01:38 - Source: CNN
How Alzheimer's destroys the brain

Story highlights

Alzheimer's may start 20 to 30 years before lapses in memory

Sandy Halperin and Dr. Sanjay Gupta have a challenge for you

CNN —  

While he couldn’t possibly have known, Sandy Halperin was likely around 35 years old when his brain began slowly accumulating the plaques and tangles of Alzheimer’s disease.

Thanks to recent advances that allow us to see disease in the living brain, we now know there is evidence of Alzheimer’s in neural tissue 20 to 30 years before one first starts noticing lapses in memory. By age 60, when Sandy first started losing words and forgetting his intentions, the disease was already advanced, even if Sandy and his family were noticing symptoms for the first time.

“There is no pain,” Sandy told me. I had asked about this because of recent papers showing inflammation in the brain being a primary enemy at the time Alzheimer’s disease starts to show itself.

According to Harvard’s Rudy Tanzi, when brain cells, known as glia, sense the death of other brain cells from plaques and tangles, they assume one thing: infection. In an attempt to fight these “foreign invaders” the brain becomes flooded with inflammatory free radicals that begin a vicious war inside the brain. But the infection doesn’t actually exist; the brain is fighting a ghost.

Watch all 7 parts of Sandy’s story as it unfolds

No, not pain, Sandy reiterated, pausing and searching hard for the right words. He told me it actually feels like cotton stuffed deeply into the base of his frontal lobes. He eloquently described this with the precision of a Harvard assistant dental professor, which he once was. But then he completely forgot what we were discussing and looked at me sheepishly. “Frontal lobes,” I gently prompt him. “Right,” he remembered. And for just a few minutes Sandy is lucid once again.

Over the last three years, we have frequently visited with Sandy as he slowly descends into dementia. There aren’t many happy endings with stories about Alzheimer’s disease, but Sandy’s story is different somehow.