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Why has there been so little progress on Alzheimer's disease?

freakonomics.com

11–20 of 355 posts

Re: Why has there been so little progress on Alzheimer's disease?

#11
I'm not saying I'm the best informed on this topic, but I thought the root cause has been known for a long time now as degraded endocrine and cardiovascular function.

That's also why Alzheimer's can take so long to develop. It's just one aspect that we've chosen to focus on because it's more clearly noticeable, but it cannot easily be treated in isolation from everything else. If it was, it would regress quickly without fixing the root causes.

Re: Why has there been so little progress on Alzheimer's disease?

#13
TLDR: gatekeepers stifled exploration and innovation.

When a topic only has a limited number of experts, those experts become gatekeepers.

Those gatekeepers directly or indirectly control research funding.

Gatekeepers necessarily harbor biases, some right and some wrong, about how the field should progress.

For Alzheimer's, some gatekeepers were conflicted and potentially directed the field in the wrong direction. Only time will reveal AB42's true role.

It's easy to find fault in Alzheimer's.

It's harder to see the general solution to the gatekeeper problem, i.e., how to allocate resources in areas with limited experts.

Re: Why has there been so little progress on Alzheimer's disease?

#14
post #7

Its done substantially better than more common diseases like ME/CFS which very few have even heard of let alone know the symptoms of and receives almost no funding at all. Alzheimer's received a further $100 million of NIH funding earlier this year ( https://www.alz.org/news/2026/100-million-dollar-alzheimers-... ). That is 6 times the total funding for ME/CFS federally which is currently just 15 million and planned…

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> long COVID is probably more accepted as a real thing by practitioners at this point than CFS

Isn't long covid just CFS that can be attributed to Covid?

If you accept that multiple viruses can cause "long " syndromes, of which long covid is just one example, it's plausible that CFS is really a cluster of syndromes, one category of which is these post viral syndromes. We just can't pinpoint the virus behind it every time because most viruses haven't been studied as much as Covid has.

Re: Why has there been so little progress on Alzheimer's disease?

#16

"One possibility: a leading hypothesis pursued by researchers (and funders) was built on science that now appears to be fraudulent." Possibly the most likely possibility?

There are multiple factors, but the one that contributes the most is that it's actually a very challenging disease to study and improve on.

1. It acts on the brain, one of the organs we understand the least.

2. It's relatively slow acting, and easy to miss in the early stages.

3. It impacts the older population which will have confounding health factors.

4. It doesn't fit neatly into a big category we already know a lot about, like infection or cancer.

Re: Why has there been so little progress on Alzheimer's disease?

#17

The major problem has been lock-in of the Abeta 42 peptide fragment as the cause. This monomaniacal focus was rewarded by grant awards to team players. Karl Herrup has a terrific book on the topic How Not to Study a Disease — The Story of Alzheimer’s from MIT Press (2021, ISBN 9780262045902). He did not win many friends but I think he is right. The consensus now is that many factors contribute to the heterogeneous di…

Reminds me of schizophrenia. A hodgepodge of different things lumped into a single label of "broad class of things we don't understand"

Re: Why has there been so little progress on Alzheimer's disease?

#18
post #4

Earlier quoted context omitted.

The article (or I guess more accurately "podcast transcription") seems to be saying that this lock-in essentially happened due to fraud, since some of the data was intentionally doctored to get the intended result. One of the guests seems to be an author of a different book about this (with the other guest being the scientist who apparently uncovered this). I can't personally attest to the accuracy of anything they s…

The focus is definitely on scientific fraud, but what makes the fraud so easy in this case is singing and selling the same song that the big teams are singing and selling. You can fly under the radar AND get funded, and if you are “lucky” become an ultra big shot like Masliah at NIA.

I don't buy the fraud explanation as the full explanation. Other areas of medicine (stem cell) has had bigger incidents of fraud on top of other major headwinds, and still has made more progress.

Fraud is everywhere and we still move forward in most arenas.

Re: Why has there been so little progress on Alzheimer's disease?

#20
post #13

TLDR: gatekeepers stifled exploration and innovation. When a topic only has a limited number of experts, those experts become gatekeepers. Those gatekeepers directly or indirectly control research funding. Gatekeepers necessarily harbor biases, some right and some wrong, about how the field should progress. For Alzheimer's, some gatekeepers were conflicted and potentially directed the field in the wrong direction. On…

> gatekeepers directly or indirectly control research funding.

Perhaps funding like public grants could be controlled by few? Should not the case for private money?

Relatively common health issues older people tend to get fair amount of private funding after all.

Rich people tend to be older and they are lot more likely to see amongst their friends and family Alzheimer's and Parkison's or even cancer and so forth and be worried about it and thus donate money to them.

In somewhat related (i.e. old people health concerns) life extension research gets all kinds of wacky non traditional research lines get funded all the time, I don't understand why would Alzheimer's would be any different.

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