Why has there been so little progress on Alzheimer's disease? • Hacker News Board

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

#351

Post by bradley13 » Thu, Apr 30, 2026, 8:36 AM UTC

skissane wrote: post #307

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:…

> 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: "adding gigatons of carbon to the atmosphere will _not_ change anything" is simply non-sensical. It goes against the basic rules of physics and causality. I'm happy to be proved wrong here, I just legitimately can't see how an alternative pos…

Exactly this. I want to be able to ask the questions above, but this is nearly impossible in most forums.

Question a clickbait "we're all gonna die" prediction, and you are immediately branded as a "denier", and no further discourse is possible.

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

#352

Post by ted_dunning » Thu, Apr 30, 2026, 11:18 PM UTC

verisimi wrote: post #110

dvfjsdhgfv wrote: post #95

Earlier quoted context omitted.

I think you are wrong, for several reasons. From the human perspective, researchers are people, and they do have their incentives. Making a breakthrough, of any kind, is important for them - even if for their career (but many do genuinely care and want to help humanity as a whole). From marketing and sales perspective, look at what happen to pharma companies capitalization when Ozempic appeared: a relatively small El…

Which illnesses have been cured? Diabetes, cancer? > From the human perspective, researchers are people, and they do have their incentives. Making a breakthrough, of any kind, is important for them - even if for their career (but many do genuinely care and want to help humanity as a whole). Researchers are people, but they are paid and directed. They can't go off and do what they like. The corporation directs them, a…

Actually quite a lot of diseases have cures. Many have very low cost cures or prevention.

And cancer isn't one disease. It is hundreds. Many of which have cures.

Diabetes was much harder to understand (and also isn't a single disease). Recent results have demonstrated islet cell transplants in type 1 that don't require life-long immune suppression. That isn't wide-spread yet but it is promising.

An interesting example of an actual cure is ulcers. Most humans who gets ulcers get them because of bacterial infection with H. Pilori. Killing that infection cures the ulcers. That didn't used to be possible because the cause wasn't understood.

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

#353

Post by ted_dunning » Thu, Apr 30, 2026, 11:21 PM UTC

leetnewb wrote: post #146

verisimi wrote: post #135

Earlier quoted context omitted.

I'm genuinely glad you have new treatments and its improving your quality of life. The point I am making is that you are a/ not getting cured, and b/ paying a lot of money. The reason for this, is this is best strategy for maximising profits. Its really the exact same model as your local heroin/crack dealer. Please set me straight if those conditions differ in your case. Profits are what pharma companies want. The co…

The local illicit drug dealer comparison doesn't apply because you can't simply ignore the development time and cost of FDA approved drugs. My post was about allocating limited capital to pharmaceutical research, and maximizing benefit. Again, if your choice is improving quality of care for 100 conditions or trying to moonshot your way to curing one disease, more patients benefit from the former even if pharma also p…

Your case is even stronger because understanding the 100 conditions is likely to lead to a few being cured and build the technology base for the moonshoot to be vastly easier.

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

#354

Post by ted_dunning » Thu, Apr 30, 2026, 11:25 PM UTC

londons_explore wrote: post #101

cpgxiii wrote: post #67

Earlier quoted context omitted.

> The FDA's approval process is stymied by a CYA culture that fails to adopt the risk profile it needs to in order to potentially save large contingents of sick and dying. Except the history of FDA approval here is that it has been too accepting of drug candidates for Alzheimers with very weak evidence of efficacy and serious side effects. This particular field would probably be better off if the FDA took a harder po…

I would like to see the FDA get rid of their binary "Approved" approach. Instead, at the start of a treatment on a patient, an analysis must be done of all available data, and the treatment only allowed if the error bars put it within the realm of the best treatment available. That means at the start when not much data is available, it is easy to give it to a patient. But over time as more data comes in it gets harde…

What you say is something that is actually already happening.

There is no longer a binary approval/non-approval status. Drugs and treatments that address terminal conditions often get special status. Drugs for rare diseases definitely get special treatment.

In addition, many studies now use continual data collection and evaluation. If the results are very good or very bad, that can be recognized much more quickly and with fewer people exposed to risk than previous types of studies. Reaction to negative events doesn't happen in hours, but it isn't all that far from that.

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

#355

Post by sien » Fri, May 01, 2026, 8:56 AM UTC

mnode wrote: post #92

gruez wrote: post #35

Earlier quoted context omitted.

> Problem was, the model was wrong. I thought despite the fraud, it's still the best model we have[1]? The fact there was fraud doesn't mean the model is immediately incorrect. At best, it means its foundations are shakier than we thought, but it's not a slam dunk repudiation. [1] https://www.astralcodexten.com/p/in-defense-of-the-amyloid-h...

Many in the research community realised the model was wrong a long time ago. This is a great read about the reasons why: 'How not to study a disease: the story of Alzheimer’s.' by Karl Herrup.

Thanks for recommending this book.

I'm now about half way through. It's really good.