Expert Q+A: Dr. Rudolph Tanzi on Alzheimer's

Alzheimer’s disease touches the lives of millions - patients, families, and caregivers alike. With groundbreaking research focused on early detection and prevention, there is growing hope for a future where Alzheimer’s can be delayed - or even stopped.

Dr. Rudolph Tanzi, Neurologist and Alzheimer’s expert at Harvard Medical School, is deeply involved in the research and development of promising new treatments. He co-discovered the first Alzheimer’s genes and later led the Alzheimer’s Genome Project, identifying several others linked to the disease. His team also pioneered the “Alzheimer’s-in-a-Dish” model, using human stem cells to recreate the disease in the lab, revolutionizing research into how the disease starts.

Read below to learn Dr. Tanzi's insights on early warning signs, practical ways to strengthen brain health, and the most exciting breakthroughs on the horizon.

Q: What are the first warning signs of Alzheimer's?

A: Everyone has had moments where they forgot what they were doing. Maybe you forgot where you put your keys -- you may have even forgotten that you were cooking at the stove when you took a phone call. When you start doing things that are detrimental, like parking your car in the garage and forgetting to turn it off, that's when you need to be concerned about the possibility of an Alzheimer's pathology that's been brewing in your brain.

Q: How does it start, and is early detection possible?

A: Amyloid plaques start building in your brain 10-30 years before symptoms, and these trigger lots of inflammation in the brain. Our goal is to detect the pathology decades in advance, similar to diabetes, cholesterol levels, etc. We need to find the indicators of brain health and track these before you get into trouble - if we diagnosed Alzheimer's the same way as diabetes and high cholesterol, it would be much more proactive vs. reactive. There are also blood tests that exist and brain imaging to know if an Alzheimer's pathology is beginning. 

Q: Is there any way to prevent Alzheimer's? 

A: If you have a family history, it increases your risk (this variant is in 20% of the population). The earlier the age of onset of your family member, the more you have to think of genetic risk. The first thing you can do to help prevent Alzheimer's is through the acronym SHIELD, which stands for sleep, handling stress, interactions with friends, exercise, learning new things, and diet. You should always get 7-8 hours of sleep per night. REM sleep is like a cleansing cycle for the brain. Handling stress, interacting with the right people, and consistent exercise are also very important. Learning strengthens and increases the number of synapses in your brain, the connections between nerve cells storing your memories. The more synapses you make, the more you have to spare. Lastly, diet is so important because our gut bacteria directly influences our brain health - treat your gut right by eating lots of fiber! A Mediterranean diet or diet high in plants, nuts, fruits, and grains is best.

Q: What will the future for Alzheimer's treatments look like?

A: We will have various drugs, some that are knocking on the door right now! Early detection is key - there are 40 million people who already have Alzheimer's pathology in their brain and will start symptoms in the next 10-30 years. In the next 5-10 years, we will see great progress in early detection and early prevention of Alzheimer's.

About the Expert

Rudolph Tanzi, Ph.D.
Director, Genetics and Aging Research Unit, Massachusetts General Hospital
Director, McCance Center for Brain Health
Co-Director, MassGeneral Institute for Neurodegenerative Disease
Professor of Neurology, Harvard Medical School