Russell Swerdlow and Jeffrey Burns had been at the copy store for hours, printing a dozen replicas of their moonshot grant proposal and organizing thousands of pages to submit via snail-mail. After finally paying the Kinko’s bill, they looked at each other and agreed, it was time to celebrate.

Swerdlow suggested their usual spot, Subway.

But Burns — more of a high-roller — thought this time they should splurge.

“We always go to Subway. Let’s do something special,” he said.

“Let’s go to Quiznos.”

After celebratory sandwiches, they waited. Fall turned to winter then spring. To the seasoned medical researchers the federal government’s pace was not unexpected. But by the time summer was half over, they started getting anxious, mentally preparing for a call confirming their grant had been rejected.

At 4 p.m. the Friday before Fourth of July weekend, Swerdlow was still at his desk when his phone rang from a Washington, D.C., number. Their grant was approved.

Swerdlow looked around futilely for anyone else in the office to high-five. He called Burns, who was in his car heading to pick up pizza for his family. Burns, overwhelmed with excitement, drove right past the pizza place and didn’t notice until he nearly ended up back home with no food.

That was back in 2011, when the University of Kansas Medical Center received $1.3 million from the National Institute on Aging to launch an Alzheimer’s Disease Research Center.

“They definitely were the Dream Team,” said former KU Medical Center Department of Neurology chair Richard Barohn, M.D., who recruited the pair in the mid-2000s. “It is a great satisfaction to see what Jeff and Russ have done tackling Alzheimer’s disease.”

Now Swerdlow, M.D., is the Gene and Marge Sweeney Professor of Neurology and director of the Alzheimer's Disease Research Center, and Burns, M.D., MS, is the Edward H. Hashinger Professor of Medicine and the center's co-director. The center they began has since become a national leader, particularly for its work researching how mitochondria and metabolism affect the brain, as well as innovations in Alzheimer’s care delivery. It’s also a pillar of medical research in Kansas. Currently funded at $15.2 million — and requesting $22.5 million for its next five-year renewal — the center accounts for 15% of National Institutes of Health funding across all KU campuses.

When Swerdlow and Burns first met as rookie doctors on the East Coast, they never guessed they’d end up in Kansas together starting the state’s first and only Alzheimer’s Disease Research Center. They have wildly different personalities, but they’ll be the first to tell you they’re better together. Not only are they fast friends, they are nearly inextricably linked professionally, from stints of biking to work together or fastidiously following diets they’re researching, to co-writing dozens of papers and spreading the word about Alzheimer’s discoveries to the public. Their unique rapport has unquestionably driven the success of the KU Alzheimer’s Disease Research Center.

“Both Dr. Burns and Dr. Swerdlow want to find a cure for Alzheimer’s disease, and part of that is talking about the ‘A-word,’ talking about Alzheimer’s disease and destigmatizing it and answering questions,” said the center’s executive director Anne Arthur, BSN, MS, ANP-BC.

“When you get their minds together you know something good is going to happen.”

An unlikely pair

Swerdlow is self-admittedly nerdy and neurotic, a native New Yorker with an East Coast academic pedigree.

Born in New York City, Swerdlow and his family later moved to the suburbs of New Jersey. During high school, outside school and tennis practice, he remembers working as a stock boy in a shopping mall jewelry store, where he got to engrave the “cheap” bracelets and necklaces (not always successfully).

He earned a bachelor’s degree in psychobiology and his medical degree from New York University. His internship, residency and fellowships were at the University of Virginia.

Meanwhile in the Midwest, Burns was — as Swerdlow describes him — “the all-American boy.”

Growing up the youngest of three brothers in Prairie Village, Kansas, Burns was all-league shortstop on the Shawnee Mission East High School baseball team. He also played basketball and spent summers running his own lawn mowing business. 

Burns attended the University of Notre Dame in Indiana, where he majored in English and Japanese, then returned to Kansas City and completed medical school at KU. His post-doctoral fellowship was at Washington University in St. Louis. 

The pair might be called unlikely, besides both being cognitive neurologists. They met through a mutual neurologist acquaintance: Swerdlow’s best friend and Burns’ older brother Ted Burns.

Before getting very far into that story during an interview, Swerdlow paused, overcome with emotion. Knowing what his friend is trying to convey, Burns stepped in to explain: Ted Burns died of cancer at 55, just three years ago.

In the late 1990s Ted Burns and Swerdlow were neurology residents together at the University of Virginia. Jeff Burns followed his brother there for his own internship and residency.

When Jeff seemed to have vanished from campus after only a few days, Swerdlow asked his friend what happened to his little brother?

“Oh,” the elder Burns told him, “It’s March — March Madness.”

Swerdlow replied, nonplussed, “What’s that?”

After a primer on the NCAA national championship basketball tournament, Swerdlow stopped by the only sports bar in town on his way home from work. There he found diehard KU basketball fan Jeff Burns, who’d been camped out there watching games the better part of the past 48 hours.

Recruiting the ‘dream team’

Even in Swerdlow’s and Burns’ line of work, there is something to be learned from the most successful KU basketball teams: to build a “dream team” you have to recruit.

Burns, looking to return with his wife, Jennifer, to their hometown, joined KU Medical Center in 2004. With a goal of launching an Alzheimer’s program, he needed a partner and thought of his first mentor, Swerdlow. Swerdlow had joined the faculty at University of Virginia and Burns knew he’d be a tough sell, not to mention his East Coast wife, Beatriz.

“I never thought that Russ would even entertain the idea of coming here,” Burns said. “I remember dangling it out there, kind of nervously saying, ‘Well, would you ever move?’ And when he said, ‘Maybe,’ I couldn’t believe it.”

After Swerdlow cracked the door open, Burns said he then turned to a “relentless recruiter,” Barohn.

Barohn saw the possibilities. Burns focused on research involving patients with Alzheimer’s and also studied normal aging. Swerdlow’s research was laboratory-based, studying Alzheimer’s at the cellular level.

“Together, I thought they could put together not only the research program but also could build the Alzheimer’s clinic and education program,” Barohn said. “Recruiting was a challenge … since we were starting from having no program at all. But they believed in the vision we had to build a program and to become a powerhouse in the Midwest.”

The goal was being approved as a national Alzheimer’s Disease Research Center, which the team thought would take years to achieve, maybe even a decade.

Barohn said he laid groundwork including putting Burns in a leadership position to develop the Clinical and Translational Science Unit, envisioned as an ideal environment to research Alzheimer’s as well as normal brain aging.

Things fell into place quickly, and just four years after Swerdlow came on board, to all of their surprise, they were approved as an Alzheimer’s Disease Research Center by the National Institute on Aging.

“They bet on the team,” Swerdlow said.

Opposites attract

Burns easily selects one word to describe Swerdlow: meticulous.

It’s one of his greatest strengths, Burns said, citing Swerdlow’s “ability to zoom in and think deeply” at the molecular level, really getting into how things work.

That facet of his personality drives the type of work he has dedicated his career to, studying mitochondria, the minuscule organelles known as the powerhouses of cells.

Swerdlow likes music and movies — quirky music and movies — and he’s fun to hang out with, Burns says, but his favorite hobby is probably work. He pours himself into it. 

As for Burns?

“He’s crazy,” Swerdlow said.

Burns had no qualms about eating the elk sandwich on an airplane during a trip to Sweden, Swerdlow recounts. If a hotel they’re staying at has a casino, Burns will do some gambling in his free time. And he once rode his bicycle from Santa Fe, New Mexico, to Kansas City, by himself.

“Like in comedy movies there’s the crazy guy … and then there’s the guy who likes to crack up, living vicariously through it,” Swerdlow said.

“I’m more of a live-vicariously-through-Jeff-guy.”

That also goes for the potentially fate-revealing Alzheimer’s gene test. The test can identify which variant of the apolipoprotein E, or APOE, genotype you have. Certain variants may mean you have an increased risk for Alzheimer’s disease.

It’s a point on which the two doctors agree to disagree, one they joke is largely an extension of everything else in their relationship.

Do you take the test or not?

“I found mine out and had no hesitation to do it,” Burns said. He considered that if he did have the Alzheimer’s gene, knowing might prompt him to exercise more, or make other lifestyle changes to at least try to decrease his risk of developing dementia.

As for Swerdlow, “I’m not a gambler,” he said. “I would just prefer not to know, because I like working pretty hard and having no excuse not to.”

To punctuate this point, Swerdlow quotes a scene from “This is Spinal Tap,” in which the bandmates are contemplating Elvis Presley’s grave. It is possible to have “too much … perspective.”

Zooming in, zooming out

Burns and Swerdlow agree, they have different ways of seeing the world.

“But that ultimately is our secret sauce,” Swerdlow said. “We complement each other nicely.”

Burns thinks of it this way: When it comes to their personalities and their research tactics, Swerdlow zooms in, and he zooms out.

Swerdlow is a pioneer in the area of mitochondria and metabolism in the brain. His honors for this line of study include a 2022 Oskar Fischer Prize, an international award for innovative Alzheimer’s research. Colleagues have called Swerdlow a “visionary” in translational neuroscience and described his work as central to how we understand the mitochondrial contribution to aging.

“It’s a theme that challenges current paradigms,” Swerdlow said. “We think that the mitochondria are very important in the disease. They might even be driving the show.”

Because of Swerdlow’s work, the KU Alzheimer’s Disease Research Center is known as one of the leading experts in mitochondrial research. After decades of focusing on other Alzheimer’s theories, many in the science community now believe mitochondria are at the center — something Swerdlow has hypothesized all along. 

Three Questions

With Jeffrey Burns and Russell Swerdlow

1. Morning beverage of choice?
JB: Coffee straight up. I generally drink it all day long, and I’ve got to get it early.
RS: All I can do is tell you why I don’t have a breakfast drink. It’s because rooming with him and seeing how the need for his breakfast drink guides his morning has scared me away from caffeine entirely. I’m not kidding.

2. Best way to take a brain break?
JB: Walking or jogging, without headphones. Your mind is left to wander and rework things, go wherever it wants to.
RS: Something distracting, like playing Wordle.

3. Favorite thing about Kansas City?
JB: It’s my hometown. It’s where I grew up, and it’s where my wife grew up. We’ve got roots here, so that’s where we want to be.
RS: The seafood. No. The people here are really nice, and the quality of life is unbeatable.

“We have helped create a shift in Alzheimer’s disease research that mitochondria and energy metabolism play a significant role in Alzheimer’s disease, whereas when we were first funded in 2011 this was not a well-accepted concept,” said Arthur, the executive director.

Swerdlow’s Alzheimer's disease mitochondrial cascade hypothesis asserts that deficient brain energy and malfunctioning mitochondria initiate late-onset Alzheimer’s disease. The theory, which has slowly gained traction since he proposed it over 20 years ago, runs counter to the longstanding hypothesis that buildup of beta-amyloid plaques and tau protein tangles in the brain constitute the root cause of Alzheimer’s disease. Rather, it proposes plaques and tangles are consequences of an upstream pathologic event, in this case mitochondrial dysfunction.

Furthermore, Arthur said, the KU Alzheimer’s Disease Research Center is developing new mitochondrial biomarkers, such as the blood-based Mitochondrial Function Index, or MFI. It also is among the first of the country’s Alzheimer’s Disease Research Centers to obtain certification for Alzheimer’s disease plasma biomarker testing from the College of American Pathologists’ Clinical Laboratory Improvement Amendments requirements.

Zooming out, Burns’ research is primarily at the whole-person level, and his leadership involves big-picture visioning and collaboration.

He’s helped KU become a model for designing studies for developing drugs and also for delivering Alzheimer’s care to patients in innovative ways, including rural Kansans.

Burns has positioned KU as a national thought leader in cognitive aging research, peers have said. His work also has informed national recruitment and research participation strategies through National Institutes of Health committees and advisory roles.

Burns directs the KU Clinical and Translational Science Unit - Fairway and the KU Alzheimer’s Disease Research Center’s Clinical Core, which is a site for national clinical trial networks. He has supported the development of more than 100 clinical research protocols across nearly all departments at the medical center.

His research aims to assess the roles of fitness and lifestyle on brain aging and Alzheimer’s disease progression, including through exercise intervention trials. He’s also collaborated on research studies exploring how diet affects brain health.

Spinning out in part from Burns’ research, KU’s Alzheimer’s Disease Research Center also is known for its development of the Lifestyle Empowerment for Alzheimer’s Prevention program, called “LEAP!” The program, designed for the general public, features a six-week course to teach science-based lifestyle strategies to boost brain health.

‘Practicing what they preach’

For a couple years around 2010, Burns and Swerdlow bicycled to work together daily. Swerdlow left home first, rode a few miles to pick up Burns, then they biked the remaining 9 miles into the office.

Besides exercising together, the two have also dieted together.

But this is no Weight Watchers. 

Burns’ and Swerdlow’s research and clinical trials involve studying exercise and diet’s effects on the brain. You might find them comparing notes on their ketones or blood glucose levels.

“We’ll challenge each other and challenge ourselves to try these things,” Burns said. “If we’re going to be asking others to do it, it’s important for us to know what it’s like.”

For one, Swerdlow jokes, “we’ve tried starving ourselves.”

It’s actually intermittent fasting, Burns explains — or suspending eating for certain hours of the day.

They’re still researching to learn if intermittent fasting can be good for the brain, but Burns said that at least for him, his own metabolism levels are better when he skips eating in the morning.

Swerdlow doesn’t eat breakfast either, but his reasons are simpler.

“I’m just not hungry,” he said.

The ketogenic diet’s effect on mitochondria and brain health has been another big focus. En route to a national Alzheimer’s Disease Research Center meeting, Arthur recalled a layover when Swerdlow and Burns searched the airport for a keto-friendly lunch. They settled on chicken Caesar salads, which they both ate, agreed they were still hungry, then promptly ordered second salads.

“It’s very entertaining to listen to the two of them go back and forth about what diet they’re trying at any given time,” Arthur said. “They practice what they preach.”

Fast friendship, shared dream

Since first meeting through Ted Burns, Swerdlow and Jeff Burns have gotten to know each other’s parents, wives and children.

Burns in fact has 10 children, and when asked if he can name each of them, Swerdlow replies with confidence, “I can — in order.”

Not only that, he adds, but he was there for the birth of the oldest back in Virginia and the youngest here in Kansas City, when Burns himself almost didn’t make it home in time from an out-of-state trip.

Even though they don’t have to, Burns and Swerdlow still room together when they travel to conferences, like a vacation with friends.

Colleagues say this camaraderie trickles down.

“The energy and the vibe of our center is so much fun,” Arthur said. “I think that stems from the two of them, the leadership they have demonstrated, a very positive, friendly working culture.”

Phyllis Switzer, a longtime KU Alzheimer’s Disease Research Center psychometrist, administers cognitive tests to Alzheimer’s research participants. She watched the two friends come together at KU, and the center grew from fewer than 10 to now over 120 staffers.

Burns and Swerdlow have the ability to meet others at their level, Switzer said.

This can be especially delicate with Alzheimer’s patients. They’re often very nervous, especially when they know they are experiencing dementia. She said Burns and Swerdlow encourage them and make them feel comfortable.

“They have this passion for this disease,” Switzer said. “You could see that not only in their research, but on a one-to-one when they sit with those patients. They just really care and want to help them.”

Swerdlow and Burns share the long-term dream to prevent and cure Alzheimer’s disease.

“I think we will accomplish that,” Burns said.

“It’s a really important time in the history of the fight against Alzheimer’s disease. We’re moving toward an era of brain health, where we’re thinking about not just disease but how do we prevent Alzheimer’s disease and maintain brain health across a full lifespan.”

But being in discovery science requires fortitude.

You may go years feeling like you’ve made no progress, Swerdlow said. Eventually, though, you see that those years have contributed to a more sophisticated understanding of the problem you’re trying to solve.

Burns said he feels an increasing sense of urgency at this point in his career.

“It’s like this constant battle to keep things moving, and they’re never moving fast enough,” he said. “I’m getting more impatient.”