671. Why Has There Been So Little Progress on Alzheimer’s Disease?
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What recent advancements have been made in early detection of Alzheimer's disease?
You may have seen the news recently about two new FDA-approved blood tests that may detect Alzheimer's disease in the early stages. Early detection is important for any disease, but especially for Alzheimer's, which can take root for 20 years before symptoms develop. These symptoms, as you probably know, include memory loss and other cognitive, physiological and behavioral issues. The reason I say that you probably know these symptoms is because Alzheimer's affects more than 7 million people in the U.S., most of them over 65. Age-related memory loss has been seen throughout human history, but the disease was not formally documented until 1906 by the German physician Alois Alzheimer. When Alzheimer autopsied the brain of a woman who had had memory loss and hallucinations, he found that her brain had shrunk and withered with numerous tangles and what he called peculiar deposits.
How has the history of Alzheimer's research shaped current understanding?
Scientists have been trying to figure out those deposits and tangles ever since. The National Institutes of Health spends around $4 billion a year on Alzheimer's and dementia research. That's up from around $1 billion a decade ago. And that puts it second only to cancer spending, which makes sense because the elderly population in the US is big and getting bigger. Much of this Alzheimer's research is centered around one dominant theory of the disease. But what if that theory is flawed?
What are the implications of flawed research in Alzheimer's studies?
No one's getting better with these drugs. Every scientist who works with them, every clinician, will say the same. If they don't, they're lying.
So is flawed even the right word, or should it be fraud?
Cheaters tend to cheat. When we find clear, overt problems in a paper or in a group of papers, often it propagates through somebody's entire work.
Today on Freakonomics Radio, we follow an investigation that found decades of problematic Alzheimer's research. And we ask, with some sense of earned optimism, where does Alzheimer's treatment go from here?
What environmental factors contribute to the risk of Alzheimer's disease?
This is Freakonomics Radio, the podcast that explores the hidden side of everything with your host, Stephen Dubner.
The story we are telling today is a sobering one and an important one. We'll hear from two people. We had hoped there would be more, but in the end, the others did not want to talk. You'll understand why as we go. Let's start here.
My name is Charles Piller. I am an investigative journalist with Science Magazine and author of the book Doctored.
The full title of Piller's book is Doctored, Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer's. Charles Piller has been a journalist pretty much his entire adult life.
I grew up in the Chicago area. I became interested in reporting kind of the way that so many people, boomers like me, did, being inspired by the Watergate investigations. I was too young to be a journalist then, but not too young to be inspired and thinking about things, particularly during the Vietnam War period and all of the societal challenges there.
Pillar is 71 years old. Before coming to Science Magazine, he wrote for the LA Times, the Sacramento Bee, and the life sciences news outlet, Stat. For the past several years, his reporting has been focused on Alzheimer's research. I asked him why.
Well, the answer is, to me, pretty clear, and that is that unlike cancer, diabetes, heart disease, and myriad other ailments that afflict us, Alzheimer's disease is something that the nation and the world has spent tens of billions of dollars on in recent decades, and yet we have no cure.
How does the amyloid cascade hypothesis explain Alzheimer's progression?
that arrests or reverses the terrible cognitive decline of the disease. And so even though there may be corruption in cancer research or in heart disease research, we've seen enormous advances in those diseases and sometimes even real cures for specific ailments that have benefited society dramatically. We have not seen that in Alzheimer's disease, and that makes it not just more tragic but also terrifying for people who are facing those possible symptoms.
What is the thinking on potential environmental drivers of Alzheimer's disease?
Yeah, it's a great question.
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Chapters
8 chapters
1
What recent advancements have been made in early detection of Alzheimer's disease?
0:03–0:59
2
How has the history of Alzheimer's research shaped current understanding?
0:59–1:33
3
What are the implications of flawed research in Alzheimer's studies?
1:33–2:22
4
What environmental factors contribute to the risk of Alzheimer's disease?
2:22–4:17
5
How does the amyloid cascade hypothesis explain Alzheimer's progression?
4:17–5:48
6
What ethical concerns arise from the whistleblower's investigation?
5:48–7:29
7
What challenges do researchers face in developing effective Alzheimer's treatments?
7:29–10:07
8
Is there hope for future breakthroughs in Alzheimer's research?
10:07–1:01:15
Speakers
5 identifiedMore from Freakonomics Radio
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