing on prevention. More than 6,000 patients in high-risk groups (family history of Alzheimer’s, genetic predisposition, advanced age) are being recruited from the U.S., Canada, Mexico and the U.K. to test an experimental drug that researchers hope will prevent the disease from developing at all.

The implications are huge, but Dr. Zhong is quick to point out that small, everyday things can also be huge factors in the fight against brain disease. “When people think about Alzheimer’s, they think, ‘I was born with this. My mom and dad had it, and inevitably I’ll get it.’ That’s only about 40 percent true. The other 60 percent is all lifestyle,” she says. “So there’s so much we can do to improve our overall brain health, to really minimize our risk of developing dementia and Alzheimer’s.”

What’s good for the body is also good for the brain, like physical activity and a healthy diet rich in antioxidants and fatty acids. Social engagement is vital, too, and mental activities like learning a new language or brushing your teeth with the opposite hand can keep your brain sharp. Dr. Zhong points out that the organ shrinks and wrinkles as you age, like a grape turning into a raisin. Keeping it juicy can be boiled down to 21 factors used to create America's Brain Health Index. The state-by-state measure (undertaken by the nonprofit National Center for Creative Aging and omega-3 supplement brand life’sDHA) looks at such things as diet, physical and mental health and social well-being. Nevada ranks No. 21, pretty average. But Dr. Zhong says the state’s Alzheimer’s population is poised for a boom.

“The growth of our Alzheimer’s population in the next 15 years is going to be 100 percent. ... We have an aging population here,” she says, explaining that at 65, your risk of developing Alzheimer’s is 5 percent, doubling every five years after that. But if people age "successfully," those percentages can change. That’s why she’s so interested in another endeavor by the NCCA and life'sDHA. “They’re rolling out a Beautiful Mind model, identifying the individual who really is an example of living a brain-healthy lifestyle.”

Here in Clark County, Dr. Zhong is collecting her own data—down to the pounds of fish locals consume—hoping to paint a picture of brain health. She is working on partnerships with the school district and UNLV, AARP and grocery stores and other entities to develop educational outreach and health initiatives that could help local minds get closer to that picture. She’s even helping to produce a brain-healthy cookbook.

“To me, what’s most important is: Is there a way we can actually put together a very grassroots, comprehensive brain health initiative and really educate and teach people what they can do to take control of their own brain health? That’s what we’re working on,” says Zhong, reflecting on how far medical science has come, making bodies so much more durable and fixable. “In the last century the lifespan has improved by 30 years. So we’re getting much healthier, and we’re living much longer, but if your brain does not age as healthy as your body, we have a major problem. We want to build a brainspan that matches our lifespan.”

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