Charles Piller

through good nutrition, exercise, controlling high blood pressure, controlling cholesterol levels, using your mind, reading, having good social relationships.

These are all things that can forestall the worst effects of Alzheimer's if you're unfortunate to be someone who ends up getting the disease.

There, in my view, is no

brain game or supplement or exercise regimen that will definitively stop a person from getting Alzheimer's.

But we know that this combination of effects, things that pay dividends in our lives generally, can be extremely important in forestalling or preventing the worst effects of the disease.

And so I would just say people should remember that they have some agency in their lives, and that's one factor.

The science, the scientists who are proponents of the amyloid hypothesis, who again, in my view, have important points to make, but their ideas should not prevent people from exploring other ways of looking at the disease and finding the combination of factors that might lead to Alzheimer's disease.

But I think what they're advocating for is to treat early and earlier with these anti-amyloid drugs that again, as I mentioned, have potentially beneficial effects, if very subtle effects on cognition.

In other words, to reduce the rate of cognitive decline that people might experience.

But when they're describing the idea of

giving these drugs to younger and younger people.

I think people should be cautious in adopting that advice, particularly people who have no symptoms of cognitive decline, but may have evidence of amyloid and tau proteins in their brain.

young people who have those symptoms, have those evidence of those proteins, might at some point be encouraged to take these drugs.

And I think you need to proceed down that path with great caution because of the potential hazards associated with them.

John, let me just say that I, again, I just want to emphasize that I think most scientists would never manipulate images.

But even a minority of scientists who do can have profound effects on thinking in the field, which is what I discovered in my work.

And I would say then that, yes, image manipulation is unfortunately quite common.

And part of the reason for it is that I think scientists sometimes become very convinced of their ideas in ways that they follow a kind of slippery slope where they might make a small change in an image in order to

exaggerate the beneficial results of a study and that they see that no one notices that they made an improper change.

And they think this is good because I'm very convinced of the truthfulness of my science and the importance of my science.