Sandra Day O’Connor, Stanley Prusiner, and Ken Dychtwald published an Op-Ed in the New York Times on October 27, 2010 titled The Age of Alzheimer’s. O’Connor is a retired associate justice of the Supreme Court. Prusiner, received the 1997 Nobel Prize in Medicine and is the director of the Institute for Neurodegenerative Diseases at the University of California, San Francisco. Dychtwald, a psychologist and gerontologist, is the chief executive of a company that consults with businesses about the aging world population.
Their brief piece recites the grim fact that Alzheimer’s Disease will affect a large portion of our elderly population, a segment that is growing faster than any other. They repeat the well known social, personal, and economic consequences of this devastating phenomenon. They call for a increase in federal funding aimed at finding a cure and/or a prevention for Alzheimer’s Disease. They cite the successful government effort to fight AIDS as an example of what focused government supported research can do. Given the prominence of the authors and that of their platform it’s likely that we will rush out and do what they propose without taking a little time to think about it. A sprint to spend without a modicum of prefatory analysis does not just affect profligate progressives; conservatives have already jumped on the the $2 billion bandwagon – that’s the number O’Connor, et al propose, a figure that will doubtless grow exponentially between now and tomorrow. They justify this spending by citing the potential savings that will accrue when we control Alzheimer’s Disease.
The AIDS analogy is not apposite. There is just one cause of AIDS – the human immunodeficiency virus. The effort against AIDS required only an effective vaccine or effective antiviral therapy. More than a quarter of a century after HIV was recognized as the cause of AIDS we still lack the former. It was successful antiviral treatment that brought the AIDS epidemic potentially under control. The difficulty facing science with Alzheimer’s Disease is much more daunting than that faced by researchers dealing with AIDS a generation ago.
To begin with while O’Connor, et al write about “Alzheimer’s Disease” they really mean dementia. At least half the people afflicted with dementia do not have Alzheimer’s Disease. Dementia is a group of symptoms characterized by a decline in intellectual function severe enough to interfere with a person’s normal daily activities and social relationships. In addition to Alzheimer’s Disease other causes of dementia in older people are multi-infarct dementia which is caused by a series of strokes (as many as 40% of case of dementia are due to this syndrome), Creutzfeldt-Jakob disease, normal pressure hydrocephalus, Pick’s disease, Parkinson’s disease, Lewy body disease, and Huntington’s disease. Symptoms of dementia may also result from depression, drug interaction, metabolic disorders (such as thyroid problems), head injury, vision or hearing problems, tumors, and infection.
Thus declaring war on “Alzheimer’s Disease” means engaging in hostilities against a host of foes. Remember how the War on Cancer is going- 40 years and counting. Consider this from the Op-Ed: Most of the medical researchers who study Alzheimer’s agree on what they have to understand in order to create effective drugs: They must find out how the aberrant proteins associated with the disease develop in the brain. They need to model the progression of the illness so they can pinpoint drug targets. And ultimately they must learn how to get drugs to move safely from the blood into the brain.
A breakthrough is possible by 2020, leading Alzheimer’s scientists agree, with a well-designed and adequately financed national strategic plan. Congress has before it legislation that would raise the annual federal investment in Alzheimer’s research to $2 billion, and require that the president designate an official whose sole job would be to develop and execute a strategy against Alzheimer’s. If lawmakers could pass this legislation in their coming lame-duck session, they would take a serious first step toward meeting the 2020 goal.
Even Dr Mengele would want to rid the world of Alzheimer’s Disease, but is ramming a bill through a lame duck session of congress the right way to do it? Read the bill linked above and you’ll see that it includes the usual suspects corralled when the federal government wants to spend a lot of money without offending a key interest group. The bill even establishes another czar. It doesn’t say anything about all the other causes of dementia besides Alzheimer’s Disease. The proponents of this legislation are not disinterested observers. They have been personally affected by family members with dementia or would benefit from the expenditure of billions of dollars by the federal government which would flow to their labs, universities, and institutes. And make no mistake about the $2 billion price tag; it’s just the first week’s rent.
It’s pure baloney to predict that we’ll have dementia under control in 10 years. This is a formidable problem that likely will require generations of work before we have effective preventions or treatments available. Am I advocating inaction and neglect? Of course not. What we should do is fund the best science that’s available. The problem is that we can’t be sure where this science is. You’d likely start with neuroscience, but many of the causes of dementia do not belong to neuroscience and even those that do may find their solutions in another branch of science.
This argument is not likely to be very appealing to those who sincerely want to do something about Alzheimer’s Disease and its cognates. Appointing a czar and a lot of committees that are politically correct (read the bill it’s only 6 pages) will spend a lot of money trying to do something specific about Alzheimer’s Disease (even if totally ineffective). This targeted approach is much more soothing to the psyche than supporting non-directed research that that may eventually pay off but which before it does may seem unrelated to dementia in general and Alzheimer’s Disease specifically. This is another case of genuinely good intentions taking us on another expensive trip to nowhere. It’s feel good legislation which once in the budget can never be cut. Can’t you hear the cries of “They want to kill old people especially those with Alzheimer’s Disease.”
The Age of Alzheimer’s is another reason why government budgets endlessly increase and why government spending can never be cut. There’s always another good cause that needs more money. Spending this money, we’re reflexively assured, will save money in the long run. Remember what Keynes said about the long run.
Hurrying science is sometimes hazardous. Read Alzheimer’s Drug Trial Reports Nine Deaths, Patients Withdrawn. The drug (ELND005) received fast-track designation by the U.S. Food and Drug Administration in April 2009, a designation that allows for a quicker regulatory review process for new drugs that are seen as necessary for treating serious conditions that have no current treatment available.
We get old and die. How many billions will they have to spend to figure that out.
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Being a primative (cheap) thinker I would compare populations with and without (or minimal) these problems and look at the differences. Think of water alone, our “universal” solvent. Just imagine the magnitude of differences. You would not believe the mistakes water companies make.
As you mentioned above, even the medical community tends to confuse Alzheimer’s with Dementia. I have seen many cases of vascular dementia (which is also a clinical diagnosis) being treated and confused as Alzheimer’s type.
I do not believe that we are even close to find a cure. We have though a show full of lights and reflectors for a group of diseases (Dementia) for what we know little, and for what we have a social pressure to give an answer or at least to use the words “fighting for a cure” . Our efforts should move to another direction, to tell the society that there is nothing wrong to die, especially with chronic diseases that usually hits you after the 8th decade, and instead to provide the best support possible. What would be of us if we are able to cure everything? Will we consider then aging as a disease? Arrogance is in our scientific name of Homo sapiens (wise man), instead we should be Homo insensatus!
An important data is also that current therapy is almost futile, I do not believe in Namenda or Galantamine in “most situations”. NICE guidelines (in England) are more pragmatic, and they recommend the discontinuation of these drugs if no clinical benefit has been shown after 6 months by a family member, caregiver or physician. These medications have not shown not only to reduce the progression of the disease, but not even to increase the placement in a nursing home. I am sure that most prescribers believe more on these drugs than on what they really do.
Many forms of dementia, including Alzheimer’s disease, are directly and indirectly the result of a toxin called peroxynitrite. Peroxynitrites can be scavenged by essential oils high in polyphenols (cloves, cinnamom leaf, bay leaf, thyme, rosemary, sage, etc.). These same essential oils can partially reverse the damage caused by peroxynitrites, such as the nitration of tau proteins and the oxidation of a variety of g protein coupled receptors (including oflactory, muscarinic, serotonin, and dopamine receptors). The chronic administration of essential oils via aromatherapy results in better memory, improved sleep, improved mood, greater alertness, and more awareness. As several small-scale clinical trials have concluded, Alzheimer’s disease can be treated (not cured) immediately and effectively with the use of aromatherapy.
Diseases are not cured not because they are impossible to figure out; they are not cured because current “treatments” generate billions of dollars in profits. Moreover, actually treating the disease effectively would mean the loss of billions of dollars in research funds for organizations and institutions supposedly interested in finding cures for diseases.
Very interesting. So aromatherapy is superior to ingesting?? I noticed that even without dementia (yet) my new atomizer helped my sleep very much, but it took about 4 nights to take effect. I get not more sleep, but much more relaxed sleep. After a month or so I didn’t need it anymore.
Just the opposite with many non drug sleep aids (various herbs, tryptophane). Helped a bit for a few days then didn’t anymore.
Operafilly
In Alzheimer’s disease (and perhaps also in some people without dementia), the polyphenols in essential oils help reverse the oxidation of serotonin receptors. This increases serotonin levels (better mood) and melatonin levels (melatonin is derived from serotonin). More melatonin can lead to more relaxed sleep. For an interesting study on this, see ECU News Services: ECU therapist studies links between scents and memory (via internet).
Ingested polyphenols do cross the blood-brain barrier, but they are not as effective as when inhaled. In the latter case, they directly reach the part of the brain most affected by the disease (the hippocampus). One of the knocks against the use of aromatherapy in Alzheimer’s disease is the diminished sense of smell in Alzheimer’s patients, but the inhaled essential oils also partially reverse the oxidation of olfactory receptors. The essential oils, thus, may in some cases help people with sleep problems, depression, and impairment of smell, as well as dementia.
Fascinating article……..reversing the oxidation of seratonin receptors……… helps behaviour problems in kids………
Thanks so much for sharing.
Regards your earlier comments, health & medicine are the same to the populace. I think a proper definition would be medical & drug insurance, not health insurance. Until many people demand none-drug alternatives it won’t change. And it takes practice to learn to say no to a doctor.
Operafilly
***Diseases are not cured not because they are impossible to figure out; they are not cured because current “treatments” generate billions of dollars in profits. Moreover, actually treating the disease effectively would mean the loss of billions of dollars in research funds for organizations and institutions supposedly interested in finding cures for diseases.****