A Man Fighting for Our Memories

Shadee Giurgius

O
Yeva Ragauskayte ur memories make us who we
are—they remind us of our
life, our love, our happiness and our
sadness. Our memories connect us to
every person that entered and affected
our lives and to all the experiences that
made us wise teachers for the younger
generation. When our memory dies, so
do we.

Research on Alzheimer’s disease aims to preserve memory function and

memory defines who we are. If we don’t have memory, we have no present,
past or future.
-Gary Small, M.D.

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Memory loss due to various dementias, especially prevalent who would fall into the category of mild age-related memory
in elders, is on the rise as a new epidemic and is sweeping challenges who he likes to call the “worried well.” According
through the older generation. It acts like a computer virus that to Dr. Small, “These are people who often have a family
sets in and systematically erases your most important files, history of Alzheimer’s disease.” In fact, the most frequently
rendering your computer useless and throwing your precious asked question he gets as a doctor hands down is: “Am I going
hours of work out the window. Alzheimer’s disease, one of the to get Alzheimer’s?” His work also encompasses a scope of
many types of dementia, is perhaps the most heart-breaking other mental illnesses including depression.
disease to witness and experience because not only does it take Dr. Small’s primary focus is on Alzheimer’s disease,
function and health from your physical body, but it takes away although he is also interested in Parkinson’s disease, which
the most precious mental asset that you thought you would can be approached in a similar manner because, as Dr. Small
enjoy for the rest of your life—your memory. claims, the strategy of early intervention prevention may be
Fortunately, many dedicated professionals and researchers as useful in Parkinson’s as in Alzheimer’s. During his many
are working hard to find answers and solutions to this great years of searching for answers, Dr. Small helped develop
medical mystery of today. One very talented man, Dr. Gary W. the new FDDNP PET (positron emission tomography) scan.
Small, has dedicated his career to saving that which makes us FDDNP is a unique chemical tracer used to help detect brain
so human. His research looks at the assessment and treatment lesions via PET scanning. With this combined technology of
of mental disorders associated with aging, early detection, tracer and PET, doctors are now able to detect Alzheimer’s
and prevention of Alzheimer’s disease using neuroimaging disease earlier than ever before. The primary goal to treating
and genetic measures. Dr. Small is a very prolific writer, Alzheimer’s disease is first detecting if it is there, and if so, at
authoring over 400 scientific publications, including his books what stage. The scan locates accumulating amyloid plaques
The Memory Bible and The Memory Prescription, and he is and neurofibrillary tangles—main characters in Alzheimer’s
recognized by Scientific American magazine as one of the degeneration.
world’s top 50 innovators in science and technology. Dr. Small’s research team combined the new chemical
Before he was an authority in the aging field, however, he marker called FDDNP with PET scans to look at Alzheimer’s
was an undergraduate at UCLA studying biology who loved disease in living patients. “Many people believe that
to play tennis, read and travel. When asked about his other Alzheimer’s disease is caused by a specific deposition of
educational interests he showed an affinity for Children’s abnormal protein deposits, which are highly correlated with
Literature—“certainly memorable”—and for art history. He cognitive decline even if they do not cause the disease,”
realized that people might wonder how and why he got into explained Dr. Small. In the past, the only way researchers
science if he had such diverse interests, and explained, “I could detect those changes was by autopsy or, rarely, a biopsy.
think I went into science because of my creative side; science Dr. Small, however, thought it might be possible to “use PET
requires novel creative thinking to answer questions.” And his to detect those abnormal deposits in the living patient even
dedication to science could be seen early on as he became the though this tool measures glucose metabolism in the brain.”
president of the Undergraduate Biology Association--a small He started talking to a colleague and friend Dr. Jorge Barrio, a
group of biology majors interested in developing additional chemist who actually spent his career in developing chemical
educational programs for undergraduates. He finally began markers to be used with PET scanning. They also collaborated
his career and decided on dedicating himself to psychiatry with Dr. Greg Cole, another Alzheimer’s disease researcher
and research when he was an Intern in International Medicine who has a very clear understanding of the structure of these
in San Francisco. While he was studying psychiatry, he was abnormal deposits. Then, they started looking at the chemical
“interested in the interface of the mind and the body” and he marker that Dr. Barrio had synthesized for another purpose just
became involved in psychosomatic medicine, or consultation a few years earlier, and “this marker turned out to be sensitive
psychiatry. Soon his primary focus became geriatric psychiatry to abnormal deposits in PET.”
and as he recalls, he “hooked onto the growing field of dementia When asked what he felt was his finest discovery, Dr. Small
and Alzheimer’s disease.” He has been studying this disease answered, “I think up until now, probably connecting genetic
for 25 years now. risk measures with PET brain imaging and showing that if we
Dr. Small is a physician, psychiatrist, and specialist in do that we can detect abnormalities in the brain decades before
age-related issues who not only works directly with older people get Alzheimer’s disease.” Dr. Small thinks that this
patients who have memory complaints, but also researches and new discovery with the plaque and tangle PET imaging may
develops revolutionary ways to detect Alzheimer’s disease. be a more important one, and if things go well “we will have
Because his clinical and research work focuses a lot on early a bigger impact because it will accelerate drug discovery.” To
detection of Alzheimer’s disease, he often sees many people further his crucial work, Dr. Small received a grant of about $8

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 Dr. Gary Small

A PET study of brain glucose metabolism in a healthy “normal” adult brain, early and late Alzheimer’s
disease, and in a child. The arrows point to areas of abnormal (reduced) brain activity in the Alzheimer’s disease
brains. The pattern of metabolism in late Alzheimer’s disease resembles that of a child’s. Courtesy of Drs. Daniel
Silverman, Gary Small, and Michael Phelps, UCLA School of Medicine, Los Angeles California.

million from the National Center on Aging to further develop “I think it is a message that is valid,” he explained. “It is one
their plaque and tangle PET scanning. that I think will help people, and it is also something that is
As director of the UCLA Memory and Research Center, he relatively new, so there is an opportunity for innovation.”
spends a lot of time researching the many questions related He finds excitement in learning new things everyday and
to the age-related mental maladies of today. In the Center enjoys being creative with the projects he embraces. Being
many services are made available to individuals with various in such a position of authority and responsibility, Dr. Small is
forms of memory challenges, including brain scans, memory also frequently featured on television and in the newspaper,
assessments, genetic evaluation, and medical examinations. and through these effective media he wants “to help people
“We follow these people over time to understand how the understand that they have more control of their health than
brain ages, how we can detect problems of brain aging, and they think as they age.” He believes in this approach because
how we can intervene and improve brain fitness in memory he has seen studies of successful aging that find genetics to
ability,” shared Dr. Small. In addition to these objectives, account for about a third of the risk of age-related illness,
the UCLA Center on Aging seeks to live by its philosophy meaning, as Dr. Small explains, that “for the average person,
of “Live Better Longer” by focusing on increasing, and more up to two-thirds of their health and longevity may be under
importantly, “adding quality to those additional years of elderly their own control.” This hints at a promising future for even
individuals.” To accomplish their mission, the Center on Aging better treatment of age-related medical issues and better ways
has been involved in developing undergraduate curricula, and to enhance the lives of the increasingly older generation.
community programs on education and memory training. Although Dr. Small thinks psychiatrists are “just as bad
Dr. Small has many great motivations to continue directing as everyone in predicting the future,” seeing as how the rate
the Center on Aging, one of which is the Center’s mission. of progress continues he anticipates that “within a decade we

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will manage not Alzheimer’s disease, but brain aging.” So is delighted to see young people involved because, according
just as we manage high cholesterol in the blood or high blood to Dr. Small, “[his] generation did not have this interest.” He
pressure, in the next decade or so we can have patients or people recalls that when he got into geriatrics, the discipline was a
at risk screened by a scan and then be offered medications or a secondary specialty that was not taken seriously. “These days,
vaccine based on the results of this screen so that, as Dr. Small however, people recognize the importance of aging and the
jovially puts it, “they can live to be 120 years old and still be possibility that we can age better as well as longer.”
able to win at Jeopardy!” Alzheimer’s researchers like Dr. Small are working every
Along with his many professional responsibilities, Dr. day directly for this goal of bettering old age by striving to
Small shares his experiences and wisdom with undergraduates preserve our memory, because as Dr. Small points out “if we
as the faculty mentor of UCLA’s Undergraduate Geriatric and don’t have memory, we have no present, past, or future.”
Alzheimer’s Disease Awareness Association (UGADAA). He

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