>> this is al jazeera america live from new york city. i'm richelle carey. here are your top stories. egypt's military interim government is formerly declaring the muslim brotherhood a terrorist organization calling for punishment of anyone involved with the group. turkish prime minister erdogan's had three cabinet members resign when their sons were arrested. christians were targeted in

three separate bombings in baghdad today. 37 people were killed. most of the deaths near a catholic church right after mass. so far no one has taken responsibility for the christmas day attacks. the catholics have been a common target for al-qaeda militants. britain channel four showed the tape by edward snowden to run counter to the queen. and let's take a look at the gorgeous sunset outside in new york city. i'm richelle carey, and you can check out our website at www.aljazeera.com. >> new drug trials for alzheimer's disease disease target people who don't have the decease but as much a 50% chance of getting it later. i'm ray suarez, and that's the "inside story."

>> five million americans suffer from alzheimer's disease. >> five million americans suffer from alzheimer's disease, and by 1950 that number will double. we'll discuss the national plan to address alzheimer's disease, and focus on newly funded research testing new drugs. here is the interesting part. the drugs will be used preventively on healthy people genetically predisposed developing the disease. we will start our discussion in a moment, but here is the background. >> what i noticed four or five years ago was my difficulty in writing complex topics.

i could not hold all of them in my mind, so it became much more difficult and frustrating to write about those things. >> david is a doctor, teacher, and an individual blogger. these days he's writing about a topic that hits close to home. >> what i'm trying to do is to take my family and my community with me into this journey so i don't get isolated as much. >> the alzheimer's association said there are five million who suffer from alzheimer's and it's the sixth leading cause of death in the united states. president obama signed into law the alzheimer's act. >> it's important work and will become more important as the baby boom generation becomes older and more are at risk.

>> reporter: the national alzheimer's project seeks to create and maintain an integrated plan to overcome alzheimer's disease, order nate research and services across federal agencies, exce course oe and treatment of the disease and coordinate international efforts to fight alzheimer's globally. >> people are afraid of this disease. i was, too. they're petrified that they'll get alzheimer's. a lot of that is due to the misconceptions about what it is, and what happens to you when, and what it's like to experience it. >> reporter: many promising treatments have been followed by unsuccessful trials. alzheimer's is the only disease to prevent, cure or slow down

its progression. >> this is not going to be an impossible disease to treat. the money needs to come from the government. it's the only place that is going to fund it. >> reporter: the director has made combating the disease a tough priority. so much so despite the $1.5 million in sequestration cuts dr. francis collins found a way to scrape together $40 million in grant money to continue the work. the other $5 million is provided by the national institute of aging. in a statement dr. collins said we'rwe are determined to capitae on exciting opportunities to find effective therapies as quickly as possible. the obama administration vowed to carry on research.

>> to fully bring alzheimer's into the nation's consciousness. >> reporter: the majority of the grant, will go to the banner alzheimer's institute of phoenix, arizona. the fund willing test treatment on adults aged 60 to 75 who have no stopples of alzheimer's sympt who have the risk of getting the disease at an older age. joining us now is dr. pierre th erio. welcome to the program. i understand you don't yet have a drug for the trial, but you know who you want to use in the test. what's apoe 4, and how do we know who has it? >> apoe 4 is shorthand for

protein, type four. it's a protein that our bodies make. it comes in three flavors, and depending on the flavor you have it turns out that you are more or less susceptible to developing alzheimer's disease later in life. >> so it's not a guarantee but it's a question of raising or lowering your chances then? >> correct, and in our case we're going to be looking for people who have two copies of that, the gene that makes the protein, which is relatively uncommon, and substantially raises the risk of developing alzheimer's disease later in life. >> so you'll be doing this test on a pool drawn from a relatively small share of the population? >> correct. we'll need to do genetic testing on people roughly ages 60 to 75 who might be interested in

learn. >> you can't have developed or gun to develop any signs of alzheimer'alzheimer's? >> correct. we'll focus on people who have no ailment. we will be testing a specific drug. what is unusual is the sequencing of things. we were fortunate to receive funding from the national institute of health based on a plan without the drug having been selected yet, but we are in the process of selecting it now. >> so you know that you want to go after the protein amyloid, am i correct? how is that related to happened? >> in an analogy that the viewers might understand, we

think that amyloid is to alzheimer's disease, it looks like it may an central player, probably not the only player, but if we can attack it with an anti-amyloid agent at the right time our wager is that before damage has occurred might be the right time to test this experimental anti-amyloid therapy. >> in the community of doctors working to understand how amyloid might be related to the brain damage associated with homicide, are there issue schools of thought, what it does, how it works and how alzheimer's disease begins? >> sure, i can't pretend that we know everything on how the disease unfolds, but we do know that this protein is found if sticky deposits in the rain and

around blood vessels. we know genetic mutations to cause misprocessing of the amyloid pathway, so to speak, will always develop alzheimer's disease. we know there is a rare mutation that blocks that pathway that for practical purposes can prevent alzheimer's disease. it looks like it's a very appropriate target and we need to test it as robustly as possible. >> right now is it expensive to determine who might have two copies of that apoe 4. we're still early days in mass testing for pieces of the genetic profile, aren't we? >> the test something pretty easy. we have piloted different ways of doing it. we can even do it by mail, so it's pretty straightforward. >> but is it something that we could do in a mass way if we

want to scene people for propensity to differ alzheimer's disease. >> we'll be testing 10s of thousands of people after informed about the purpose of the testing would be willing to undergo the tests. i think we're looking at tens of thousands of people. and bear in mind hundreds of thousands of people had already been tested, so this is not a totally out of the box approach. >> life expectancy has increased a great deal in recent generations. given that big generation. genes, lifestyle, proteins aside, isn't life expectancy alone something that is going to

increase the pool of alzheimer's disease sufferers in the population? >> you're exactly right. ironically we're aging successfully, but that makes us susceptible to monday age-rela age-related deceases, so you're right, it is one of the major factors. >> so as you embark on pretty groundbreaking research, do you already have some idea of what you hope to figure out, and how long it will take to do it? >> we do. i want to acknowledge erik rhimon who has been articulating this for years that maybe before the rain is ravaged is th.

could it slow down or prevent loss of memory that other things that could possibly occur. can we slow down damage that occurs to the brain, and measure that slowing affect with sense stiff brain imagerying and will we be able to do faster studies in the future based on bio markers. and lastly this may an good test of the sow called amyloid hypothesis. does this apply at the same stage before the symptoms emerge, slow down or derail the whole disease process. >> thank you, good luck with the research. >> thank you. >> we'll take a god shark.

when we return we'll look at treatment and a possible cure. this is "inside story."

>> welcome back to inside story. i'm ray suarez. >> welcome back to inside story. i'm ray suarez. we're looking at alzheimer's disease and research with new treatment. we welcome our guests. dr. peterson, we've been talking about clinical trials and apoe 4. but what about now. is there anything we can do for people who are early in the disease today? >> well, right now, ray, it appears that probably the most effective--the treatments we

have against alzheimer's disease are lifestyle modifications. i think that exercise, intellectual activities, staying involved in your social networks are really the best prevention methods we have right now. but i'm sure what dr. therio and others have talked to you is "s" that there are drug trials designed to assess the effectiveness of disease-mod disease-modifying technology. >> is there a way to slows the disease progress but things we can do to help shore up the brain? >> i think that's entirely likely. that we will end up with a cocktail of approaches. involving both pharmacological, drug therapies, vaccines, and a variety of pharmacologically

developed treatments in companiment with lifestyle modification, exercise and the like. this is not different from what we do with heart disease. when we look at heart disease and the problems from hardening of the arteries to the heart we talk about lifestyle modification, and lowering of our blood sugar and the like. i think that's where we're going to be down the road. >> i've been talking to neurologists, and people who look at the money involved in providing healthcare to americans. and they shutter when they talk about the demographic wave that is breaking over the country, a whole new generation, a very large generation of older americans. are we really ready to cope with millions more cases of alzheimer's? >> i can tell you i don't think

we are. we've got a long way to go. right now there is over 5 million americans with the disease, and over 15 million caregivers. when we talk about cost it is costs the united states every year in costs for care over $200 billion. that's just cost of care. that is not talking about research dollars. so when we look at that we really have to make an investment in our research programs through the nih, and make shows investments at the same levels that other diseases have investments are been made. we've been successful. we have prevention for heart disease for stroke. we know there are things you can do for diabetes. we've been successful in those areas and we need to make the same investments to be successful in that same prevention and modifying drug for alzheimer's. >> dr. peterson was also talking

about lifestyle changes. with people for whom the disease has already begun to take its toll, it's not that easy. this is not something that you can just tell somebody to do and then leave them to their own devices for the rest of the day. we don't really have a trained core of assistants, those who can help those with alzheimer's do what is in their best interest. >> well, as we look at workforce we'll need help in those areas as companions, nursing assistance, home care and residential care. right now people still are struggling to access services, and to get the support that they need to get through it. you know, ray, alzheimer's lasts four to eight years. some people live as long as 20. when you think about the type of care needed at that period of

time recognizing that it gets worse over time, so they need more and more help. we are in a position whereas time goes on with the trajectory of the disease we need more people helping us take care of those people that are living with alzheimer's disease. >> we're going to take a short break. when we come back we'll talk more about the demographics of alzheimer's disease and ask if researchers are confident that they're getting close to unlocking the mystery of the disease. this is "inside story."

>> the challenges that i know about of who is going to care for us. one of the big problems is that

as our population gets older there is going to be more cases of alzheimer's, but the middle age population, sons and daughters, there are fewer and fewer of those. there are going to be fewer unpaid caregivers. >> welcome back to "inside story." i'm ray suarez. that's david hilfiger. he has been blogging about his own alzheimer's disease, track the condition and give people a sense of what is at stake for our country. continuing with our discussion now, researchers in the united states and around the world have spent circle amounts of time and money trying to find causes and treatment for this scourge. are you more confident than a year ago, two years ago that we're getting closer? >> i think so, ray.

i think we understand a lot more about the disease and it's underlying processes than we did a few years ago. we have a good understanding of what is the underlying biology. what are the proteins involved in producing this disease and causing the damage? we can now measure those proteins. we can measure them through imaging studies, spinal fluid, blood, it gives us a real index of what is going on in these individuals. i think we're able to slate whose at greatest risk of developing the disease five, ten, 15 years down the road. where we're lagging behind is what are we going to do with "b" it? where is the therapy, and that's coming down the road. i think there are several drug trials under development right now that may, in fact, have an

effect on the underlying disease process. that's what we need to see in the disease prognosis. >> the screenings and genetic pre-disposition may be easier for us to know. those people who may be unlucky enough to have an early on set of the disease, maybe we're coming close to being able to identify that. but what about people who are over 80 for whom alzheimer's is just a disease of old age? >> right, i think you properly characterized where the field is. we have a sub group of people who in the truly genetically determined families, meaning in those families it is 50:50 because the gene is operating them. fortunately, that is only 1% of the all of the disease. there is another category of genetic pre-disposition.

people who are homozygote for this allele characteristic. those people are greatly elevated risk of developing the disease, but that's only 2% to 3% of the population. what you refer to is the general population, the individuals out interest who are at risk for developing the disease in their 80s, 80 plus, and that's the bulk of the disease. but even in those characteristics, those families there, is still a tendency for the disease to sort of run in the families. so there are much more less deterministic pre-disposition but still there are genes that tell that's certain individuals are at increased risk for developing the disease, and that helps characterize the risk profiles. >> until dr. peterson and his colleagues experienced some of the break through that is they think they're getting closer to,

what do you need and what do the people you advocate for need? >> i think one of the most important things we can tell a family living with alzheimer's disease is they need to get support. they need to get help. and if they get educated about the disease, and they can build a care team in a way, and by care team i mean family members, informal neighbors, friends, but also those companions, doctor, community services, day center, all those things together can form that care team and can help families get through the course of this disease. it really is a marathon. it is not something that is over and done with in a year's time or two year's time. they need to plan for that. accessing support services makes a big difference for people. if they understand how the disease works and they can learn from a support group, for example, or from visiting a website, if they can learn--learn about the disease and how they can interact in

different ways that might be easier in communicate be with the disease then they can be more successful. that is going to have an impact on their every day life because this disease can go on for a long period of time. one of the worse things that i see happen is when people think they can do this by themselves. it's hard to ask for help over a long period of time. it's important that people think about that, the earlier that they can do it, if they can plan with the person who has alzheimer's disease and engage them in the process, that can be really helpful for everybody. >> beth joined us from chicago. dr. peterson in minnesota. thanks to you both. that brings us to the end of this edition of inside story. in washington, i'm ray suarez. in washington, i'm ray suarez. ♪

children once sacrificed their childhoods, even their lives, working in american mills, mines and factories. the us rooted out child labor practices 75 years ago. but today, us agriculture remains a stronghold for child labor. >> i know most kids come out here to help their parents out, get the money to pay the bills. >> it's just another day on the fields of america. >> hi, can you tell me your name? >> gabriella. workers like gabriella are not uncommon. >> how old are you?