As I wrap up my final days at ACE Alzheimer Center in Barcelona, I’m left with a strange mix of clarity about how Alzheimer’s care unfolds across disciplines, and awe at just how much memory, identity, and systems are intertwined. Over the past two weeks, I’ve had the opportunity to work with neurologists, neuropsychologists, and clinical trials teams. What’s become clear to me is that treating Alzheimer’s isn’t just about science or medicine; it’s about stories, rhythms, and decisions made in deeply human, often vulnerable, moments.
Inside the Consultation Room: The Neurologist’s Lens
My days with the neurology team began in rooms where families sat tensely, recounting small changes; missed appointments, forgotten words, trouble following recipes. These conversations always came first, and always without the patient present. Only after the context was set did the neurologist invite the patient in for structured memory testing. This two-step approach felt delicate but necessary, allowing families to speak freely and ensuring patients weren’t overwhelmed from the start.
I became intimately familiar with the MMSE, a standardized screening tool that covers orientation, memory recall, drawing, language, and arithmetic. It was humbling to watch it unfold in real time. One patient, for example, breezed through early questions—day, time, place—but froze when asked to close their eyes and tap their shoulders. Another, a 92-year-old man, laughed softly every time he forgot a word, saying “no recuerdo” with both grace and resignation. His self-awareness was striking.
But the most haunting moments came when cognition was severely impaired. In one visit, I observed a married couple, both with severe dementia. Their children led them in gently, bypassing the usual family-patient split because neither parent could follow the structure. The wife intermittently hummed but didn’t seem to understand the questions; the husband sat silently, eyes closed, unmoving even during basic commands. At one point, his wife stood up, wandered, sat back down, repeating this cycle in a loop of confusion. It was difficult to watch. These were no longer just clinical cases, they were lives reshaped by memory loss. And yet, even in these visits, I saw and learned the neurologists' ability to adjust tone, simplify structure, and preserve dignity.
The Neuropsychologist’s Toolkit: Finding Patterns in the Fog
Compared to the fast-paced nature of neurology, neuropsychology sessions were long and intimate. The tests were wide-ranging: naming animals, drawing clocks, identifying objects layered in pictograms, repeating numbers forward and backward. What fascinated me most was how these seemingly simple tasks revealed distinct patterns of impairment. A patient with frontotemporal dementia struggled with inhibition and planning; another who likely had Parkinson’s showed rigidity in movement but retained linguistic fluency. And then there was a man from Peru whose test was halted midway due to suspected psychosis. His answers veered off course quickly, and he seemed increasingly disengaged.
I also began to see how the same patient might behave differently in individual versus group settings. During memory workshops, many people performed better, possibly due to the rhythm, social pressure, or emotional comfort of familiarity. But in one-on-one testing, hesitation and anxiety were more pronounced.
One detail that surprised me, and felt deeply tied to place, was how patients answered the question “What country are we in?” Some said “España.” Others said “Catalunya.” The neuropsychologists accepted both. It wasn’t a moment for political correction, but rather a reminder that identity and memory are inseparable. Even in cognitive decline, national belonging remains rooted in language, experience, and pride.
Clinical Trials in Real Time: One Patient, One Pathway
One of the most meaningful moments of my final weeks came during a follow-up visit with a patient enrolled in a clinical trial testing semaglutide, a GLP-1 receptor agonist typically used for type 2 diabetes. At ACE, it’s being studied for its potential cognitive benefits in Alzheimer’s disease, a relatively new and promising direction.
This particular patient was older and visibly underweight, someone who, on paper, would be considered at risk for the most common side effect of semaglutide: weight loss. And yet, over the course of 10 weeks, he had maintained both his weight and his cognitive score on repeated memory tests. It was encouraging, but it also raised questions. The neurologist wondered whether he might be in the placebo group, after all, it’s rare for someone that lean to tolerate the drug without noticeable metabolic shifts. Still, the fact that his memory score hadn’t declined was meaningful. Sometimes, in Alzheimer’s, holding steady is its own kind of progress.
For me, this visit felt like an unexpected intersection of my research and this clinical space. My own work back at Tufts focuses on GLP-1R. To see semaglutide, a GLP-1R agonist, being tested in a real-world Alzheimer’s trial gave my benchwork new context. It reminded me that what we do in the lab, tweaking sequences, running assays, hypothesizing about signaling cascades, has a direct line to patients like him.
Watching him work through the memory test, chatting calmly with the nurse, agreeing to the next blood draw without hesitation. It reminded me that every molecular target has a human face.
Closing Reflections: Beyond the Clinic
In these final weeks, I’ve realized that leadership in this setting doesn’t always look like taking charge. Sometimes, it looks like listening, really listening, to patients who can’t find the right words, to doctors who calibrate empathy with efficiency, to a system that balances hope with limitation. I’ve spent six weeks trying to make information clearer, processes smoother, and patient experiences a little more understandable. But in return, I’ve received something more profound: a glimpse into how science becomes human.
This project has changed how I view science, not just as discovery, but as dialogue. I’ve learned that memory loss isn’t just about forgetting, it’s about how we hold on to what still matters: identity, belonging, family, and trust.
As I pack up to leave Barcelona, I carry with me images that will stay long after: a woman laughing during her MMSE, a family quietly absorbing a diagnosis, a trial participant asking, “Will this help others too?” I hope the answer is yes.