Dr. James Noble isn’t one for being boxed in. The neurologist and neuroepidemiologist at NewYork-Presbyterian/Columbia is an expert in dementia, but a sampling of his work reflects his broad clinical and research interests: He’s investigating the link between periodontal disease and Alzheimer’s disease. He’s developed a prototype for a device that helps diagnose concussions in real time. He’s researching how hip-hop can be used in health education and cofounded a nonprofit, Arts & Minds, to support the power of visual arts in improving wellness for dementia patients and caretakers.
These seemingly disparate projects all tie together for Dr. Noble. “First, I’m passionate about each of them. They tend to reflect a problem that I’m trying to solve or a question that I’m trying to answer,” he says. “And second, if I can prove in a methodical and scientifically rigorous way that all these things can make a difference for people, I believe they are worth doing.”
Dr. Noble spoke with NYP Advances to discuss his diverse body of work and the motivation behind his passion projects.
When did you know you wanted to specialize in neurology, with a focus on dementia?
A seminal moment for me in med school was when a professor brought an individual with Parkinson’s disease into class while doing a lecture about the basal ganglia pathways affected by Parkinson’s. This gentleman walked very slowly and required two people to help him. But when the professor turned on the man’s deep brain stimulators, he began walking around the aisles normally. It made me excited about what was possible in neurological care.
My interest in dementia solidified when I was a third-year resident. I met with the neurology chair at Columbia at the time, Dr. Timothy Pedley, who asked me what I wanted to do for my fellowship. Through that discussion, I realized I was interested in the brain and behavioral neurology. During my residency, I also ended up working with almost every faculty member in our Division of Aging and Dementia, and I liked the very human approach they took with patients. It was “old school” in the sense that they recorded classic descriptions of what they saw and got to know each patient and how the disease affected them as individuals.
You received a grant to study periodontitis and Alzheimer’s disease. What led you to make this connection?
I come from a family of dentists, including my father, who is a retired periodontist. I remember hearing him talk about the ravages of periodontal disease on his aging patients. When I started my epidemiology fellowship, it was known that periodontal disease was related to stroke, and stroke was related to dementia. I thought it would be interesting to see if there was a more direct connection between periodontitis and dementia.
For my master’s thesis, I identified an association between Porphyromonas gingivalis antibodies and cognitive impairment within the Third National Health and Nutrition Examination Survey (NHANES-III) cohort. Then, along with Dr. Panos Papapanou, director of the Division of Periodontics at NewYork-Presbyterian/Columbia with whom I’ve been doing this type of research, we created a cohort within the Washington Heights-Inwood Columbia Aging Project (WHICAP), an existing epidemiologic study where they were already gathering data like brain imaging, plasma, and neuropsych testing. We added oral health examinations.
I see my research on periodontal disease and concussions as part of an effort to uncover life course risk factors for dementia.