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

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

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.

Learn more: https://peterattiamd.com/

Show notes page for this episode: https://peterattiamd.com/AmandaSmith

Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/

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#25 - Scott Harrison: transformation, finding meaning, and taking on the global water crisis

#25 - Scott Harrison: transformation, finding meaning, and taking on the global water crisis

We discuss: How Scott and Peter met [3:45]; Scott's tragic family story that shaped his life and altered his trajectory [8:00]; High school years, rebellion, and music [30:30]; Life as a club promote...

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#24 - Tom Dayspring, M.D., FACP, FNLA – Part V of V: Lp(a), inflammation, oxLDL, remnants, and more

#24 - Tom Dayspring, M.D., FACP, FNLA – Part V of V: Lp(a), inflammation, oxLDL, remnants, and more

In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject o...

19 Loka 20181h 29min

#23 - Tom Dayspring, M.D., FACP, FNLA  – Part IV of V: Statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain

#23 - Tom Dayspring, M.D., FACP, FNLA – Part IV of V: Statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain

In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject o...

18 Loka 20182h

#22 - Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipoproteins

#22 - Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipoproteins

In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject o...

17 Loka 20181h 4min

#21 - Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation

#21 - Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation

In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject o...

16 Loka 20181h 26min

#20 - Thomas Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology

#20 - Thomas Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology

In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject o...

15 Loka 20181h 14min

#19 - Dave Feldman: stress testing the lipid energy model

#19 - Dave Feldman: stress testing the lipid energy model

In this episode, Dave Feldman, discusses his journey from software engineer to n=1 experimenter, his experience with low-carbohydrate diets, and his hypothesis that cholesterol levels are influenced b...

8 Loka 20183h 10min

#18 - Richard Isaacson, M.D.: Alzheimer's prevention

#18 - Richard Isaacson, M.D.: Alzheimer's prevention

In this episode, Richard Isaacson, a neurologist and director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine and NewYork-Presbyterian, discusses strategies for staving off Alzheimer's ...

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