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

freakonomics.com

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

#321

Post by zosima »

pcrh wrote: post #320
pfisherman wrote: post #299

Earlier quoted context omitted.

I don’t quite follow the reasoning behind this being “unbiased”. Studies must be designed to answer specific research question. What is the question being asked by the study in question. If the question being asked is whether AB the right target (in humans), then it would need to consider other forms of human evidence, such as genetic evidence, alongside alternative explanations of failure — bad molecule, wrong isofo…

The question asked in the Cochrane review linked to above is whether there is evidence that current treatments targeting amyloid provide relief. Their conclusion is that the effect is too small to be considered beneficial. Especially when considering the undoubted side-effects, which include edema and micro-bleeding in the brain. It doesn't ask whether amyloid is causative of the disease.

I wonder. Because if that was the question, why would they include anti-amyloid treatments that were never approved and are not part of any current treatment regimen and dilute the real effect of the approved antibodies? (Not that the approved antibodies are a silver bullet, but clearly they have some positive effect.)

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

#322

Post by pcrh »

zosima wrote: post #321
pcrh wrote: post #320

Earlier quoted context omitted.

The question asked in the Cochrane review linked to above is whether there is evidence that current treatments targeting amyloid provide relief. Their conclusion is that the effect is too small to be considered beneficial. Especially when considering the undoubted side-effects, which include edema and micro-bleeding in the brain. It doesn't ask whether amyloid is causative of the disease.

I wonder. Because if that was the question, why would they include anti-amyloid treatments that were never approved and are not part of any current treatment regimen and dilute the real effect of the approved antibodies? (Not that the approved antibodies are a silver bullet, but clearly they have some positive effect.)

The Cochrane review did not ask the question of whether Lecanemab (for example) worked, it asked the more general question of whether targeting amyloid worked. If targeting amyloid, generally, worked you might expect all approaches to targeting amyloid to show some efficacy. So they included all those for which clinical trials had been conducted. Obviously some treatments didn't pass the threshold required and so were not subsequently approved. If you only included successful trials you would bias the outcome.

It's possible, of course, that some methods of targeting amyloid might work where others failed. But even those that claim success (Donanemab and Lecanemab) have a very modest benefit.

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

#323

Post by solumunus »

notepad0x90 wrote: post #230
solumunus wrote: post #59

Earlier quoted context omitted.

The potential profits from an Alzheimer’s treatment are extremely high, I doubt it’s being overlooked. > and it's hard to think our older loved ones might be affected A large proportion of people don’t need to think about it because they have witnessed the horrific effects on loved ones first hand.

but not as much as cancer or hiv

I can't see why HIV treatment would generate more profit than dementia, that doesn't make any sense to me. Dementia affects a lot more people, and it affects the wealthiest possible demographic. What is your logic there?

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

#324

Post by hcknwscommenter »

hotstickyballs wrote: post #169
stingraycharles wrote: post #158

Earlier quoted context omitted.

> It's much like climate science today: any dissent at all, even just questioning the predictions of catastrophe, immediately brands you as a heretic. I think this is not a great example, as there’s a huge group of people that, in fact, does not agree with the consensus and would happily fund research that (tries to) prove otherwise. I fully agree with your point, though, just not the example.

That’s not true. If you want to have a job at a prestigious institution then the research committees are pretty consistent in their biases.

There are so many counterexamples proving that your statement is just not true. I'll give you just one example, the Berkeley physics professor Richard Muller that took funding from the Koch foundation to attempt to "prove" that the satellite temperature data was "miscalibrated" and estimates of actual warming were overblown. Started the project in 2010. First published in 2011 showing that in fact the warming was real and using more advanced calibration techniques actually showed the warming was worse than we thought.

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

#325

Post by ddorian43 »

DANmode wrote: post #202
ddorian43 wrote: post #104

Earlier quoted context omitted.

What is your approach towards nutrition ? Meaning which exact diet do you expect to help in mental health?

Different person, unrelated to the above advertisement but: Sometimes any diet. Mental health struggles can exacerbate, (and be exacerbated by!) forgetting to eat, not wanting to eat, forgetting or passing up the things that keep you in homeostasis, choosing the less correct things because of an emotional response, a physiological response in a “diminished” state.

I asked because I already know the correct answer, which is "metabolic psychiatry", meaning versions of keto/carnivore/epilepsy-keto diets (the latter is the strongest).

Context for old people in assisted living: https://www.metabolicmind.org/resources/news-views/podcasts/...

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

#326

Post by Kim_Bruning »

tim333 wrote: post #245
jhedwards wrote: post #193

Earlier quoted context omitted.

> It's much like climate science today: any dissent at all, even just questioning the predictions of catastrophe, immediately brands you as a heretic. I'm not sure I understand this. We've added hundreds of gigatons of carbon to the atmosphere. There's no mystery here, it's basic physics and chemistry that this will change things, and it's accepted that we don't know exactly _how_ things will change. The alternative:…

Climate science is much more complicated - there are many things you could disagree with beyond will tons of carbon change things, yes or no. Like are we doomed or will it just get a bit warmer before we switch to solar for example. There are also money issues like with the alzheimer's situation. If climate change is dooming us then we should send more money to climate scientists.

> If climate change is dooming us then we should send more money to climate scientists.

Depends! If you're a large fossil fuel company, the obvious move might be to spend more money on advertising agencies scientists, or entire foundations who question climate science instead.

... which they did. https://link.springer.com/article/10.1007/s10584-013-1018-7

Meanwhile, the basics were known since the 19th century. https://www.rsc.org/images/Arrhenius1896_tcm18-173546.pdf

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

#327

Post by Yizahi »

tastyfreeze wrote: post #304
pfdietz wrote: post #303

Earlier quoted context omitted.

> It's much like climate science today: any dissent at all, even just questioning the predictions of catastrophe, immediately brands you as a heretic. The financial motivation for fraud is all on the side of climate-change denial. Literally trillions of dollars of motivation.

Hah! What do you call the cap and trade group? The whole trillion dollar "carbon credit market" is a farce built to profit from climate change catastrophism.

You are mistaking the beneficiaries here. Carbon credit scheme is indeed a greenwashing scam and it is pushed by the oil and gas (plus adjacent) industries. It is plainly obvious that shuffling emissions between jurisdictions does jack shit against reducing the actual real amount of emissions to the atmosphere. Basically the main proponents of the carbon credit fraud are the same people financially motivated to reject long term climate change consequences (aka anti-"catastrophists" in your lingo).

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

#328

Post by tim333 »

idiotsecant wrote: post #308
tim333 wrote: post #245

Earlier quoted context omitted.

Climate science is much more complicated - there are many things you could disagree with beyond will tons of carbon change things, yes or no. Like are we doomed or will it just get a bit warmer before we switch to solar for example. There are also money issues like with the alzheimer's situation. If climate change is dooming us then we should send more money to climate scientists.

I am baffled by the number of people on HN, presumably a website for and by technical people, who fail to consider secondary and tertiary effects when it fits their worldview to do so. There is a yawning abyss of states in between extinction and 'boy sure is a few degrees warmer out here' and none of them are good. Many organisms would benefit from a warmer climate, just not humans. We rely on extremely narrow condit…

I get your point but on the other hand humans live quite well in places like Medicine Hat say where it swings from -40 C in winter to +40 C in summer. Against that the likely warming by say 2100 is I think 1.5C up from what it is today which might be just about noticeable?

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

#329

Post by throw4847285 »

yxhuvud wrote: post #208
throw4847285 wrote: post #198

Earlier quoted context omitted.

"Consensus science" is science.

Yes, though when the consensus doesn't work for predictions then it is a matter of time until it stops being science.

A degenerating research programme.

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

#330

Post by red-iron-pine »

idiotsecant wrote: post #308
tim333 wrote: post #245

Earlier quoted context omitted.

Climate science is much more complicated - there are many things you could disagree with beyond will tons of carbon change things, yes or no. Like are we doomed or will it just get a bit warmer before we switch to solar for example. There are also money issues like with the alzheimer's situation. If climate change is dooming us then we should send more money to climate scientists.

I am baffled by the number of people on HN, presumably a website for and by technical people, who fail to consider secondary and tertiary effects when it fits their worldview to do so. There is a yawning abyss of states in between extinction and 'boy sure is a few degrees warmer out here' and none of them are good. Many organisms would benefit from a warmer climate, just not humans. We rely on extremely narrow condit…

> Many organisms would benefit from a warmer climate, just not humans.

and a whole fuckin lot that wouldn't, and that may collapse the ecosystem

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