Heidi Roth studies the mysteries of memory
The UNC School of Medicine researcher’s work leads to earlier diagnosis of Alzheimer’s disease and other types of dementia.
A high school biology class opened Dr. Heidi Roth’s eyes to the hidden mechanics of the natural world.
Roth has been chasing secrets ever since — the mysteries of meaning, life and the brain.
“I’m a seeker,” she says. “I love learning and then distilling that knowledge into a clear picture.”
Today, Roth studies how memory, language and sleep intersect with cognitive decline as we age. At the UNC School of Medicine, the behavioral neurologist is the division chief for sleep medicine, directs the Aging Brain Clinic and is an investigator within the Duke-UNC Alzheimer’s Disease Research Center.
“Too often, when someone experiences changes in brain function, it’s dismissed as ‘just a little dementia’ without identifying the root cause,” Roth says. “I want older adults to understand what’s happening with their cognition — and then help develop personalized interventions to support their brain health.”
Cognitive clues decoded
In 2002, Roth came to Carolina to help start the UNC Memory and Cognitive Disorders Program.
“There’s been a huge shift in the dementia field toward early diagnosis and getting ahead of the processes that cause neurodegeneration,” she explains. “We want to give people who are aging an individualized intervention program for brain health.”
Roth’s patients, typically 50 and older, come to the clinic with a variety of symptoms — changes in speech and personality, difficulty writing or multitasking, and shifts in depth perception and sight.
To identify the cause of a patient’s symptoms, Roth and her team at the clinic will perform a neurological examination, scan the brain using MRI, assess biomarkers for different diseases, and run blood tests. They also consider the impact of medications, diet, exercise and sleep.
“I like to see the whole picture,” Roth adds. “Most neurologists tend to define themselves by the specific diseases they study, like multiple sclerosis or epilepsy. But behavioral neurology isn’t focused on one disease. It cuts across conditions and looks at the syndromes that emerge when the brain is injured — especially those that affect thinking, behavior and psychological function.”
Personalized care, national impact
Sleep is a vital yet often overlooked component of brain health. At the ADRC, she leads projects that collect sleep data using questionnaires and wearable devices. These studies help assess sleep quality and identify disorders like insomnia and circadian rhythm disruptions.
Roth’s research aims to better understand how these factors interact and how early interventions might delay or prevent cognitive decline. Studies suggest that up to 45% of dementia risk is tied to modifiable factors, including sleep quality.
“One of the reasons I have found sleep so compelling is that sleep interventions can make such a tremendous difference,” she says.
Roth also directs the center’s clinical core, overseeing a longitudinal study that aims to identify risk factors for Alzheimer’s disease and other types of dementia across a person’s lifespan.
Data from her research is part of a National Institutes of Health study that analyzes brain scans and blood tests from more than 17,000 participants to understand how multiple brain diseases can interact to cause dementia.
By building a more diverse and comprehensive dataset, Roth and her collaborators hope to uncover patterns that lead to earlier, more effective interventions.
“I’ve learned to see the patient not just as a set of symptoms or an MRI scan, but as a person with a story, shaped by their environment and experiences,” she says. “The hope is we can make discoveries that allow us to intervene in the years before the symptoms of Alzheimer’s emerge.”
