Dr. Jeff Burns on What’s Changing in Alzheimer’s Diagnosis and Treatment
Dr. Jeff Burns has spent over two decades studying Alzheimer’s disease, and notes that the science has never moved faster.
As co-director of the University of Kansas Alzheimer’s Disease Research Center, he sees the shift firsthand: new blood tests that catch the disease earlier, new drugs that can slow it down — and a healthcare system still catching up to both.
In this episode, he explains Alzheimer’s effect on the brain, what recovery can look like with earlier treatment, and why geography impacts access to care.
In This Episode:
Your Host: Emily Kaplan
Our Guest:
Dr. Jeff Burns, neurologist, professor of medicine, co-director of the University of Kansas Alzheimer’s Disease Research Center, and chairman of the nonprofit Alzheimer’s Policy Working Group
This Episode Explores:
- What actually happens in the brain during Alzheimer’s disease?
- How do new blood tests and PET scans change the diagnostic timeline?
- What does Brent Beasley’s recovery reveal about the value of early treatment?
- Why does rural access remain such a barrier to care
- How can primary care help overcome it?
- What would it take for early Alzheimer’s screening to become standard practice?
What Actually Happens in the Brain With Alzheimer’s
Alzheimer’s disease involves two features that show up clearly under a microscope: amyloid plaques and tau tangles. Amyloid plaques are a protein that builds up in the brain and appears tied to nearby cell injury and death. Tau tangles work differently. They’re the buildup of a protein (called tau) inside brain cells that are already dying or injured.
For more than a century, the only way to see these features was during an autopsy. PET scans changed that about 15 years ago, giving researchers a way to see amyloid and tau in a living brain for the first time.
Neither marker tells the whole story, though. Some people carry amyloid and tau their entire lives and never develop symptoms. Others do. Dr. Burns is candid about it: Alzheimer’s is more complicated than any single protein, and some people appear resilient to changes that would devastate someone else.
What Brent Beasley’s Recovery Reveals
Dr. Burns describes himself as a skeptical scientist, someone who has watched plenty of promising treatments fail over 25 years in the field. That skepticism is part of what makes his experience with Dr. Brent Beasley, featured in Episode 1, so striking.
New anti-amyloid drugs show a modest effect on average, but some patients respond dramatically. Dr. Beasley is one of them. For a physician who has watched treatments fail again and again, witnessing that kind of recovery firsthand is something Dr. Burns still doesn’t take for granted.
However, timing matters most. Dr. Burns compares Alzheimer’s to cancer staging: the earlier treatment starts, the more likely a patient is to respond, and the mild cognitive impairment stage offers the best odds. Once someone reaches the moderate or severe stages, these drugs are far less effective.
How to Expand Access to Alzheimer’s Treatment
Dr. Burns is blunt about the biggest obstacle to early Alzheimer’s care today: It isn’t the science; it’s access. That reality hits hardest in rural states like Kansas, where specialty neurology clinics are already overloaded.
Dr. Burns’ solution is a hub-and-spoke model built around primary care rather than around specialists. His team is currently developing workflows, tools, and training so primary care physicians can diagnose and manage Alzheimer’s patients directly. A key piece of that model is a blood test, p-tau217, that can flag the likelihood of amyloid in the brain without a specialist referral or a PET scan.
[Healthcare] Policy plays a role, too. Dr. Burns points to Medicare’s GUIDE Model, a pilot program that funds post-diagnosis dementia care, as a good first step, though he says there’s still a long way to go in covering the cost of screening and long-term support.
Watch the full episode to hear what Dr. Burns believes it will take to make early screening standard for everyone.
Key Terms and Questions From Today’s Show
What are amyloid plaques and tau tangles, and how are they different?
Amyloid plaques are a protein that builds up between brain cells, while tau tangles are a different protein that builds up inside brain cells that are already dying or injured. Both are hallmark features of Alzheimer’s disease, though researchers are still working out exactly how the two interact.
What does a positive amyloid PET scan show?
An amyloid PET scan shows the presence and location of amyloid plaque in a living brain, something once visible only after death, during an autopsy. A positive scan doesn’t confirm Alzheimer’s disease on its own, but combined with cognitive testing and a patient’s symptoms, it plays a central role in diagnosis.
What is p-tau217, and how is it used to test for Alzheimer’s?
P-tau217 is a blood-based biomarker test that reflects the likelihood of amyloid buildup in the brain. It’s highly sensitive and specific, and unlike a PET scan, a primary care doctor can order it, which makes it a promising tool for catching Alzheimer’s earlier, especially for patients without easy access to a specialist.
Can amyloid plaques be reversed with treatment?
New anti-amyloid drugs can reduce amyloid plaque and, for some patients, meaningfully slow or partially reverse cognitive decline, though the effect is modest on average. Patients who start treatment earlier, particularly during the mild cognitive impairment stage, tend to see the strongest results.
How do you know if memory changes are normal aging or something more?
Some cognitive slowing is a normal part of aging. What isn’t normal is new, persistent change: repeating questions, forgetting recent conversations, or struggling with tasks that used to come easily. Dr. Burns recommends bringing those changes to a primary care doctor rather than assuming they’re age-related.