The Healthy Brain Aging Initiative was developed by Tulane’s Neurology Chair, Dr. Demetrius Maraganore, in response to the notably high incidence of Alzheimer’s disease and dementia in Louisiana.
The research from this program is focused on Alzheimer’s and dementia prevention and memory disorder treatments using the latest evidence-based research and movement disorders treatment, like Parkinson’s, related to brain aging.
Maraganore, a Chicago native born to Greek immigrant parents, graduated from Northwestern and spent much of his career at Mayo Clinic. He moved across the world for a year to study Parkinson’s and genetics in London as part of his training at Mayo.
After 24 years at Mayo, Maraganore got the itch to move back home and began work as the chair of the department of neurology at community health systems associated with the University of Chicago, where he spent the next nine years of his career.
While he was working in Chicago, Maraganore’s father developed Alzheimer’s disease — the same condition that plagued his grandmother and great-grandmother.
“Here I am as the fourth generation, and I was starting to sweat a little bit,” Maraganore said. “Why is there so much Alzheimer’s in my family. And what can we do to prevent Alzheimer’s disease.”
So, Maraganore pivoted again. This time, he opened the Center for Brain Health in Chicago — a place where people could go and learn about their modifiable risks. He found that there are more than 20 modifiable risk factors for Alzheimer’s disease, and they could be found using genetics tests.
Patients at the brain health center can get genetically tested to determine their risk for Alzheimer’s and receive personalized interventions to try to reduce their risk.
Maraganore hopes the new brain aging center in New Orleans can provide the same care for Louisianans, a globally known hotbed for Alzheimer’s risk and prevalence.
“My idea was to come here and develop a four-pillared program: prevention, treatment, research and support,” Maraganore said. “If you can prevent Alzheimer’s in New Orleans and Louisiana, you can prevent it anywhere in the world.”
How did you design the new research center? What principles did you use?
I wanted something concrete, bricks and mortars — a unique partnership of expert care stakeholders, something that would provide a range of services to all people in our community. Initially, it was Tulane-only, but partnering with LCMC Health, University Medical Center and LSU has helped us go bigger.
We have eight different experts. We have neurologists specializing in movement disorders and memory disorders, including Alzheimer’s prevention. We have advanced practice nurses. We’ve got social workers, geriatricians — and we’re all in the same space with a very large staff that support us.
We are able to see patients there, and we provide them care in a multidisciplinary way, incorporating holistic approaches, but also evidence based medical approaches.
Who are ‘super-agers’? What can researchers learn from them?
We’re doing studies of special populations across the nation of people who are over age 90. They are super-agers. And we’re beginning to learn what’s-what. Where’s the fountain of youth? What are the factors that allow you to get to be 90-plus free of Alzheimer’s, even when carrying a genetic risk for Alzheimer’s?
Growing up in a Greek household and spending most of my childhood summers in Greece with my relatives, I was exposed at a very early age to the Mediterranean diet.
The Mediterranean diet is the diet of Greece, Southern Italy and Spain. For research purposes, we use a snapshot of the diet common on the island of Crete in Greece in 1961. That’s the benchmark reference.
That particular dietary pattern has been studied for several decades, now in observational studies and in randomized clinical trials, as the only diet that, at any age, cuts your risk for death in half.
It cuts risk of cancer in half, heart disease in half, risk of stroke in half and risk of dementia in half.
It’s not only a neuroprotective diet, but it’s a neurorestorative diet. It restores brain health.
Why aren’t we all eating the Mediterranean diet then?
Well, we learned to love the things that aren’t good for us. We have developed this Westernized pattern of diet that’s very inflammatory and that promotes gut dysbiosis, which promotes an unhealthy composition and overgrowth of bacteria in the gut. That triggers a whole cascade of immune events and neural events that lead to inflammation in the brain and increase the odds for dementia.
The reality is, that even in the affluent, primarily white suburbs of Chicago, where I had been practicing, only 25% of this privileged population was adhering to the Mediterranean diet.
So imagine how things might be. You know, here in the South, probably a very small proportion of people are adhering to the Mediterranean diet.
In the years that I’ve been doing healthy brain aging efforts, we teach people about the Mediterranean diet. We even give them weekly diaries that they can keep to track their eating habits. But, it’s very hard for people later in life to change how they eat.
So, as researchers, we asked ourselves: “Do we have to change the way we eat? What if we just change our gut bacterial composition?”
We’ve been doing experiments in aging rats and also in mice engineered to get Alzheimer’s, feeding them the Western diet versus the Mediterranean diet. We’re finding that the animals receiving the Mediterranean diet have healthier gut compositions of bacteria and are smarter than the animals that are fed the Western diet.
Then, we looked at taking the gut bacteria from the healthy Mediterranean animals and fed it by mouth to the Western diet animals.
Could we improve animals’ gut composition and could we improve their cognitive performance?
The answer is, yes.
We are actually developing a Mediterranean diet-derived probiotic that people will be able to take as a capsule to improve their cognitive performance and to prevent cognitive decline and dementia. It’s something that we hope to bring to clinical trials very soon, after December 2025.
I know we’re not going to stop eating po-boys or fried catfish in Louisiana anytime soon. But, I do believe that we can continue eating foods that we’re accustomed to eating while also converting the gut to a healthy gut that will then lead to a healthy brain.
What keeps you busy outside of work?
I picked up the harmonica. Every Saturday for the last eight years, I’ve been taking lessons with a guy in Dublin, Ireland. I’m a guy born in Chicago, living in New Orleans, being taught the blues harmonica online by a guy in Dublin. That’s the definition of globalization.
We’re exploring the blues and jazz and American standards and rock and folk and country — all expressions of the harmonica. I like Neil Young, Bob Dylan, Bruce Springsteen or Rolling Stones. I have a number of songs that are in my repertoire.
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