#164 - Amanda Smith, M.D.: Diagnosing, preventing, and treating Alzheimer’s disease, and what we can all learn from patients with dementia

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 7 June 2021

⏱️ 122 minutes

🔗️ Recording | iTunes | RSS

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Summary

Amanda Grant Smith is a geriatric psychiatrist with decades of experience treating patients with dementia and Alzheimer's disease. In this episode, Amanda shares how she developed a passion for geriatric psychiatry as a means to support dementia patients. She explains how to recognize, define, and diagnose dementia—a process that still remains somewhat elusive. They also talk about the significance of ApoE genotype and compare the various forms of dementia including differentiating between Alzheimer’s disease and Lewy body dementia. They discuss the current landscape of clinical trials, the drug pipeline, and talk about a very promising monoclonal antibody directed at amyloid beta that has the potential to be a disease-modifying drug. They conclude with a discussion about how to define “healthy aging” and reflect on how understanding dementia can shape one’s life philosophy.

We discuss:

How Amanda developed a passion for geriatric psychiatry [3:15];
Defining and diagnosing dementia and Alzheimer’s disease [13:30];
Medical tests for dementia and their relationship to clinical symptoms [22:45];
The pathology of dementia, and the role of the tau and beta-amyloid protein in Alzheimer’s disease [33:15];
The significance of ApoE genotype, and differentiating Alzheimer’s disease from Lewy body dementia [43:15];
The evolution of Alzheimer’s disease prevention, care, and medications over the last 20 years [52:45];
Psychiatric support for dementia patients (and caregivers) with depression and anxiety [1:02:45];
Drug pipeline, clinical trials, and major challenges to overcome [1:13:45];
Redefining Alzheimer’s disease and designing effective trials [1:23:00];
The promise of monoclonal antibody treatments for Alzheimer’s disease [1:34:15];
How we should measure outcomes in dementia trials and define “healthy aging” [1:42:30];
How understanding dementia can reshape our life philosophy [1:53:45]; and
More.

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Transcript

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0:00.0	Hey everyone, welcome to the Drive Podcast.
0:13.0	I'm your host, Peter Atia.
0:14.8	This podcast, my website, and my weekly newsletter, all focus on the goal of translating
0:18.7	the science of longevity into something accessible for everyone.
0:22.4	Our goal is to provide the best content in health and wellness, full stop, and we've assembled
0:27.0	a great team of analysts to make this happen.
0:29.4	If you enjoy this podcast, we've created a membership program that brings you far more
0:33.2	in-depth content if you want to take your knowledge of the space to the next level.
0:37.3	At the end of this episode, I'll explain what those benefits are, or if you want to learn
0:41.0	more now, head over to peteratiamd.com forward slash subscribe.
0:46.3	Now without further delay, here's today's episode.
0:51.1	My guess this week is Dr. Amanda Smith.
0:53.0	Amanda is the Director of Clinical Research at the University of South Florida Health Bird
0:57.4	Alzheimer's Center and Research Institute.
1:00.3	She is also a professor of psychiatry and behavioral neuroscience at the University of South
1:04.6	Florida, and she specializes in the treatment of patients with Alzheimer's disease.
1:10.9	She received her MD from Thomas Jefferson University and did her residency and fellowship
1:15.1	at the University of South Florida.
1:16.9	She specializes in Alzheimer's disease clinical research, along with the diagnosis and treatment
1:21.8	of patients with AD and other memory disorders.
1:25.7	She's an active member in the memory disorder community, and I actually met her through
1:30.7	our shared interest in a nonprofit that you may have heard of, hilarity for charity.
	...

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