Latest / StartUp Health NOW Podcast / Why Dr. Craig Ritchie Brings Optimism to StartUp Health’s Alzheimer’s Moonshot Impact Board

Transcript

Why Dr. Craig Ritchie Brings Optimism to StartUp Health’s Alzheimer’s Moonshot Impact Board · StartUp Health NOW Podcast

• 0:00
  Welcome back to StartUp Health NOW, the podcast where we celebrate the entrepreneurs and the innovators who are transforming health. I'm Logan Plaster.
• 0:08
  What is the picture that comes to your mind when you hear the words Alzheimer's disease? I'm willing to guess that for most people it's a picture of an older person, maybe a grandparent.
• 0:19
  This person has begun to lose elements of their memory perhaps, and that loss is making it harder to complete daily tasks, things they used to do so well.
• 0:28
  My guest today, Craig Ritchie, wants you to know that that picture of Alzheimer's where symptoms are present and are altering a person's life in major ways is what he calls Alzheimer's dementia, and it's different from Alzheimer's disease in some very important ways.
• 0:44
  Craig Ritchie, as it happens, knows what he's talking about.
• 0:47
  He's the CEO and founder of Scottish Brain Sciences, he's a renowned Alzheimer's researcher, and he's also a member of StartUp Health's Alzheimer's Moonshot Impact Board.
• 0:58
  According to Craig Ritchie, Alzheimer's disease can be invisible and can present in younger, healthy appearing people. Now, when I think about Alzheimer's disease, I think about, dare I say, somebody like me.
• 1:09
  I might have Alzheimer's disease. I'm 55 years old, and I might be having those early changes in my brain.
• 1:15
  In order to slow down or even cure Alzheimer's, says Ritchie, we need to bring more focus and do a lot more research into this population who may have the disease but have yet to show signs of dementia.
• 1:28
  That's easier said than done, however, since it involves tearing down some older ways of thinking. We're actually unlearn- unlearning- Okay... a lot of things. [laughs] Yeah, makes sense.
• 1:38
  That we, that we took as sort of mandated and truths- Okay... about dementia, which may not necessarily be true early in the course of disease.
• 1:48
  In my conversation with Craig, you'll learn more about the current state of Alzheimer's research and hear why Ritchie is optimistic about what can be accomplished by a community of innovators like the one we've formed through the Alzheimer's Moonshot.
• 2:00
  This is a huge challenge, but it's totally surmountable. Yeah. But it needs this coordinated action. You know- Yeah... not one group, not one company, not one academic is gonna cure Alzheimer's.
• 2:10
  I left this interview feeling encouraged about the near term future of Alzheimer's innovation and about the possibilities of our Alzheimer's Moonshot.
• 2:18
  Much more to come on that front in the weeks and months to come, so stay tuned. In the meantime, let's get into the interview. Craig Ritchie, thanks for taking the time with me today.
• 2:30
  It's very exciting to have you on the Alzheimer's, uh, Moonshot Impact Board.
• 2:35
  You bring a, a wealth of experience, and so today I wanna hear, uh, learn a little bit more about you, the work you've done, and kinda what some of your hopes are for the future, not just of our Alzheimer's Moonshot, but just of research and innovation within Alzheimer's- Sure...
• 2:48
  in general. So great to see you today. Thank you. Thank you. Remind us where you're, you're calling in from, 'cause I think that's part of this sort of global conversation. Yeah.
• 2:57
  So I'm, I'm, I'm, I'm based here in Scotland. Uh, I'm CEO and founder of Scottish Brain Sciences, but I also have an academic position at the University of St. Andrews.
• 3:06
  Uh, and right now, uh, I'm in my office in Edinburgh- Very nice... uh, which is the headquarters of, of Scottish Brain Sciences. How long have you been in, in brain health and, and neurodegenerative, uh, diseases?
• 3:18
  Yeah, I mean, I, I, um, trained as a psychiatrist. I graduated from medical school in '91, trained as a psychiatrist.
• 3:25
  But I think my, my first, um, real exposure to, to Alzheimer's disease, neurodegenerative disease, was in, in '97, uh, when I was fortunate enough to work with a guy called Colin Masters, who's a professor of neuropathology at the University of Melbourne in Australia.
• 3:41
  And I spent four years, uh, working in Melbourne, um, really helping in many ways, um, the work that he was doing in identifying new targets for Alzheimer's disease.
• 3:54
  And I did the drug discovery bit, the drug development bit, I should say. Um, and that was kind of the launch pad, if you like, for my interest in this, in this area. And I think what we've, we've all learned
• 4:06
  over these last few years is that a lot of the drug trials that were taking place, you know, 20, 15, 20 years ago weren't successful because we didn't really understand enough about the disease, particularly in the earlier stage of the disease, which we now know to be- Mm...
• 4:22
  20 odd years before symptoms develop.
• 4:24
  So I was fortunate enough about 10 years ago to start leading some pretty big cohort studies, and those studies were really illuminating in terms of looking at risk factors for later life dementia and brain changes that take place in, in people in their 50s and 60s.
• 4:43
  And- Yeah... a huge amount of data has come out of that, which I think in the end of the day is gonna help us understand the disease, find new targets, better treatments, earlier detection.
• 4:52
  And, you know, I still believe that if we can pick this, these diseases up early enough, we can cure them. Yeah. And that's what motivates me.
• 4:59
  You know, part of the goal of this channel is to translate some of the great work that's being done to a, a, you know, a consumer audience to, to folks, I guess, just who aren't academics, who aren't in Alzheimer's research.
• 5:11
  Sure. So help us understand what the current best understanding of... You just mentioned just understanding of the disease has shifted a lot. Yeah. So understanding the risk factors, I guess we could start there. Mm-hmm.
• 5:22
  The risk factors for Alzheimer's. Well, one, one of the things to think about is this distinction, which I think is really important, between Alzheimer's disease and Alzheimer's dementia.
• 5:34
  So generally speaking, I think the public, and a lot of, dare say, experts as well, believe them to be synonymous. They're the same thing. Okay. They're not, you know?
• 5:47
  Alzheimer's dementia is a clinical syndrome that takes place in later life predominantly and is defined by symptoms. Yeah. Memory problems, you know, mood symptoms, behavioral problems, et cetera.
• 6:01
  How most people envision Alzheimer's. Exactly. How you would, how... If so- if I just walked into a room and said, "Alzheimer's- Mm-hmm... what do you think about?"
• 6:09
  You would immediately, I think, most people would think about an older person who's, um-You know, needing a lot of support, they're forgetful, they're maybe getting lost, or maybe their driving ability is going down, et cetera, et cetera.
• 6:22
  Now, when I think about Alzheimer's disease, I think about, dare I say, somebody like me. I might have Alzheimer's disease.
• 6:27
  I'm fifty-five years old, and I might be having those early changes in my brain, which if left unchecked- Mm... would, would develop dementia in, you know, fifteen, twenty years' time. Interesting.
• 6:39
  Now, what we know, what we understand about, let's just call it Alzheimer's at the moment, until very recently, has always been through investigating people with a dementia syndrome. Got it. So risk factors for dementia,
• 6:57
  you know, um, cardiovascular illness, um, heart disease, I should say, or, you know, uh, diet, smoking and alcohol.
• 7:07
  From lots of studies over the years, the- we've, we've developed this notion of what are the risk factors for dementia.
• 7:12
  Now, they may well be the same as the risk factors for disease, but they're not necessarily the same. Interesting. So
• 7:19
  wh- when we do these studies like I mentioned earlier, PREVENT and EPAD, and, you know, the PREVENT study looks at forty to fifty-nine-year-olds. The EPAD study looks at everybody over the age of fifty.
• 7:30
  So you're beginning to pick people who are ostensibly healthy and look at their brain, and it might be different risk factors.
• 7:37
  Different risk factors might have different impacts on changes in the brain that we measure through brain imaging or through, um, or through blood sampling or spinal fluid. So we're learning...
• 7:48
  We're actually unlea- unlearning- Okay... a lot of things. [laughs] Yeah, that makes sense. That we, that we took as sort of mandated and truths- Yeah...
• 7:57
  about dementia, which may not necessarily be true early in the course of disease. And we need that knowledge if we're gonna treat people earlier. Yeah.
• 8:06
  You need to know what are the targets and what's the, you know, how do you manage risk factors? How do you manage comorbidities, et cetera. So I think unless you do the science in the- Yeah...
• 8:15
  in the, in the, in the people where this is most relevant, i.e. the younger people, then you're never gonna have that knowledge to make informed decisions.
• 8:23
  Well, you bring up an interesting point, which is about the role of early, early detection.
• 8:27
  I feel like it wasn't-- if my understanding is that it wasn't that long ago that early detection wasn't a priority because there wasn't a lot we could do for someone- Sure... maybe we caught it early.
• 8:38
  And my sense is, uh, that that's shifting. So kinda where are we at in the value of early detection of Alzheimer's disease? Yeah.
• 8:46
  I, I think there's a, there's a, there's, there's a really great debate to be had on, on that point about early detection.
• 8:53
  I, I, I, I, I, I sometimes quite, get quite animated and, and, and, um, resistant to the notion that what you can do about it is only a drug treatment. Mm. Sure.
• 9:08
  Because there's so many other things that people maybe could or should do if they have early disease detected. So there's lifestyle changes, there's managing comorbidities.
• 9:18
  But probably most importantly is the people with, you know, high risk because of... You know, I do a lot of work with, um, um, former rugby players, you know.
• 9:29
  And they've obviously been involved in contact sport, and there's all this association in contact sport and that, and, and, and, and later life dementia, that these people are saying, "Do I have a problem?"
• 9:42
  Or if they've got early symptoms, "What's wrong with me?" Now, I wouldn't sit there and say, "Well, we don't have any drug treatment for this, so I'm not gonna try and answer your question." Yeah.
• 9:53
  I would move heaven and earth to answer that question. Yeah. You know? So I would say, you know, if somebody says, "What's wrong with me?" Or, "What's my risk?"
• 9:59
  Or, you know, "Is there something I should be worried about?" Then I will answer that question, and that question could involve blood tests. It could involve, you know, cognitive evaluation.
• 10:07
  It could be good history taking. But it's not... It doesn't have to wait for a drug to be available. Yeah. Now that there are drugs available, [laughs]
• 10:15
  you know, that, that, that again, in some ways is a, is a great catalyst and an amplifier for what we should have been doing anyway. Yeah. Uh, which is, you know, people...
• 10:24
  There's lots of diseases in medicine that have no treatment, but people still want to know what's wrong with them. Yeah. And the first step is actually answering that question- Yeah...
• 10:34
  irrespective of what you can do about it. And like you said, treatment doesn't just mean pharma. No, of course. Yeah. It's, it's- And, and also you have a lot of people who, you know, who may... W- we think that probably
• 10:48
  if you take somebody with what's called subjective cognitive disorder, so they've got a sense that something's not quite right with them, and if you look at those individuals, you know, the vast majority don't have a neurodegenerative disease.
• 11:00
  They've got anxiety, they've got depression, they've got other issues. So in many ways, detecting disease is important, but also is not detecting disease. Yeah.
• 11:10
  So if those people don't have amyloid or they don't have tau or they don't have any changes in their brain associated with neurodegenerative disease, that's incredibly important information.
• 11:18
  Because then you can start working with them on what is actually causing their concerns, which might be depression, anxiety, you know, other factors. So- There you go. You're pulling from your psychiatry.
• 11:28
  Was it psychiatry or psychology? Psychiatry. Yeah, yeah. Psychiatry. You're pulling from your psychiatry background there and recognizing- Yeah, exactly... you know- We call them functional cognitive disorders...
• 11:36
  the sort of the whole person, you know- Exactly. [laughs]... um, and how it contributes. Um, let's talk about innovation a bit. We're having this conversation- Yeah... because of this Alzheimer's moonshot, uh- Sure...
• 11:46
  because the idea is to bring together, uh, researchers and founders who are on the cutting edge, creating new, um, not just treatments, but also, you know, uh, care pathways and just ways of helping caregivers- Mm...
• 12:00
  et cetera. So tell me what you think is the state of innovation for Alzheimer's right now. Is it just kind of a long slog, or do you see kind of a, an uptick in what we are capable of doing?
• 12:11
  Oh, look, I think there's, there's, there's, there's definitely a moment here where, um-The science has matured to an extent. The conversations that we're having are the right conversations.
• 12:24
  The, the ambition of the, of the scientists, the expectation of the public- Mm... is all coming together in this moment to say, you know, "We can do this." Mm.
• 12:37
  Uh, you know, I think, you know, to be fair, it has been driven by successes with, with pharma called, you know, with, with, with drug, with drug treatments.
• 12:45
  I think, you know, other huge moments for the field have been blood-based biomarkers.
• 12:50
  You know, to get a blood test for, for Alzheimer's and, you know, over time we'll have blood tests for other neurodegenerative conditions. So this is a different world to the one we lived in in the 20th century.
• 13:03
  You know, I think everyone's embracing this, um, expectation. I don't even call it hope, this expectation that we're on the cusp of something amazing. Mm. Um, you know, we've seen such successes in HIV 20 years ago.
• 13:17
  We obviously saw incredible successes in medicine achieved with vaccines for COVID. You know, I think, you know- Yeah... this is, this, this is a huge challenge, but it's totally surmountable. Yeah.
• 13:28
  But it needs this coordinated action. You know- Yeah... not one group, not one company, not one academic is gonna cure Alzheimer's.
• 13:34
  You need to, you need to foster and, and, and amplify this, this, this expectation, this hope. But you need to make sure that, you know, we're all rowing in the same direction [laughs], you know?
• 13:46
  How would you, how would you like to see that coordinated action play out?
• 13:50
  It's an, it's one of those nice sentiments, and yet when you're an academic, maybe in a lab, it's a bit more challenging to, whether it's share data or to, um- Sure... align yourself with someone else and encourage them.
• 14:02
  Like, what, what, how would you like to see coordinated action?
• 14:05
  Well, I think, you know, I, I, I, you know, I'll, I'll take a step back and before I answer that, because I think, um, one of the things that, you know, and I've obviously had conversations with leadership in, in startup and, and, and on this moonshot, and I think, you know, one of the things that's critically important is you call it a moonshot because the, you know, that was obviously a huge moment in, in, in human history to, to put a man on the moon.
• 14:29
  But it was a very clear target, man on the moon. Four words, you know? What are we, what are we, what are we trying to achieve with Alzheimer's disease? And- Mm...
• 14:43
  and the chair of, of, of the moonshot, uh, once said to me, um, there's a quote from, I think it was George Harrison, you know, "If you don't know where you're going, every road will take you there."
• 14:54
  And I think one of the first things to be able to do is define is what is the goal? What is the moonshot? What is the, what is the man on the moon moment? And I think it's very clear. It's curing Alzheimer's disease.
• 15:03
  Now, how do you cure Alzheimer's? Well, you've got, you've got, only got two things you need to do. You need to detect it early, and you need to, and you need to knock back, you need to treat that disease.
• 15:14
  So now within that program of companies who are, and academics working on it, you need to agree, well, what part of that are you working on? Is it, if you're a diagnostics company, is it early detection?
• 15:26
  If you're a therapeutics company, is it a new target that's gonna be effective early in the course of the disease?
• 15:32
  Because to be fair, uh, you're not gonna cure Alzheimer's disease when it's at the dementia stage because the brain is- Yeah... unfortunately so far advanced that it's just not gonna be possible.
• 15:44
  So- It's literally degenerated. Yeah. It's, it's, I mean, it, it's, it's quite emotive to say this, but it's the palliative care stage of disease. Yeah.
• 15:52
  It's the, the disease has spread to an extent that cure is not really an option anymore.
• 15:58
  Whereas if you can detect Alzheimer's pathology, whether it be amyloidosis or the spread of tau, so early in its course, I think there's every expectation you can reverse, you can stop those changes, you might even be able to reverse it.
• 16:11
  So I think there's, there's, there's, there's how do you... Well, I think what you have to do is you have to get motivate, motivated individuals who are willing to share data, who are willing to share ideas- Yeah...
• 16:21
  who are willing to network their expertise and recognize that we're all just part of something. We're not, we're no single group's gonna be able to cure this on their own. Yeah.
• 16:31
  And I think that's what bringing people together does. Yeah. It also makes me think about the role of entrepreneurs in a situation where sort of the public is expectant of a cure.
• 16:41
  Oftentimes the, um, the focus gets put on a large multinational pharmaceutical company. What do you feel like is the role of smaller companies, entrepreneurs, re- individual research teams? How do they play into this?
• 16:57
  Well, I think they, they, uh, number one, you have to, you know, sign up to the vision. You have to believe it's possible.
• 17:04
  And then you also have to recognize that, you know, taking the moonshot analogy, that your company might be, you know, building the rocket booster. Mm. Your company might be providing the fuel.
• 17:14
  Your company might be providing the helmet and the spacesuit. Yeah. Yeah. You know? You, you, you know, so, so no one company now is gonna be able to provide the entire NASA. Yeah. You know? I mean, I think we're
• 17:29
  4,000 companies or something? Uh, 20,000, I recall. 20,000 companies working on- 20,000 companies, 400,000, no. Yeah, a couple hundred thousand people, f- 20,000 companies.
• 17:38
  And, and, you know, it's, it's, it's the, it's the kind of the, the, the, the, the, the cliche where J- JF Kennedy, you know, spoke to the janitor at NASA in Houston, said, "What are you doing?"
• 17:46
  He said, "I'm putting a man on the moon." You know, each of those companies- Correct... needs to believe that they're putting a man on the moon or they're curing Alzheimer's.
• 17:53
  Now, you know, each of them isn't gonna say, "Well, everything I do in my company, everything I do as an entrepreneur, everything I do in my academic group is gonna be the end story. I'm not, I'm not, I'm not NASA.
• 18:05
  I am the spacesuit. I am the rocket booster." Yeah. "I am the- I love it... the watch pad." You know? Yeah. "I am the communications director." You know? "I'm the..."
• 18:14
  You know, there's, there's so many components of those companies, and we're just part of it, and we have to accept that. Yeah.
• 18:20
  Now we're gonna-Most of those companies that were involved in that sort of probably became very successful companies as a consequence. [laughs] Yeah. Yeah. Rolex. [laughs] You know?
• 18:29
  Goodyear was, uh, part of making the suits. Goodyear. Yeah. They, they...
• 18:33
  So being part of this, of this cure is probably still gonna be not just for the, for the, for the value you bring in knowing you were part of the curing of Alzheimer's, you've also probably got a good, you know, corporate, you know- [laughs] Yeah...
• 18:44
  legacy from that. Yeah. So, you know, when the- All the connections that come from that, all the sort of rising tide. Yeah, absolutely. All the boats go up.
• 18:52
  Um, thinking about the Alzheimer's Moonshot more specifically, I know we're only one quarter in, have you had any reflections or thoughts over what you've seen in terms of the companies that have applied or just the ve- very, the first couple of months of, of activity?
• 19:06
  Yeah, no, I, you know, I think it's been incredible, um, you know, with, with as you say, just a few weeks into the program and then the, the, the, the number of companies,
• 19:18
  the number of companies has been overwhelming i- in many ways. But I think also what's really, um, gratifying is the, the diversity of the companies in terms of what they do,
• 19:32
  um, whether it's diagnostics or therapeutics or care.
• 19:36
  I mean, I think, you know, I've, I've always gotta be very careful that we don't forget there's a lot of people, millions of people, in fact, almost billions of people with lived experience, and we don't wanna throw the baby out with the bathwater.
• 19:47
  Yeah. Of course, we wanna get excited about getting a man on the moon. We wanna get excited about curing Alzheimer's.
• 19:51
  But, you know, in that five or 10 years before that happens, there's a lot of people with lived experience who need much better quality of care- Yeah... and access to care.
• 20:01
  So, you know, we need to maintain that work stream, uh, until we cure it. Uh, and we will. We do.
• 20:08
  Um, but the other thing which was, you know, and I hope this doesn't sound a little bit sort of almost narcissistic, but it was, you know, I've been working in this space for 25 years, and what was really gratifying was also there's a whole bunch of companies that I had no recognition of, you know?
• 20:23
  And I think a lot of people who have lived in a particular bubble or echo chamber thought we knew everything. Yeah. And then you see these other companies and you go, "Wow, I did not know that." Yeah.
• 20:34
  And that was just so uplifting to think, you know, we, we, we, we know about the big pharma companies, we know about the companies who are in the public eye in some ways or go to the conferences, but to see these other companies that maybe aren't quite so visible, it's like you said earlier, you know, bring that tide in, all these boats will rise.
• 20:53
  And I think this is, that was for me, to see things, amazing work going on outside of the echo chamber was just brilliant, absolutely brilliant.
• 21:03
  One of the things I love about these moonshot initiatives is how truly global they are. Mm.
• 21:08
  Oftentimes, if you're, if you were with a sort of typical healthcare venture fund, you might say, "Okay, the US market is sort of the largest and the most lucrative- Mm...
• 21:16
  and so we're, we're gonna focus where the money is," right? Yeah. And when you pull back and you have a health moonshot focus, all of a sudden you get this amazing- Mm-hmm...
• 21:24
  global conversation 'cause that's, you know- Yeah... people are brilliant and, uh, and, and passionate all around the world. Here you are in Scotland.
• 21:33
  We, I know we've got a number of European companies, Australian companies. I mean, really, um, we draw from a number of places in terms of our applicants.
• 21:42
  And so I'm just kind of curious what role you think like a, a more global conversation has to do with Alzheimer's if folks are truly bringing a different perspective, um, when they, when they come together cross border.
• 21:58
  Yeah. The def- And I think, you know, I, I, I mentioned, you know, this echo chamber. There's always a risk that we, we, we, we listen to people who we've listened to before or we enjoy listening to.
• 22:08
  There's a kind of familiarity. And in some ways that creates, you know, what, what we refer to in science as confirmatory bias. Mm. You have this, you, you have the belief you know what you're doing because- Yeah...
• 22:22
  you keep talking to each other and you fuel each other's belief system, and it might be the wrong belief system.
• 22:27
  So bringing people, like I said, other companies, other ideas, other thoughts into this and accommodating those and accepting them and valuing them actually means, "Oh, I did not know that. That's interesting.
• 22:37
  Maybe we should pivot." Yeah. Or maybe that's, you know. And I think not only is that sort of complexity and that diversity so important to, to, to probably get to the right answer, if that makes any sense,
• 22:49
  we've also gotta recognize that, that Alzheimer's disease is a, is a global problem. It's not a US problem. Yeah. It's not a Scottish problem. It's not a Scandinavian problem. It's a global problem.
• 22:58
  In fact, we all, we all know that the burden of disease is actually falling, um, you know, um, more in low and middle income countries than it is in, in, in higher income countries.
• 23:10
  So whatever we do to cure Alzheimer's has to be globally applicable. Yeah.
• 23:15
  So whether it's a diagnostic test or a therapeutic intervention or a lifestyle modification or an algorithm or whatever it might be, we have to make sure that those things work across the world- Mm...
• 23:26
  and not just in where they're developed. I think it's realistic. It's a reality in some ways that, you know, because of high economic areas having probably more companies, more investors, more...
• 23:39
  The reality is that I think a lot of these companies are gonna be established initially in, in, in, in- Mm... North America, Europe, Australia, Southeast Asia.
• 23:48
  But we al- we almost have to, within the Moonshot, say, "Well, what's your plans for globalization?" And by globalization, we don't just mean opening up in new big markets- Yeah...
• 23:57
  but making sure your tools, your therapies are, can be used, um, wherever people are at a risk of Alzheimer's. Yeah. I think that accessibility piece is a huge part of the global conversation- Mm...
• 24:12
  because you get into one single market and it's about product market fit and just the revenue you can get from that market. Mm. When you start thinking globally, you have to think about access. Yeah.
• 24:22
  You have to think about, um, cost, geography, um, and it just- Exactly... shifts, shifts your entire mindset.It does. And I think, you know, at the end of the day, how do we, how do we...
• 24:34
  It's quite, I mean, I'm kind of new into this entrepreneurial space.
• 24:37
  I'm only eighteen months as a CEO, and I think, you know, you have metrics which understandably from an investment community and from a revenue perspective, you need to keep your company alive, you need to be able to grow, et cetera.
• 24:49
  But you've also got values around impact, which are maybe sometimes less tangible. Mm-hmm. But how, how do you know that what you're doing is having an impact?
• 24:56
  And for me, impact means is it getting to the people who need this most?
• 25:01
  Um, and we have to put mechanisms in place within the company, within our companies to ensure that we're also valuing the impact that we have on society and healthcare. And I think,
• 25:14
  you know, it's a, it's a bit of a cliche, but if you put purpose before profit, you will profit. [chuckles] Mm. If you put profit before purpose, your company will probably fail. Yeah. You know?
• 25:25
  So I think these are attitudes, mindsets, especially when we're working in, in Alzheimer's disease. You know, we're not selling a product for,
• 25:35
  you know, into a shop for, you know, like a coffee bar or, you know, you know- Yeah... [chuckles] you know, a kind of a, you know, a kind of a, you know, a clothes shop. We're actually trying to cure Alzheimer's. Yeah.
• 25:47
  So we have to... The impact has to be, did we cure it? Yeah. Uh, what are you most excited about to accomplish in your own company over the next, let's say, twelve months? I, I, I, I, you know,
• 25:59
  I, I, I'd like to think that my company, Scottish Brain Sciences, will be a major player in this space. You know?
• 26:09
  It sounds a little bit arrogant, but, you know, say, with little components, you know, I'd probably like to build the whole rocket, you know, sort of thing. Yeah.
• 26:14
  But, but I think there's, there's things that we have, things that we're trying to do which will have a major impact. But also
• 26:21
  i-if I can, it's also maybe to take what I've just been talking about here and have a little bit of an influence in saying to other companies, other academic groups that we can demonstrate the art of the possible, that what we do in Scottish Brain Sciences will be a motivator, that this can actually...
• 26:39
  'Cause we need some wins. You know, we need to have successes around, you know, implementing certain things that we're doing. So I think that we're not necessarily a company that develops a single product.
• 26:49
  We're a company that's, you know, helps enable other people to develop their products.
• 26:53
  So with what we do with the, the cohort study, the database we're generating, the biobank we're creating, that we can be an enabler of, you know, we can be a scaffold in some ways for a lot of these other things to build off of.
• 27:05
  So I think if we're, if we're part of the moonshot or a big part of it or an influencer, that would, that would look good to me.
• 27:13
  Um, but also, you know, at the end of the day, I'm a clinical academic, you know, so I also want to produce knowledge, and I also want to make sure we, we help patients. Yeah.
• 27:22
  We've talked mostly about the innovation around early detection and treatment.
• 27:26
  I wonder if you have any thoughts about the innovation that you are seeing or would like to see around caregiving and around just kind of where patients are today. Yeah. I mean, this is, you know- Is there anything?
• 27:39
  I mean, is there- Oh, huge amount. I mean, I think there's, there's... The one thing I immediately think about is that there's, there's a huge amount of resources, a huge amount of, um, um, you know, commitment from
• 27:57
  numerous sectors of society, be they, you know, um, healthcare related, social care related, third sector related.
• 28:05
  But one of the problems I see, and I think a lot of care, you know, uh, products are around how do people access all of these different resources.
• 28:18
  I mean, you know, certainly from personal experience working here in Scotland, I'm, I'm hugely impressed by the number of companies or charities or institutions that are providing support, but it's very hard for a patient or a caregiver to navigate it- Yeah...
• 28:32
  and to know what's out there. So in some ways there's, yes, we develop more products, if you like, for people with lived experience, but we've also got to make sure that they're somehow visible and accessible to people.
• 28:44
  Yeah. And that could be an algorithm, it could be an app, it could be a whole bunch of different things.
• 28:48
  And then there's of course the other part of this, which I think is really important, is how do, how do we help people with lived experience to enjoy contributing to society as much as possible?
• 29:01
  And one of the things I think about is,
• 29:04
  you know, as an analogy, you know, people who, you know, um, have, you know, you know, challenges with, you know, walking or what have you, and maybe in a wheelchair, you know, it's not that long ago that you didn't have ramps up into shops.
• 29:20
  Right. Right. You know? Or you didn't have ramps in the pavements. This was a huge impediment to people in a wheelchair to be able to get around. Society's still not very dementia friendly. Yeah.
• 29:32
  There's things that we could be doing that could help people to continue to drive, to continue to access, and I think the world around us is, is not very dementia friendly and probably getting worse in some ways- Yeah...
• 29:43
  because of all the stuff that's on this that we rely on so heavily. Yeah. And these things are actually really hard for people with dementia to use. You know?
• 29:51
  I remember, I know I'm going off on a tangent here, but I remember about twenty years ago being involved in a project where, you know, everybody was, you know, banks were all closing, so you needed to use a PIN number to get your money out of the bank.
• 30:02
  People with dementia can't remember their PIN number. Yeah. Suddenly they're being- I can barely remember my PIN number, let alone [laughs]... well, they're being excluded.
• 30:09
  So the, the way society's moving is actually excluding people with lived experience rather than including them.
• 30:14
  And given the prevalence of this condition, I think it's something which we need to, companies can maybe help to develop solutions that maintain people's quality of life- Yeah...
• 30:26
  in a society which is forever changing, and it should be changing with us, not, not against us.
• 30:31
  I've read stories about these, and typically it's somewhere in Scandinavia where there's like a little village that's been created. Yeah.
• 30:37
  You know, how do you feel about those sorts of projects?Yeah, no, I mean, I've, I've, I've, I've actually had the privilege of visiting one of those outsides.
• 30:44
  Uh, it was, I think IKEA played a major part of, of developing such a community. I think- As long as they didn't make the, uh, residents, you know, assemble the furniture, then it's all good. Yeah, exactly.
• 30:55
  Well, that's, that's, that's, that's, that's... Yeah, that's not, that's not a diagnostic test. That's the brain test, yeah. We don't, we don't, we'd all fail that one. But no, look, I've got mixed feelings about that.
• 31:04
  I mean, just at the personal level is, you know, do you, do you create these environments for people, elders, seniors, people with dementia live, or do you want them to continue to live in the communities they've always lived in?
• 31:15
  Yeah. You know, wouldn't... You know, most people I've met, dare I say it, in my clinical work, want to stay at home as long as possible. Yeah.
• 31:22
  When you're moving into a facility or what have you, and, you know, I can, I can see both sides of the argument. I completely can. But, you know, wouldn't it be great if people didn't feel the need to move?
• 31:33
  People with cancer don't feel the need to move. People with, you know, other medical conditions don't feel the need to move. So why do people with dementia or a brain disease, you know, have to, you know...
• 31:44
  Even though these places may be amazing and beautiful and wonderful, you've still got to leave your home- Yeah... and leave behind a lot of those memories and familiarities.
• 31:52
  So look, it sounds like I'm down on them, but I think there's also ways of trying to integrate and make- Sure.
• 31:58
  I mean, I, I remember reading somewhere, I think it was in Japan, where they, they, they looked at these houses they could build that actually almost adapted as you grew older. Interesting.
• 32:07
  So they kind of, you know, they actually had almost like dynamic housing. Yeah.
• 32:11
  So they were super cool for somebody in midlife with young children, and then they were super cool for people who are older who need a bit more support. Smart homes that actually adapted with. Yeah. Interesting.
• 32:19
  These are, these would be interesting things to- Yeah... learn more about. And it could be, it could be something relatively simple.
• 32:25
  It could be a modification that would mean a lot to you as you age, but wasn't some dramatic remodel. Exactly. And I think, you know, things like Alexa and other, other smart speakers are available.
• 32:36
  But I think, you know, these are the kinds of things, these are the technologies that could maintain people in an, in a community and environment for longer because they, they allow you to, you know, to, to have that familiarity, that connection with the outside world, with the, you know, speaking, you know, speaking to your phone, speaking to your, your, your IT system is a lot easier than typing something in or working out what the app does and all these sorts of things.
• 33:00
  So I think there's a lot of technologies which can enable people to stay the best versions of themselves for as long as possible. Speaking of which, last question.
• 33:09
  Knowing what you know about brain health, is there anything that you do to kind of keep yourself cognitively fit? Run. Run? Okay. [laughs] Run. Run. Um, variety of reasons. Number one, tries to keep the weight off.
• 33:25
  You know, I think, you know, to, to, to stop eating is gonna be a bit of a challenge, so I think running to, to burn the calories. But also, it's, it's great head space. I run on my own. I don't listen to music.
• 33:37
  I just, I just use that time to de-stress and to... You can't be doing anything else while you're running. You can't be looking at your phone. You can't be answering emails. Yeah. So yeah, number one, run. That's good.
• 33:48
  Yeah. Craig, appreciate the time. So excited to have you on the Alzheimer's Moonshot Impact Board.
• 33:53
  Um, I've already seen what you've brought to the table in terms of your passion and your knowledge, and I'm very excited to see what comes next. Thank you so much, Logan. All right. Wish you the best in your work. Okay.
• 34:04
  Thank you. All right. Take care. Be well. [upbeat music] Thanks for listening to Starter Health Now. We'll be back again with another episode next week. [upbeat music]