AAIC Special Series Part 8:
Closing out our special series spotlighting the 2022 Alzheimer’s Association International Conference, Dr. Percy Griffin joins the podcast to discuss highlights from this year’s event.
Guest: Percy Griffin, PhD, director, scientific engagement, Alzheimer’s Association
Find more highlights from the conference, including on-demand content that is available to watch through September 1, 2022 at 11:59p.m. PT , at the AAIC website.
Learn more about Dr. Percy Griffin at his bio on the Alzheimer’s Association website.
Listen to our AAIC special series episode with Dr. Carl Hill, mentioned by Dr. Chin at 3:41, on our website, Spotify, Apple Podcasts, YouTube, or wherever you listen.
Listen to our AAIC special series episode with Dr. Heather Snyder, mentioned by Dr. Chin at 18:22, on our website, Spotify, Apple Podcasts, YouTube, or wherever you listen
Find the news highlights on diet, racism, preeclampsia, COVID-19, and more mentioned by Dr. Chin at the AAIC website.
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Intro: I’m Dr. Nathaniel Chin, and you’re listening to Dementia Matters, a podcast about Alzheimer's disease. Dementia Matters is a production of the Wisconsin Alzheimer's Disease Research Center. Our goal is to educate listeners on the latest news in Alzheimer's disease research and caregiver strategies. Thanks for joining us.
Dr. Nathaniel Chin: Welcome back to Dementia Matters. Today, we’re concluding our special series previewing AAIC 2022. After seven episodes highlighting key scientists, studies and events from the world’s largest dementia research forum, the conference kicked off last week on July 31st to showcase the latest groundbreaking findings in Alzheimer’s disease research and dementia caregiving. Joining us to talk about this year’s conference and its highlights is Dr. Percy Griffin, director of scientific engagement at the Alzheimer’s Association. Dr. Griffin, welcome to Dementia Matters.
Dr. Percy Griffin: Thanks for having me here.
Chin: To start, what is your role at the Alzheimer's Association and how did you get into this field?
Griffin: Thank you, Nate. So, as you mentioned, my role is director of scientific engagement, and I work with the different Alzheimer's Association chapters in providing ongoing education to make sure that they're educated on the new and emerging research that is coming about in the Alzheimer's field. But in addition to that, I also work with, you know, the scientists in the field from all over the world through our international society to advance Alzheimer's research and treatment – ISTAART. Just generally I like to say my job is, I'm going to engage and talk to anyone who wants to hear me talk. I got into the Alzheimer's field initially right after undergrad where I started working as a junior scientist in a lab that studied Alzheimer's and Parkinson's disease. This carried on through my master's work, my masters in pharmacology work. Then after that I went to grad school and got a PhD also studying the interaction between sleep inflammation and Alzheimer's inflammation in the brain and Alzheimer's disease. Then I took a brief stint out of the Alzheimer's field in consulting, but, you know, it quickly called right back to me and I started working at the Alzheimer's Association. I've been there ever since.
Chin: Well, maybe you answered this question but I'm going to ask it anyway. Do you have a specific interest within the field of Alzheimer's? Is it sleep, because of your training or have you chosen a different topic?
Griffin: Yeah, so sleep and some of the modifiable risk factors are very, very interesting for me right now because those are things that can potentially be changed to to change a presence's risk of getting Alzheimer's. Also I enjoy some of the understanding of the aspects of the disease having to do with inflammation in the brain. How these immune cells that we're just beginning to understand may impact some of the biologies that may increase your risk of getting Alzheimer's. And one other thing that I'm also very passionate about is increasing the underrepresented populations in Alzheimer's disease. We know that these populations are underrepresented in clinical trials, underserved by these institutions that are supposed to be helping them in the medical field, and also underdiagnosed with the disease. We need to make sure that this one, two, three punch is taken away to make sure that these people can have access to proper care.
Chin: And for our listeners who are interested further in that very important topic, you can listen to an earlier episode with Dr. Carl Hill, who during this series also spoke to some of the issues that we're facing in the field and potential ways that we can address those now. Now that the conference is over, Percy, do you have a sense of what kind of turnout AAIC 2022 had this year?
Griffin: I do! We had more than 10,000 attendees from all over the world. This is not just in-person. We had more than 5,500 people who were at the conference center itself, and the rest were virtual. Our conferences are hybrid, so it's not just that we're going to record the sessions and then you can view them later. You can interact with the people in the room at the same time as the conference is going on. It allows for that level of engagement. We keep all of the content on the platform for 30 days after the conference, so if you missed a couple of sessions you can go back and watch it in your leisure time, which is great and something that you usually couldn't have done if all of the sessions were only in-person. So, driving that level of accessibility. We also had more than 2,900 posters and 700 podium presentations, so, as I said, there is no way that anyone is going to make it to all of those presentations. It's just good to have that content on the platform for later.
Chin: Yeah, I will say that, as someone who watched it in the hybrid-virtual format, I greatly enjoyed being able to attend live and do the recordings after the fact. I'm not surprised you had such a great turnout. You were in beautiful San Diego this year, although one of your speakers in the beginning really challenged San Diego and said – well, next year it's going to be in Amsterdam and we're going to have greater than 10,000. So it'll be interesting to see if those hosts in Amsterdam are correct. Did you get a sense, too, of how many research participants attended or at least non-scientists who are simply interested in understanding what's happening in the field?
Griffin: So I don't have the specific numbers on that, but just through conversations with people in the hallways and whatnot, there were certainly a lot of those around as well. We also had some Alzheimer's Association leadership that were there, so these are not necessarily trained scientists but they are definitely passionate and want to get involved and are involved in so many ways in our communities. They were also there. They got to interact with the researchers. It was just fantastic to see that interaction and even just how that puts the work that the researchers are doing in context. As someone who used to do lab science and bench science myself, you know, when I'm there at 2AM working with myself or whatever, this gives me my reason why I'm doing it. It’s so nice to see those kinds of interactions as well.
Chin: Working at 2AM doesn't sound like a good time, Percy, but certainly it's a wonderful mix at the conference to see people with different disciplines, different backgrounds, different interests, of course. And that makes me think about the themes, because one of the key themes that I enjoy seeing as a clinician is the dementia care pathway or theme at the AAIC conference. What were some of the other key themes this year at the conference?
Griffin: So I want to touch on two that are making real headway. First is the progress that we're making in the area of biomarkers, specifically blood biomarkers. If you told me even five years ago that would be where we are today in terms of the progress that we've made for blood biomarkers, I would not have believed you. It is tremendous and impressive progress in coming up with accessible tools that will aid in the diagnosis of Alzheimer's disease. These are being used in specialized clinical settings as well as specialized research settings, but as we move more and more towards implementation of these blood biomarkers we want to make sure that we're not doing more harm than good, right? We want to make sure that these are applied appropriately. The Alzheimer's Association convened a work group to come up with appropriate use recommendations on how these may be applied in the clinic and what some of the cautions as well as the safeguards that need to be put in place. This was published in our journal – the appropriate use recommendations were published in our journal at the end of July. A second theme that I see a lot of progress in is looking at risk reduction. We all know about early detection and diagnosis and definitely the progress being made in treatment as well, but risk reduction is one that people have started paying close attention to. One particularly striking example was the results from the EXERT trial. After twelve months, study participants with MCI in both aerobic exercise intervention and stretching showed no cognitive decline. An analogous group or comparison group of older adults with MCI from the Alzheimer's Disease Neuroimaging Initiative who did not get those interventions showed significant cognitive decline over twelve months so that is incredible and that is incredibly encouraging as well. It just shows that these non-drug interventions actually can have an impact on the disease and the disease progression.
Chin: Were there any new or emerging topics this year that you didn't have at AAIC 2021?
Griffin: So we – I'll not necessarily say that they were new, but a heightened focus on the social determinants of health. Social determinants of health are, you know, the environment in which people live, they work, they play, you know, and have an opportunity to age. We're beginning to understand how that impacts the disease progression. One big example of this was the plenary by Dr. Margot Kushel, who talked about dementia and homelessness. I tell you, all the people that I spoke to at the conference just kept talking about that because it's something that is just there and staring at all of us, but we had never paid – like at least I hadn't paid attention to it as, you know, something that can be done to help improve the health of those living with dementia. I think that's just an example of how we're beginning to look at the disease not just as something that happens at one point in time, but across the life course and all of the experiences that people have across the life course and how they may impact the risk for getting the disease, and how people age in a healthy way.
Chin: And Percy, I want to ask you some specific questions about some of the news highlights that came out of the conference but before I do that, I really want your perspective on what you think some of the key highlights, key findings from this year's conference were.
Griffin: Yeah, so definitely that – I'm just going to harp on it because it was just so impactful for me is that plenary on homelessness. It's just one that I will recommend to everyone to see, doesn't matter whether you're a researcher – I studied cells back in the day – so it was just phenomenal. I also got a chance to see a panel on phase two clinical trials that were looking at a number of different diverse approaches for treatments, so some of them were looking at drugs that look at the cytoskeleton, like the highway that things are moved along in the cell. One of the presentations was looking at how the brain uses energy, so changes to insulin in the brain during Alzheimer's disease. And another one was just looking at making sure that the connection between the brain cells just don't die. All of these – it was just encouraging to see all of these move along. These are certainly moving along the clinical trial pathway, but one other piece of the conference, which just doesn't necessarily – it does and it doesn't – but it's not necessarily scientific results, but was the involvement of early career researchers. Early career researchers were present and they were visible in all of the aspects of the conference. You know, we're talking about early career research chairing sessions, early career researchers such as the ISTAART ambassadors taking charge and helping the conference in so many ways. At the end of this conference, I just want to say that I felt so encouraged and, I'm going to tell you, the future of Alzheimer's and dementia research is so very bright.
Chin: That is a nice thing to say, and certainly things like the ISTAART program really facilitate that. Now before we get to some other specific questions, another general question – and you kind of alluded to it – clinical trials. You know, sometimes at these conferences they talk about. bigger, larger trials that are going on. Were there any key findings, positive or negative, involving medications that were discussed at this conference?
Griffin: So we have four late stage monoclonal anti-amyloid antibodies that are making their way through clinical trials. You know, we're all waiting to hear what the readouts would be in the next couple of months, but we are also, as I mentioned with the phase two clinical trials, looking at other disease mechanisms. These are looking at other aspects of the disease and things like inflammation, things like metabolism, things like how the synapses engage with each other. We also saw trials looking at neuropsychiatric symptoms, such as agitation, making good progress. With all of these trials I think we tend to say whether trial results are positive or negative, but what we should recognize is, first of all, the tremendous amount of progress in that we're studying all of these things but also with every trial, regardless of what the results are, we learn something. That is the key piece, right? We're learning the brain is a complex organ. Alzheimer's is a complex disease. No single treatment is likely going to be a silver bullet for this disease. The fact that we have all of these drugs in development is my key takeaway. It’s that the field is invigorated and the field is moving forward in targeting the disease in so many different aspects to provide potential options for those living with Alzheimer's and other dementias.
Chin: Right, so a heterogeneous disease and heterogeneous treatments, right?
Chin: Well then, so I reviewed some of the news coverage in the public media that was coming out of AAIC and I picked out a few topics that I was hoping you could really explain or share with our listeners. The first one that I found was that – this is sort of one of the headings – was “cognitive decline linked to ultra-processed food.” So, can you explain what that study was looking at?
Griffin: Yeah, so this was a study that was conducted in a Brazilian population. They found that – this was over 10,000, almost 11,000 people, over an eight year follow-up – and they found that people who consume the highest amounts of ultra-processed food, so we're talking about more than 20% of your daily caloric intake, have a 28% faster decline in global cognitive scores, including memory and verbal fluency and even executive function. This is an interesting study, and just to define a few pieces of that – ultra-processed food means like it's gone through a lot of processing, has a lot of preservatives, sugars and fats. We're talking about breakfast cereals. We're talking about candy. All of the things that we tend to enjoy. This highlights an important point that it might be easy to say, ‘Sure just cut out ultra processed foods and things are potentially going to be better for you,’ but most people don't have – people with lots of jobs, people who are busy don't have the time to make healthy, nutritious foods from scratch, right? And also certain people live in food deserts. These are the only options that they have available to them. This understanding of how modifiable risk factors for Alzheimer's and other dementias. might not easily be changed, right. Just because it can be changed doesn't mean that it can be done so in an easy manner, but again this was a very interesting study and very, very striking results. 28% is huge, so just to talk through that.
Chin: And earlier, Percy, you mentioned one of your interests being disparities and health equity research. There was an important study that came out really talking about how experiencing racism can play a role in the development or the pathology or changes of Alzheimer's disease. Can you explain this study?
Griffin: Yeah. This was new data that was presented at AAIC, and it found that middle-aged, community-dwelling adults who were exposed to interpersonal racism – so that's racism that you get from interacting with people with different views and different biases – and institutional racism – so this is racism that has to do with some of the institution schools, et cetera, that put in place policies and things that prevent advancement for certain individuals. These individuals, these adults who had interpersonal and institutional racism had lower memory scores. These findings were driven by Black individuals and also adults of different races, so white, Black, Latin American, Asian American, and multiracial, who had experienced a wide range of discrimination through life had lower semantic memory in later life compared to those who had not. This points to racism as trauma, which can induce negative biological changes such as inflammation and this may put people at an increased risk of dementia. All of this is just to say that racism may very well be a major contributor to an increased risk of dementia in Black and Latino populations.
Chin: And that's such a critical finding given that we know from other population studies that people from Black communities and Hispanic communities have a higher risk of developing dementia later in life. This is one potential sort of, I don't want to say mechanism, but explanation for some of those statistics that we're seeing.
Griffin: Yeah, and it again all has to do with those very important social determinants that we're now beginning to explore in more detail.
Chin: Well another important topic that's on the minds of a lot of our listeners, and one that Dr. Snyder spoke to earlier before the conference started, is COVID. So there was a great COVID conference, or there was a great COVID showing I should say as far as the scientific sessions, and a lot of articles that came out as a result of them. Could you share with us some of the key things that you heard from the COVID seminars?
Griffin: Yeah. So what I heard and what was particularly striking was the loss of smell, which some people who have COVID report experiencing, but not the initial disease severity is a better predictor of the long-term cognitive deficits following a COVID infection. Also, staying in the ICU has also been found to increase a person's risk of dementia. During the pandemic, being of female sex, lack of employment, and lower socioeconomic status were associated with more cognitive symptoms. So it's important to know that, you know, this loss of smell might be pointing to this inflammation that is happening in the brain and that might be why you get more cognitive symptoms. With all of this though, it is important to point out as well that just because you get COVID does not mean that you're going to get dementia. We don't know that for sure yet. We're still studying this. We've just learned about COVID, and we've been trying to understand it for the past two years but there's so much work to be done. This is why the Alzheimer's Association convened the SARS-CoV-2 international consortium with technical guidance from the World Health Organization to better understand the long-term impact of COVID on the brain.
Chin: And I'm glad you mention it, because we're not trying to scare people. We were still – the groups are still studying this and so one doesn't necessarily mean you're going to develop the other. You did speak to inflammation and brain inflammation, and that's actually something right that you got your PhD in. There was a very interesting report that came out of AAIC this year talking about preeclampsia – high blood pressure during pregnancy – and how that was linked to some markers of brain inflammation and Alzheimer's disease. Can you share with us what that study was about?
Griffin: Yeah. High blood pressure during pregnancy was associated with white matter pathology, which is a predictor of accelerated cognitive decline, 15 years after pregnancy according to a study of about 500 women. Now women with severe pre-eclampsia, which happens in about 5 to 8% of pregnancies worldwide, had significantly higher levels of beta amyloid, which is one of these Alzheimer's disease related brain changes, than those who had non-hypertensive pregnancies. Right, we know that what is good for the heart is good for the brain. If we're seeing these high blood pressure during pregnancy, which affects the heart, it's somewhat unsurprising that we're seeing these effects on the brain as well. However, it's important to stress the importance of access to appropriate medical care for people before and during their pregnancies, especially those in lower socioeconomic status and people from underrepresented populations, but it's such an interesting study to have seen.
Chin: And my last specific highlight that I, of course, being someone very who enjoys and loves sleeping I wanted to ask you about, is this finding that sleep disruption – and that was the phrase they use, sleep disruption – increases risk for dementia by about 17%. If you could just explain our understanding of why sleep may be a risk factor then?
Griffin: Yeah. Some of the emerging biology surrounding sleep is showing that when we sleep, we tend to kind of clean out the brain of some of these clumps that accumulate, so not getting quality sleep might increase your risk of keeping these clumps in the brain. Also sleep is important for making sure that some of the memories are encoded for the long term. Seeing this study was – it was certainly unsurprising and, again, it almost feels like the theme – and maybe I'm just seeing this everywhere. Sleep disruption and changes in the circadian systems has been linked to inflammation as well, so it keeps coming back to inflammation. That's why I'm so excited about its potential for us to understand so many different aspects of the disease. But yeah, 17%, again, is quite significant. What we're realizing here, and I feel like this is a theme that we've talked about throughout our conversation here, is that we have these modifiable risk factors. These are things that can be changed, right? They’re non-drug interventions, but are things that have such huge impacts on the disease. We're talking about things like racism. We're talking about things like ultra-processed foods. We're talking about sleep. It's so exciting to see all these angles being explored and increasing our understanding of the risk for developing Alzheimer's and other dementias.
Chin: So, Percy, based on the presentations from this conference, the ones you were able to attend and have seen, where do you think the Alzheimer's disease field is moving in the next year?
Griffin: I say this – I don't know how to even put this – but I think the Alzheimer’s field is moving for the better, everywhere. We're trying to understand all of the aspects of the disease and that is encouraging to see. One thing that I think was a big focus, that I saw, was making sure that there was more conversation and more intentionality in making sure that the representation of underrepresented populations in this research because that is critical, right? As you mentioned yourself, it’s that these populations are disproportionately affected by the disease. We need to understand what the social determinants of health are that lead to this increased effect of the disease on these individuals, but also what different biologies might influence this increased risk. I think the field is more and more moving in that direction with some of the conversations that I was able to be a part of, so that was very good to see.
Chin: So to end, Percy, now I asked you a question about the next year, so I want you to think bigger. In the next decade, when you think about the future of Alzheimer's research, or I should say just all neurodegenerative research, what excites you the most?
Griffin: One thing that is super exciting and great to think about is the potential for combination therapies and precision medicine approaches for people with Alzheimer's. As I mentioned earlier, this is such a complex disease. It's a heterogeneous disease. It's not – no one treatment is going to be perfect for all people, but having several tools in our arsenal that will allow us to target the different biologies that change in the disease is how we will provide effective therapies for the people living with the disease. Seeing the diversity of approaches that are being explored right now to kind of tackle the different aspects of the disease has been very, very exciting and has tremendous potential to come up with treatments for combination therapies and precision medicine approaches.
Chin: Well, I certainly see why you are the director of scientific engagement at the Alzheimer's Association. Percy you're such a – it's a pleasure to talk to you, but you're so positive and optimistic. I feel better having just listened to your answers. I want to thank you for being on Dementia Matters, Dr. Percy Griffin, and I certainly hope to have you on in the future.
Griffin: Sure, thank you so much for having me.
Outro: Thank you for listening to Dementia Matters. Follow us on Apple Podcasts, Spotify, Google Podcasts, or wherever you listen or tell your smart speaker to play the Dementia Matters podcast. Please rate us on your favorite podcast app -- it helps other people find our show and lets us know how we are doing. Dementia Matters is brought to you by the Wisconsin Alzheimer's Disease Research Center at the University of Wisconsin--Madison. It receives funding from private, university, state, and national sources, including a grant from the National Institutes of Health for Alzheimer's Disease Centers. This episode of Dementia Matters was produced by Amy Lambright Murphy and edited by Caoilfhinn Rauwerdink. Our musical jingle is "Cases to Rest" by Blue Dot Sessions. To learn more about the Wisconsin Alzheimer's Disease Research Center and Dementia Matters, check out our website at adrc.wisc.edu, and follow us on Facebook and Twitter. If you have any questions or comments, email us at email@example.com. Thanks for listening.