IAmA Nobel Laureate, Dr. Paul Greengard, Director of The Fisher Center for Alzheimer's Research. AMA!

I work in the field of long term care including those with dementia and alzheimers. My colleagues and I are of the opinion that the food we are eating in this and the previous few decades are the real culprits to the increase in both alzheimer's disease and autism. What is your opinion on this?

Excellent question. There is strong evidence for an association among diabetes, cholesterol and Alzheimer's Disease. Although the mechanism is not known, there is compelling epidemiological evidence. Maintaining a healthy diet is beneficial. Thank you for being on the front line of care for the greatly increasing number of patients suffering from this disease.

It is my hope that you and your colleagues will put an end, or find the cause, of this epidemic. The financial strain of caring for dementia patients is bankrupting our society and impacting our already strapped government resources. I appreciate the work you are doing!

Thank you. Time to get back to work!

I meant, time for ME to get back to work!

what do you think was your greatest achievement so far?

Elucidating the molecular and cellular basis of communication between nerve cells, as well as gaining insight into how this communication fails in various neurological and psychiatric disorders, such as Alzheimer's Disease.

What are the differences between studying Alzheimer's 30 years ago and today?

Today it is possible to use a vast arsenal of scientific tools to study the disease. A variety of molecular biological approaches have enabled the identification of mutations in genes that make Beta Amyloid. We now know of hundreds of mutations that either increase the likelihood or guarantee the development of Alzheimer's Disease. We know the identification of the enzymes responsible for the formation of Beta Amyloid. The greatest progress has been the development of the amyloid hypothesis, which has remained the major driver for Alzheimer's Disease research and for drug development. There are several different compounds currently in clinical trial which show some promise. It has also been demonstrated that there are pathological changes in the brains of people destined to have Alzheimer's Disease 25 years prior to the manifestation of dementia.

can those pathological changes occurring 25 years earlier be seen by an examination by a knowledgable doctor?

There are two broad categories of Alzheimer's Disease, called familial and sporadic. Familial Alzheimer's is attributable to a defective gene, this gene can be passed on to offspring and guarantees that the child will have the disease as well. Sporadic Alzheimer's Disease, also known as Late-Onset Alzheimer's Disease, does not greatly increase the likelihood of offspring getting the disease. In a few Alzheimer's Disease research centers, doctors can demonstrate pathological changes many years before onset of dementia in the familial but not in sporadic cases.

What is a likely attack for future remediation of a person who has signs of Alzheimers 25 years down the line? What is your guess when this might be available?

It is impossible to predict when a cure might be available. However, it is clear that treatments directed towards some of the symptoms will become more and more efficient. In the meantime, stay as physically and mentally active as possible. There is strong evidence that such activity can delay the onset of Alzheimer's Disease. To learn more about Alzheimer's research, check out www.alzinfo.org.

By definition then, is early onset also familial Alzheimer's?

In general, there is a close correlation between early onset and familial Alzheimer's.

What makes Alzheimer’s different than other forms of dementia?

Dementia means loss of cognitive function. Alzheimer's Disease is believed to be due to the accumulation of a toxic substance known as Beta Amyloid. The Beta Amyloid accumulates in specific regions of the brain and kills the nerve cells in those regions. In other forms of dementia, other parts of the brain are affected. Alzheimer's dementia is irreversible. It is also the most common form of dementia.

Hello Doctor~ I am currently studying to become a medical researcher or medical practitioner, but other than that I'm not sure what I want to pursue specifically. I have a slight general idea, but my question is:

How did you ultimately decide to devote yourself to Alzheimer's research? Edit: typo haha.

It is clear that a large increase in the number of professionals working in the field of geriatric medicine will be needed to face the vastly increasing numbers of patients that are predicted to exist by 2050. Any motivated student should be encouraged to take this route.

Hi and thank you for doing this AMA. I was wondering what your thoughts were on the potential role of DAMPs or sterile inflammation in initiating certain categories of disease including Alzheimer's?

It is an area of active research and hopefully we will bring new insights into the pathology of Alzheimer's Disease in the coming years. Inflammation is now well established as a component of the pathology seen in Alzheimer's Disease. However, efforts to use anti-inflammatory drugs to prevent or delay the onset of Alzheimer's have not been very encouraging so far.

Have you seen any improvements or set backs with the use of marijuana? Does it help treat it? or does using marijuana cause Alzheimer's?

Over the last couple of years several studies have addressed the possible role of cannabinoid (the active compound of marijuana) in neurodegeneration and especially in Alzheimer's Disease. At this point, there are really no convincing studies one way or the other.

How long have you been researching Alzheimer’s?

About 30 years.

How much does the Nobel Prize weigh? Also do you walk around town wearing your Nobel Prize?

I have never weighed it and I don't walk around town wearing it.

I read recently about a small study that showed Alzheimer's patients also had some kind of fungal infection in their brains. From what I read it's still very preliminary, but do you see promise in the possibility of using anti-fungals as an Alzheimer's treatment?

No, I do not. Indeed it is a very preliminary study.

Are there any researches proving a connection between ADHD medicine intake which the new generations of children consume heavily compared to the past and the disease you are researching?

The widespread use of ADHD medicines is too recent to know the possible impact on developing Alzheimer's Disease. As of now, there is no evidence for such a connection.