A Conversation with Jeffrey Cummings, MD, ScD
Director Emeritus, Cleveland Clinic Lou Ruvo Center for Brain Health

Q: You’ve been a leader in Alzheimer’s disease and dementia for about three decades now. How has the field changed?

A: When I started, neurodegenerative syndromes such as Alzheimer’s disease were regarded as a death sentence. Once you were diagnosed, you were doomed to a steady decline until you died from it. When the first drug — tacrine — was approved in 1993, the thinking began to change toward a recognition that there are ways Alzheimer’s disease can be controlled, making it a condition one may be able to live with.

Thirty years ago, diagnosing Alzheimer’s disease was based almost solely on symptoms. Now, advances in imaging — MRI, CT and PET scanning — allow us to make the diagnosis with more certainty:
• We can see amyloid protein on PET scans, which is very specific to Alzheimer’s disease.
• PET imaging of tau protein — at this point used only for research — promises to be an important tool for disease staging and therapy monitoring.

Q: What’s coming up next in the field?

A: No new Alzheimer’s-specific drugs have been approved in 15 years! I think we’re very close to approving two exciting new drugs with a mechanism of action very different from existing therapies. Both aim to reduce amyloid plaques and slow neurodegeneration.

Q: What does the future look like?

A: There are few diseases with a greater potential impact on public health. If nothing more is done to combat it, we are facing 130 million cases worldwide by the year 2050, compared with about 50 million now. The costs of caring for these patients are staggering. Even if only one-third of patients could be helped with new therapies, the savings would be enormous.

People often ask me if we’re on the verge of a real breakthrough in Alzheimer’s disease. I have stopped predicting, and I honestly can’t say if we’re one step away or 100 steps away. But I do know that in order to progress, we must take the next step.

You Can Help
Interested in learning more about the trials? Want to help? Cleveland Clinic needs individuals with memory loss as well as those who are cognitively normal. A complete list of trials at the Lou Ruvo Center for Brain Health is at clevelandclinic.org/brainhealthtrials.

Contact Cleveland Clinic at 855.LOU.RUVO or healthybrains@ccf.org to see if you or someone you know is a match for any of the trials.

Increasing the number of clinical trials for promising drugs and getting patients enrolled in them are critical challenges we must address immediately. Thank you for your help.

Photo: Jeffrey Cummings, MD, ScD, Director Emeritus, Cleveland Clinic Lou Ruvo Center for Brain Health. Courtesy of Cleveland Clinic