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The false hope of the new Alzheimer’s drugs Are they as effective as Big Pharma claims?

(Credit: Ryan Pyle/Corbis via Getty)

(Credit: Ryan Pyle/Corbis via Getty)


and
January 23, 2024   8 mins

“Dementia steals people’s lives, turns their relationships upside down, destroys their hopes and dreams,” said David Cameron, as president of Alzheimer’s UK. This was back in 2017, and his ambitions were impressive: the Government had just published plans for £60 million research funding a year to bring together industry, charities and academia to “accelerate progress towards disease modifying therapy, and ultimately a cure by 2025”.

So, how likely is that? Are we really on track to be one year away from a cure? Right now, dementia and Alzheimer’s disease are the leading cause of death in England and Wales, with the number of cases predicted to triple over the next 40 years. That means, if nothing changes, one in two of us will be directly affected by it — either by caring for someone with the condition, or developing it ourselves. Yet no new drug has been approved for Alzheimer’s in 20 years.

No wonder, then, that at the end of last year, the news that two new dementia drugs were set to be approved for use in Britain was greeted with great excitement. The drugs, lecanemab and donanemab, were both celebrated as a “new era” in Alzheimer’s treatment, claiming to slow the progression of disease. Until now, treatment has only slightly alleviated the symptoms, at best. Since the announcement, Alzheimer’s Research UK and the Alzheimer’s Society have renewed efforts to get them to patients.

Now, we are told that “routine screening for over-50s [is] closer”. Research published this week in JAMA Neurology linked blood test results of a protein implicated in Alzheimer’s disease, tau, to a later changes on scans. The clamour for the “wonder drugs” will inevitably grow louder. But can we believe the hype?

Dementia has long existed across human history. And Alzheimer’s is the most common form. While advances in medicine have increased our understanding of the disease, and we know that age, genetics and lifestyle play a part in the progression of it, we still don’t know what triggers it. Aluminium exposure is one theory; infection and immune system malfunctions have also been posited, though are treated as unproven. But the most enduring one, and the one into which most funding flows, is the “Amyloid Hypothesis”.

Amyloid protein is found in all healthy people but in Alzheimer’s disease, the protein is found to have behaved abnormally: it clumps together forming plaques which cause “tangles” which disrupt communication between the brain cells. The cells malfunction, die and, over time, different areas of the brain shrink. The “clumps” cause the production of another protein, tau, which causes tangles and more damage; the two have been called the “trigger and bullet” in the disease. 

The two new “wonder drugs” both address the amyloid theory. Both are “monoclonal antibodies”, which target the protein in different ways. Donanemab’s antibodies recognise and remove amyloid when it is in plaque form, while lecanemab targets the amyloid as it forms fibres and tangles. But they don’t come cheap. Lecanemab is priced at £21,000 per patient annually with donanemab expected to be similar. And this, along with their efficacy, will be what Nice is looking at before it decides to recommend the drug — or not — later this year.

The new drugs certainly seem credible. Large trials have been conducted and published in high-profile journals, examining their impact on memory, brain scans and blood test results.

The Trailblazer study investigating donanemab was published in JAMA last year. It assessed over 1,700 adults, with an average age of 73, who had been diagnosed with early Alzheimer’s. Over 18 months, half of those studied received the active drug and half the placebo, all of them completing disease scores, indicating symptoms and cognitive ability as the trial progressed.

Eli Lilly, the drug developer, stated in a press release that “47% of participants on donanemab showed no decline on CDR-SB, a key measure of disease severity after 1 year, compared with 29% of participants on placebo.”  Moreover, “participants on donanemab had 40% less decline in ability to perform activities of daily living at 18 months”. Meanwhile, images of brain scans which seem to persuasively illustrate the disappearance of amyloid were widely published.

Given that dementia progresses over a period of time at differing speeds, the developers were keen to highlight their “rate of decline” measurement. The implication of their results was a significant slowing of the disease. But that by no means tells the whole story. Participants in the trial also had their cognitive function measured on the Alzheimer Disease Rating Scale. For those taking the placebo, their scores dropped by an average of 13 points. For those taking donanemab, their scores also dropped — but by an average of 10 points. So both groups found their cognitive function worsened, but with a difference of three points on a scale of 146. The question to ask must surely be: how much difference do those three points make.

As for the lecanemab trials, Biogen and Eisai announced “highly statistically significant results… representing a 27% slowing of decline”. These were conducted in a slightly different fashion. The 1,795 adults, ranging in age from 50-90, were assessed on an 18-point score in tests which looked at their memory, problem solving, hobbies and abilities in personal care. Half got the active drug, the other half, placebo.

After 18 months, both groups had experienced decline, as would be expected in people with dementia. Those taking lecanemab had scores which had declined by an average of 1.21 points. And those on the placebo had deteriorated more, by an average of 1.66 points over the course of the trial. That’s a difference of 0.45 points on an 18-point scale, described as “moderate” in the paper.

It is also important to note that the people who were recruited to the trials were only those with the “purest” forms of Alzheimer’s. For every 10 patients put forward, seven or eight were rejected. Those who were accepted had high amyloid levels but were relatively young and free of other diseases. To pick these patients, according to Dr Seb Walsh, a public-health doctor researching dementia at Cambridge University, is to misrepresent how the disease occurs among the vast majority of the population. Most people’s dementia is complex, occurring when they are in their eighties, and caused by several disease processes.

“By selecting amyloid-only patients,” he says, “they were giving the drug the best possible chance to show an effect, and yet even so they found an effect (after 18 months of fortnightly infusion treatment) that was so small it probably wouldn’t be noticeable to a doctor.” If the drug were given to a broader range of people diagnosed with Alzheimer’s disease, the already-small improvements might even disappear altogether.

And there’s another problem. The side effects.

Over a quarter of the participants in the lecanemab trial suffered drug infusion reactions, while there was brain swelling (which can be mild, such as flushing, or more severe, with changes in breathing and heart rate) in 13%. Others experienced headache, confusion and visual disturbance. Donanemab had similar side effects and three people also died in the trial — something researchers ascribed to the treatment.

So, while the press releases make a persuasive case for the effectiveness of the drugs, the overall difference is so small as to invite the question as to whether patients or families would even notice. What sort of improvement would these small differences represent in the real-world? And more important: are they worth the risk?

“My view,” says Professor Robert Howard, Professor of Old Age Psychiatry at University College London, “is that we’ve just about reached the point where we couldn’t have treatments that remove amyloid more aggressively because of the side effects of brain bleeds and swelling.”

It is this finding that is exercising — and dividing — scientists. For what does it mean for the new drugs if, as the trial showed, a big reduction in brain amyloid doesn’t translate into a hugely impressive reduction in or slowing down of symptoms.

One body of clinicians continues to hold to the hypothesis. Craig Ritchie, a Professor of the Psychiatry of Aging at the University of Edinburgh, worked on the donanemab trial and claims it has “a profound effect on the core pathology of Alzheimer’s disease namely cerebral amyloid”. He maintains that the slowing of the progression of the disease coupled with a reduction in amyloid build-up is not a coincidence. He believes that more time is needed to show the full impact of the reduction in amyloid on symptoms. “These drugs give us hope that we can do something, that these are the first drugs of an important new generation of treatments.” In order to push out this treatment, he has quit the NHS and set up Scottish Brain Sciences as an “independent research company” to run studies and give patients free access to the latest diagnostic tests and medications through trials funded by the drug industry. He, too, is funded by the industry.

These proponents of the new drugs also insist that monoclonal antibodies will show more impact if they are given before amyloid has damage to the brain. Therefore, they say, it needs to be given earlier — possibly even before someone has any symptoms of dementia.

That’s where the proposal that screening people — the so-called “Alzheimer’s blood test”  would come in. It would test people before they have any memory problems for their future dementia risk. But, offered as a “check up”, it would come with wide ethical issues. There would inevitably be false positives and negatives — causing needless anxiety or false reassurance. Nor would a result necessarily lead to people being offered treatments that could lower their chances of getting dementia later. But could it make sense in a research setting, as an opportunity to try these new treatments to see if they could make a difference if given earlier? 

Professor Howard is sceptical. The amyloid treatment, he says, “is a cul de sac, a dead end. And, worse, it means that the money and energy in drug development and trials isn’t being put into something that might work.” he says. “The argument that maybe the drugs need to be given earlier to make a difference is really just a wish or a hope. There is no data to suggest that it is true,” he says. “I worry that the “treat earlier” argument has become a way of saying ‘don’t blame the drugs for not working, blame the patients’.”

Various Alzheimer’s charities have heavily advocated for these drugs to be made available quickly. When lecanemab was approved in the US, a public letter hosted by the US Alzheimer’s Association in 2023 described it as “a foundational gamechanger”, saying: “No barrier can be allowed to stand between our patients and a treatment that has a reasonable risk-benefit ratio.” There may be a less philanthropic reason why they are so enthusiastic about the new treatments. A closer look at the signatories revealed that some had drug industry connections. And the charity itself received over $750,000 from Eisai and $430,000 from Biogen in 2023, who make lecanemab.

The inevitable result of these two amyloid-removing drugs being licensed means all drug companies will want to make and market their own versions, regardless of the criticisms. After all, it’s harder for regulators to say “no” when there are similar drugs on the market and the big charities are rooting for them.

But that hasn’t stopped the charities from investing £5 million in developing a blood test that will “revolutionise dementia diagnosis”. They say that currently only 2% of people get the detailed diagnosis they need and that significant investment is needed to ensure the NHS can identify people with Alzheimer’s disease far sooner. The Blood Biomarker Challenge, available within five years, will help do that. “If we can fix diagnosis, we open the door for a cure. It’s a bold ambition but, with someone developing dementia every three minutes in the UK, we must aim high,” they say.

But Dr Seb Walsh, a public health doctor researching dementia at the University of Cambridge, says the hype and hope is unkind: “For 20 years we have been promised wonder drugs within 5 years — but still we wait,” he says.

He also says it’s bad research practice to pre-empt your results before you do the research. “We don’t know how useful these tests will be, how well they’ll perform in the ‘typical’ NHS dementia patient (more complex than the people in existing research studies), that’s the whole point of doing the research.”

But the key question, and the one that Nice will be weighing up over the course of the year, is whether any of these new drugs represent the best use of public money. Given the small benefits, the risk of side effects, but the lack of other decent alternatives, the question will be how to weigh that up as independently as possible. Spending similar sums on social care might well provide greater benefits for patients and families than the drugs. Is it right that a drug — with minimal benefits — should be funded when the same money invested into social care might do more good for patients and families getting more practical help?

Obviously, a drug that worked would have massive, global market potential. But the hyperbole from doctors and researchers in this area — especially those with industry funding — is unhelpful. It means that the pressure to upsell the effectiveness of a drug is particularly intense. This, then, diverts money into look-alike drug development and drains it from continued research. Clearly the pharmaceutical industry and its relationship with the private and public sectors has a lot to answer for. Currently, Alzheimer’s has no cure and treatment has progressed little despite decades of research and billions of pounds. As our investigation shows, we should be cautious about the promise of these new “wonder” drugs which risk benefiting only the drugs companies.

“There is still much we don’t know, but we really need to know,” Dr Walsh says. “We are unlikely to ever, truly ‘cure’ dementia — this is more false hope.”


Deborah Cohen is an award-winning, medically qualified TV, print and radio reporter.

 

 

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J Hop
J Hop
4 months ago

Not only are these drugs harmful and non-effective, but the amyloid theory of Alzheimers is dead on delivery. It’s being artifically kept alive by the promise of more and more profitable drugs, much like the lipid hypothesis keeps statins alive. The amyloids are a symptom not the cause, just like cholestrol plaques are a symptom and not the cause of heart disease. Alzheimers is a metabolic disease, just like most cancers. https://pubmed.ncbi.nlm.nih.gov/24249045/

Muiris de Bhulbh
Muiris de Bhulbh
4 months ago
Reply to  J Hop

Whereas I don’t share your scepticism on statins, I am much more open to it with these drugs. Meanwhile Thomas H Bak, an Edinburgh based cognitive neuroscientist (@thbaketal) has shown that multilingualism delays dementia by 4-5 years, but that doesn’t make a profit for anyone.

Caradog Wiliams
Caradog Wiliams
4 months ago

Your last point says it all. We are all in self-destruct mode from the day we are born and we rely on the drugs to keep us alive. Isn’t it time to focus all this money and time on changes to lifestyle? Unfortunately, governments will have to do the hard work because individuals (under 30s say) don’t believe that they will ever get old.
I think you are a doctor and you are wrong about statins – you have been brainwashed.

Steve Murray
Steve Murray
4 months ago

I think you’re right. GPs are incentivised to push statins into their older patients regardless of need, since they get paid to meet a certain percentage of their patient population who’re taking them.

David Lonsdale
David Lonsdale
4 months ago
Reply to  Steve Murray

A recent telephone conversation with a GP (not my appointed one).
Doc. “Your blood test shows a raised cholesterol level. I’d like to prescribe you a statin.”
Me. “Don’t bother, I won’t take them.”
Doc. “Oh, why?”
Me. “…their benefits are grossly exaggerated. For instance, the Relative Risk Reduction is always quoted, when the Absolute Risk is more relevant and a lot lower.”
Doc. “But you must be aware, the trials are funded by the manufacturers so there’ll always be some exaggeration.”
Me. (to myself) “WTF!”

Muiris de Bhulbh
Muiris de Bhulbh
4 months ago
Reply to  David Lonsdale

Of course the absolute risk reduction is lower, because fewer than 100% of the population is affected. Your point is very valid for rare events, halving the risk from say 1/10m to 1/20M is irrelevant for most of us, not so valid for commoner life changing conditions. I also agree that jumping to long term medication should be the last option, not the first.

Muiris de Bhulbh
Muiris de Bhulbh
4 months ago
Reply to  Steve Murray

I have never accused someone with whom I disagree of being brainwashed. It says more about you, than it does about me.

Muiris de Bhulbh
Muiris de Bhulbh
4 months ago

Apologies, that should be a reply to Caradog Williams.

Jason Smith
Jason Smith
4 months ago

Blimey, the commentators on this site are reliably the most miserable bunch of misanthropes on the internet. Firstly, in the west we live longer, healthier and happier lives than at any time in history. Secondly, I think the government already does more than enough nannying of the population.. We all know what we should do to stay healthy – eat more veg, regular exercise, don’t drink. We just choose not to. The problem is that many are unwilling to accept the consequences of not doing those things, and so cry to the government to make them stop. Frankly, if these drugs help slow down dementia, I’m all for carrying on with the research.

Steve Murray
Steve Murray
4 months ago
Reply to  Jason Smith

Don’t drink?? What you mean is (and yes, i’m putting words you should’ve used into your mouth here) “don’t drink excessively”. There are health benefits to a couple of glasses of fresh ale or wine (red in particular) a few times a week, preferably in a social setting.
Being abstemious certainly doesn’t lend itself to being less miserable!

Victoria xx
Victoria xx
4 months ago
Reply to  Steve Murray

I think those benefits are largely down to the social setting!!

Steve Murray
Steve Murray
4 months ago
Reply to  Victoria xx

No only the setting. There are compounds in both cask ale and red wine which boost the immune system and help keep blood vessels in good condition. The key, as in most things, is moderation and enjoyment rather than drinking for the sake of it.

J Hop
J Hop
4 months ago
Reply to  Steve Murray

There aren’t any health benefits to drinking actually, as the reservatol etc in the booze is offset by the presence of the neurotoxin, ethanol. It’s like adding eucalyptus leaves to your tobacco cigarettes and saying it’s a healthy de-stressor.
That said, drink up in modertation, sure! I do and my husband enjoys a cigar every now and then and we both indulge in cake and cookies on occation. Just don’t think it’s good for your body. It’s an unhealthy indulgence, no matter what the booze companies say.

Steve Murray
Steve Murray
4 months ago
Reply to  J Hop

So basically, there are health benefits, which you’ve identified and tried to offset. It’s like life; you either live it by avoiding any risks or you accept that everything (worth doing) may have a downside.

I’ll take the risks.

J Hop
J Hop
4 months ago
Reply to  Steve Murray

If you mean the benefit is doing something unhealthy just because you enjoy it and life is short then yes, I wasn’t offseting it I was openly supporting it.

Steve Murray
Steve Murray
4 months ago
Reply to  J Hop

It’s not unhealthy, since you’ve readily identified the health benefits. The upsides outweigh the downsides, if enjoyed in moderation. It’s not an “indulgence” – it’s a simple activity as old as humanity (there’s evidence of brewing ale going back into pre-history). If you don’t wish to imbibe, that’s fine with me, but please, spare us any further homilies.

J Hop
J Hop
4 months ago
Reply to  Steve Murray

There are mental health benefits but not physical benefits is my point and I DO inbibe. I drink on the regular and am not telling people not to, just saying there are no physical health benefits. Geez! Go have a drink already.

Madas A. Hatter
Madas A. Hatter
4 months ago
Reply to  Steve Murray

The human immune system cannot be ‘boosted’. It can malfunction but is already an amazingly complex self-regulating constellation of processes.

Bruno Lucy
Bruno Lucy
4 months ago
Reply to  Steve Murray

My grandfather had his calvados every day day that Hod made, smoked like a chimney and died the ripe age of 93 and more because he was bored my grandmother having predeceased him.
statistically it is a non starter but although they lived through 2 wars, there must be something connected to lifestyle.

jane baker
jane baker
4 months ago
Reply to  Steve Murray

The old joke,you won’t live longer,it’ll just feel like it! I don’t drink,I don’t like the bitter tang of alcohol,but I get the joke!

Caradog Wiliams
Caradog Wiliams
4 months ago
Reply to  Jason Smith

We certainly live longer. We are healthier if you include diseases like TB, smallpox, diphtheria. But we are definitely not fit, as in we don’t walk in the fresh air. Arguably, this makes up more unhappy than we were.

Damon Hager
Damon Hager
4 months ago
Reply to  Jason Smith

I agree with you about lifestyle, but it’s important that people aren’t needlessly deceived about illusory wonder drugs.
“Let’s be frank,” I said to our family doctor when my mother was alive, “existing medications for dementia are basically placebos, aren’t they?”
Doctor: “Yes.”
I’m not advocating pessimism, just honesty.

Diane Tasker
Diane Tasker
4 months ago
Reply to  Damon Hager

I agree but placebos do sometimes work possibly though reducing stress if the brain is convinced of the benefits

Martin Smith
Martin Smith
4 months ago
Reply to  Jason Smith

Agree with everything but your last point. ‘If’ is doing alot of work there. What ‘if’ the drugs don’t work but there’s lots of money to be made from prescribing them daily to 33% or more of the population? What ‘if’ such a policy means that an incorrect medical theory has to be kept alive to justify the prescribing policy? And what ‘if’ such an eventuality means that new research into more promising theories are therefore suppressed and demonised? Not like it hasn’t happened before… just saying.

jane baker
jane baker
4 months ago
Reply to  Jason Smith

There is no such thing as dementia and it’s insulting to say there is. It’s natural to get forgetful as you get old and it’s natural to need care and nurturing same as children. It’s hateful to subtly demonise and set apart some people as a ‘problem”.

R D
R D
4 months ago
Reply to  Jason Smith

Jason, I agree with you.
And to take it further, I also think its not fair to incessantly hammer pharmaceutical companies (“big pharma”) , as if they were no different from tobacco companies.
Nobody else – nobody – is making drugs for anything. Not universities, not charities, not researchers, not NGOs. Universities do indeed generate good ideas – but only a pharmaceutical company can turn their ideas into a tablet.
It’s reasonable for people to refuse drugs or vaccines, if they like. But its really nice that we all have a choice – i.e. that drugs exist.
Thank goodness for pharmaceutical companies.

Anna Bramwell
Anna Bramwell
4 months ago
Reply to  Jason Smith

What evidence is there that lifestyle factors help? I lived for years in a small Italian village in the hills. Noone drank much,bread didntt have salt, everyone walked a few miles a day. The rate of Alzheimers was about 2-3%.

Alex Lekas
Alex Lekas
4 months ago

Focusing on lifestyle takes work. It puts the onus on the individual who then has to do icky things like exercise and eat properly. What are you, some type of monster expecting people expecting people to take responsibility for their health?

J Hop
J Hop
4 months ago

Statins are way over prescrbed here in the United States while heart disease deaths continue to climb. One doctor notoriously joked about “putting them in the water supply” to the eager nodding of almost every other physician at the conference. They are the #1 subscribed medication in the country next to anti-depressants. They move the needle on a small number of persons, notably men over 50 who have already had a cardiac arrerst, and do nothing but pile on massive life changing side effects in everyone else, including diabetes.
https://www.remnantmd.com/p/statins-suck?utm_source=post-email-title&publication_id=487823&post_id=139326339&utm_campaign=email-post-title&isFreemail=true&r=7y6hi&utm_medium=email
Even mainstream (i.e. heavily financed by pharma) institutions are gloming on.
https://www.bmj.com/content/363/bmj.k5110
The UK has already pulled back on it’s prescribing frequency. Yet here in the USA they are recommeneded for basically everyone over 30. I’m not kidding.

Bruno Lucy
Bruno Lucy
4 months ago

I am baffled that your comment didn’t get more thumbs up. Right on the money. As a kid, starting with my grandparents, I was surrounded by old people, well into their 80’s……driving their cars and fit as fiddle. Junkfood wasn’t part of the diet. My grandmother had this amazing vegetable garden and I can’t remember one meal coming out of a tin.
Youngsters are certainly doing themselves a favour eating all that cr…y food

jane baker
jane baker
4 months ago

I was told I had to take a statin pill every day for the rest of my life or I would drop down dead in the street. I replied I hope so,that’s just what I want,my ticket out. I changed my surgery,that was oddly just before COVID and lockdown. I dont trust doctors now. I’ve met my new doctor once and he’s very nice,but he took my blood pressure and said it’s now perfectly normal so that proves I don’t need statins. I just have to endure the pain of being human and alienated from God.

Simon Blanchard
Simon Blanchard
4 months ago

Those free miracle drugs, diet and exercise won’t do any harm either. Hopefully there is now a wider understanding of exactly how Big Pharma operates. I laughed out loud when I got to the bit about the argument for treating early. Great article.

Jeremy Bray
Jeremy Bray
4 months ago

It could make a profit for language teachers if it was shown studying a language in old age delayed cognitive decline. I would certainly sign up to study another language if there was credible evidence dementia could be delayed a few years.

Martin Smith
Martin Smith
4 months ago
Reply to  Jeremy Bray

Why not just do it anyway?

jane baker
jane baker
4 months ago

And caring for people and having a family who love you and all rely on you. Not me sadly,my sister. My lovely sister who sustains us all with her love.

Damon Hager
Damon Hager
4 months ago
Reply to  J Hop

Indeed. And I was also struck by this passage from the article:
“Dr Seb Walsh, a public-health doctor researching dementia at the University of Cambridge, says the hype and hope is unkind: ‘For 20 years we have been promised wonder drugs within 5 years — but still we wait,’ he says.”
As the child of two deceased parents who both had dementia, I grow weary of these irresponsible announcements. As you suggest, there is not even a consensus regarding cerebral amyloid, and the uncomfortable truth is: clinicians don’t know.
The suggestion of a “cure” by 2025 was in equal parts laughable and offensive. I’d say that even 2125 would be pretty optimistic.

jane baker
jane baker
4 months ago
Reply to  J Hop

You’ve said it better than me!

Anna Bramwell
Anna Bramwell
4 months ago
Reply to  J Hop

I was struck by the substantial improvements shown by people given a placebo. It was less than the others, – but why should there be any improvement at all?

Lillian Fry
Lillian Fry
4 months ago
Reply to  J Hop

Before any treatments can be effective, we must find the cause. There are most likely multiple causes or different causes for different individuals. If cause(s) can be determined, true prevention might be possible but that would cut off the incentive for big pharma profits.
This study supports the theory that a virus may cause Alzheimer’s and gives way more hope to those of us who care for Alzheimer’s victims: https://www.nature.com/articles/d41586-023-01824-1
One thing that needs further study is how early the vaccine must be given to have the effect demonstrated here.

Katherine Bhana
Katherine Bhana
3 months ago
Reply to  J Hop

Sending Prayers and Support. My mom was diagnosed with Dementia disease when she was 62 years old 2 years ago. The Donepezil did very little to help her. The medical team did even less. Her decline was rapid and devastating. It was Hallucinations at first, then Walking difficulties. Last year, a family friend told us about Natural Herbs Centre and their successful Dementia Ayurveda TREATMENT, we visited their website naturalherbscentre. com and ordered their Dementia Ayurveda protocol, i am happy to report the treatment effectively treated and reversed her Dementia , most of her symptoms stopped, she’s able to walk again, sleep well and exercise regularly.she’s active now, I can personally vouch for these remedy but you would probably need to decide what works best for you.

Gerry Quinn
Gerry Quinn
4 months ago

It’s a slow degenerative disease of the brain that occurs over many years. I do not believe there will ever be anything like a cure, or even anything that helps a whole lot.

Hugh Marcus
Hugh Marcus
4 months ago
Reply to  Gerry Quinn

Like obesity & type 2 diabetes its prevalence has grown massively over the last 30 years though. This leads some researchers & doctors to suggest it’s linked to the rise in processed foods & western diets high in carbohydrates. Needless to say their ideas aren’t popular because there’s no big win for drug manufacturers & everything to lose for the corporations who make ultra processed foods

Matt M
Matt M
4 months ago
Reply to  Hugh Marcus

Is that not because of extended life expectations? Most people who get Alzheimer’s are in their 80s and 90s. 30 years ago they would probably have died of cancer, heart disease or strokes. Now we can control those and people die a few years later of diabetes, dementia, covid or flu. What happens when were cure them? We live to 100 and die of the next thing on the list of causes of death.
It is similar to your point about western diets – it points to a strange aspect of humanity. Norman Borlaug’s “green revolution” in the 1970s created undreamed of food abundance which our biology couldn’t handle. We all got fat! But now these GLP-1 agonists that control appetite (ozempic, wegovy etc) are pretty impressive. Soon we will all be slim! But what problem does that create? And so it carries on…

UnHerd Reader
UnHerd Reader
4 months ago

For the love of God, why do we as a society tolerate this monsense. Good food exercise, company , social interaction and very possibly magic mushrooms would provide far more benefit than these pseudo scientific ( and seemingly poisonous )substances. Three dead ! Magic mushrooms are totally non toxic and would be a far more fruitful avenue of exploration

Lesley van Reenen
Lesley van Reenen
4 months ago
Reply to  UnHerd Reader

I might agree with you, but first want to know your age and your ailments.

Mike Downing
Mike Downing
4 months ago

Kerching, kerching, kerching !

Does Mr Gates have shares in the next big pharma bonanza ? I think we should be told.

One of the unforeseen consequences of the great (actual) advances in medicine over the years has been our growing inability to countenance death or at least the process of dying at all.

So now we live in a world where the people with loadsadosh will be throwing it at the Big Pharma snake-oil salesmen who promise ever more outrageously impossible dodges to cheat the grim reaper while those with slightly less dosh will be paying to be finished off at a time that ‘fits in with their lifestyle’ á la Rantzen.

I thought Sweden had done a giant reevaluation of statins using historic data and found there to be at best very marginal advantages to taking them. Given that we’ve changed our minds several times about which fats are even ‘good’ or ‘bad’ for you, the whole argument for using statins is up for debate surely ?

Likewise breast screening programs which turn out to be a huge waste of time and money and save perhaps one life a year. But who would dare act on this now and spend the money on something better like health promotion for instance?

So the ‘health’ budget balloons and overall the outcomes get more and more marginal that are demanded by the terrified public. The average age of death from Covid was over 80 after all and now we’ve bankrupted everything and can’t even pay for the service we were meant to be ‘saving’.

But these are big money-spinners for Big Pharma. So at least someone’s getting a payback.

Mrs R
Mrs R
4 months ago
Reply to  Mike Downing

Well said. It is extraordinary that despite all the advances in pharmaceutical interventions we have never been sicker. Chronic illnesses and allergies are off the scale – even amongst children. Compare the data from pre 85 to after wards. Something has happened. Over processed and chemically laden foods, too many pills and unnecessary vaccines – some are good but not all for goodness sake. Food and drugs (in America they run the two together under the auspices of the seriously compromised FDA.)
In the US over 50% of children suffer from a chronic illness, I’m not sure what it is in the U.K. but from my own observations as a teacher, when I started my career there were no children with allergies, no children with serious challenging behavioural issues in my class. Those with problems were neglected children or from seriously deprived homes. However, when my career ended some ten years ago or so there were several children suffering from allergies, emotional or behavioural issues in every class throughout the school no matter how great and supportive the parents. This is so wrong and we need to find out what is actually causing these issues with some serious independent research not simply allow pharmaceutical companies to make excessive profit out of these illnesses. One of things that I found most shocking during the pandemic was the fact that people were prevented from going out for walks or to the gym, shut up at home people drank more alcohol and ate more than usual and became less fit. All that despite the clear evidence that the virus was overwhelmingly affecting the obese, the frail elderly and immune compromised. There were no campaigns for healthy eating and exercise on tv only fear porn.
I’ve lost faith.

Lesley van Reenen
Lesley van Reenen
4 months ago

Lifestyle for sure.

Mike Bell
Mike Bell
4 months ago

As we saw with Covid, the average journalist had had so little training in the use of statistics and interpreting claims that they just parrot the wild claims of the proponents.
We should all be wary of anything which uses phrases like cure for Alzheimer’s. This is regularly trotted out for things seeking funding. (Is it the ‘Z’ in the name which makes it sound so much more important than other age-related diseases?)

Jeremy Bray
Jeremy Bray
4 months ago

Perhaps the most fruitful area of research is psychology. How can we ensure that we behave in a fashion that increases our chances of surviving into healthy old age rather than indulge in destructive pleasures. Put that way it might be that philosophy is the most fruitful area of research. We need to accept the effects of the choices we make.

Thomas Wagner
Thomas Wagner
4 months ago
Reply to  Jeremy Bray

Do what we recommend and you may not live longer, but it will seem like forever.

Allison Barrows
Allison Barrows
4 months ago

After everything we’ve learned about the pharmaceutical industry and the “vaccines” they created that aren’t vaccines at all but spike protein delivery systems that are causing healthy people to drop dead, why in hell would anyone believe them about this new drug?

That one professor, Craig Ritchie, is the perfect example of a get-rich-on-misery snake oil salesman. And the fact that Alzheimer’s is the cause of 70% of deaths in England and Wales makes me wonder if we aren’t being deliberately poisoned. The foods we eat are stuffed with chemicals. What’s floating around in the water we drink, bathe and cook with?

When I was growing up, no one had peanut and gluten allergies, and fat kids were nonexistent. Now, obesity is epidemic in even very young children and youngsters are drugged with Ritalin for a “condition” called inattention. And drug companies are cleaning up by selling mentally ill people the idea that they can change their sex with hormone blockers.

No. These companies proved to the world they can’t be trusted.

Sue Sims
Sue Sims
4 months ago

Where did you get that statistic from, Allison? Alzheimers is only the leading cause of death in England and Wales by a short head, and averaging males and females – nowhere near 70%. Here’s the relevant summary from the Office for National Statistics (the 2022 figures, since last year’s haven’t yet been released):

The leading cause of death for males was ischaemic heart disease (38,730 deaths, accounting for 13.3% of all male deaths), while for females it was dementia and Alzheimers disease (42,635 deaths; 15.0% of all female deaths).

There is, of course, a good reason for worrying about Alzheimers and dementia: they make life very difficult for both the sufferers and their carers because, unlike most of the other leading causes of death, they affect the mind and the capacity to reason. But there’s no point in exaggerating the figures.
Again, it’s untrue that ‘fat kids were non-existent’. They were far rarer, certainly, but as Katherine Whitehorn (born in 1928) wrote: ‘I always loathed and was catastrophically bad at any sport I ever attempted and even in the gym I was the fat girl who got stuck trying to get over the horse, with the exasperated teacher saying: “Girls, this is not funny.”‘ My husband’s best friend at school (and for many years subsequently), born in 1953, was morbidly obese, and there was always at least one fat child in all my classes as I progressed through the school.
None of this is to deny your major points, all of which I agree with; but exaggerating does more harm than good, as it’s only too easy to suppose that if one debunks exaggerations, the underlying thesis can also be rejected.

Allison Barrows
Allison Barrows
4 months ago
Reply to  Sue Sims

My mistake. I misread the above article’s stats. Deliberately exaggerating figures was not my intent.

Sue Sims
Sue Sims
4 months ago

Understood!

Martin Smith
Martin Smith
4 months ago

We knew x

Johann Strauss
Johann Strauss
4 months ago

It seems to me that the results of the RCTs are not particularly impressive and at best these drugs offer an improvement in an endpoint but not in actual symptoms which is what counts of course. But a great way for Pharma to make a killing.

Alex Lekas
Alex Lekas
4 months ago

Don’t worry folks. The nice people at the WEF, in conjunction with their partners at the WHO, are busy prepping the battlefield for “disease X,” their next lab-created scourge that aims to do what Covid could not.
I am, however, curious about the growing prevalence of this condition – with the number of cases predicted to triple over the next 40 years. Seriously? That’s a huge leap.

John Abeles
John Abeles
4 months ago

To the extent that these antibody ( aka immunoglobulin) based drugs have any marginal effect it may be due to actions other than removing amyloid or interfering with amyloid aggregation ( it is likely that amyloid is a result rather than a cause of Alzheimer’s, in my view)

It is known that antibody infusion has an effect of down regulating T cell responses ie is somewhat immunosuppressant – and thus can be antiinflammatory

This finding is utilised in a fairly longstanding therapy called IVIG ( intravenous immunoglobulins) to treat inflammatory autoimmune conditions

There are good data to indicate that chronic neuroinflammation is a major component of Alzheimer’s and other neurodegenerative diseases

Thus these immunoglobulin based therapies may be acting as expensive and somewhat toxic immunosuppressant antiinflammatories – at least in part –
and their effect on amyloid possibly may be spurious

nikos goat
nikos goat
4 months ago

It’s a bold ambition but, with someone developing dementia every three minutes in the UK, we stand to make an absolute fortune, despite this treatment clearly showing no tangible benefit” they say.

Did anyone try varying diet, learning and exercise in controlled groups? Plenty of evidence to support self care but no profit. Big Pharma is a legal mafia peddling fear, lies and useless but harmful chemicals, enabled by their lapdog regulatory frameworks and nefarious ‘philanthropists’. The whole world seems to have developed a collective dementia … Statins? mRNA? Opioids? Add your pfavourite scam here…

Robin Whittle
Robin Whittle
4 months ago

Please read the research articles cited and discussed at: https://vitamindstopscovid.info/00-evi/ . Regarding dementia: https://vitamindstopscovid.info/00-evi/#3.3
Ayers et al. 2022 https://www.pnas.org/doi/abs/10.1073/pnas.2113489119 showed that Parkinson’s disease (PD), dementia with Lewy bodies and multiple system atrophy (MSA) all involve misfolded (prion) alpha-synuclein tangles and that the structure of the misfolding was different in each of these three diseases. 
Ogura et al. 2021, in Japan https://www.sciencedirect.com/science/article/pii/S2405650221000617 showed that MSA sufferers averaged 10.5 ng/mL (26 nmol/L) circulating 25-hydroxyvitamin D and that PD sufferers averaged 13.4 ng/mL (34 nmol/L), while healthy controls averaged 27 ng/mL (67 nmol/L). PD does not lower 25-hydroxyvitamin D, so the causality is from low 25-hydroxyvitamin D to neurodegeneration. (p = 0.0001).
The immune system needs at least 50 ng/mL (125 nmol/L) to function properly. This cannot be attained with the UK government’s lousy 0.015 mg (600 IU) a day recommendation for supplemental vitamin D3. 
Inadequate circulating 25-hydroxyvitamin D is the greatest single preventable cause of human disease and other forms of ill-health, in all or almost all countries.  Only a fraction of the Earth’s population have the 25-hydroxyvitamin D they need for full immune system function. They get it from UV-B exposure to ideally white skin (only possible year round near the equator, and it always raises the risk of cancer, since it damages DNA) and/or from proper amounts of supplemental vitamin D3 cholecalciferol. There is nowhere near enough vitamin D3 in food to raise 25-hydroxyvitamin D levels to more than a fraction of what the immune system needs.
Most medical professionals are not at all interested in this. Important research which challenges their drug, vaccine and surgery centric view of improving health is like water off a duck’s back.  Likewise immunologists.
https://vitamindstopscovid.info/00-evi/#00-how-much includes New Jersey based Professor of Medicine Prof. Sunil Wimalawansa’s recommendations https://www.mdpi.com/2072-6643/14/14/2997 for vitamin D3 supplemental intake to attain at least the 50 ng/mL (125 nmol/L) circulating 25-hydroxyvitamin D, which the immune system needs to function properly. As he noted in a recent FLCCC webinar, these are ratios of body weight, with higher ratios for those suffering from obesity: https://odysee.com/@FrontlineCovid19CriticalCareAlliance:c/Weeekly_Webinar_Aug16_2023:d?t=3386 This is because people suffering from obesity convert less vitamin D3 into circulating 25-hydroxyvitamin D than normal-weight people.
The average daily vitamin D3 intake should be:
70 to 90 IU / kg body weight for those not suffering from obesity (BMI < 30).
100 to 130 IU / kg body weight for obesity I & II (BMI 30 to 39).
140 to 180 IU / kg body weight for obesity III (BMI > 39).
For 70 kg (154 lb) without obesity, this is about 0.125 milligrams (5000 IU) a day. This takes several months to attain the desired > 50 ng/mL circulating 25-hydroxyvitamin D. This is 8 or more times what most governments recommend. “5000 IU” sounds like a lot, but it is a gram every 22 years – and pharma grade vitamin D costs about USD$2.50 a gram ex-factory.
Neither vitamin D3 nor 25-hydroxyvitamin D are hormones – they are not signaling compounds. Calcitriol functions as a hormone when it is produced by the kidneys. When calcitriol is produced, in response to the detection of a cell-type-specific condition, in intracrine (within a single cell) signaling, it acts as an intracrine agent, by altering the transcription of genes (and so the protein production and overall behaviour) of that individual cell. This is unrelated to hormonal signaling. The common statement that “vitamin D is a hormone” is completely incorrect – Vieth 2004 https://sci-hub.se/10.1016/j.jsbmb.2004.03.037.

Rob N
Rob N
4 months ago

Interested that there was no mention of what, I thought, was a strong contender for cause/contributor to dementia etc namely dental health. It may not be correct but good dental health looks an obvious good thing and is mostly more straightforward.
But with all these things the problem is that people don’t plan ahead especially because they know/hope it will be someone else picking up the tab.
We need to move away from socialised medicine to some sort of insurance backed one where those who are likely to need less treatment/medical expenditure pay less and so there is an incentive to look after yourself (though being healthy should be a big incentive all by itself!).
We also need to accept that the NHS is NOT the envy of the world. It is, in fact, terrible in almost all ways.

Martin Smith
Martin Smith
4 months ago

There have been cases of widespread misfolded amyloid proteins in brains where the persons did not have dementia. I think these count as black swans.

UnHerd Reader
UnHerd Reader
4 months ago

https://www.prnewswire.com/news-releases/new-study-by-taurx-shows-a-minimum-dose-of-hydromethylthionine-could-slow-cognitive-decline-and-brain-atrophy-in-mild-to-moderate-alzheimers-disease-300965395.html

Low dose methylene blue has been shown to be able to stop Alzheimers disease. I hate the peddling by Big Pharma. Long Live Dr. Raymond Peat.

jane baker
jane baker
4 months ago

STFU will ya. Being Alive is the leading cause of DEATH. I started to get suspicious about two years ago,that late,of the increasing medicalization – and subtle DEMONIZATION of Old Age. And why were,are,perfectly lucid,competent and capable people basking in a kind of Happy Glow as they told us of a the diagnosis of future Alzheimers or whichever term is currently in vogue,that they might have maybe in forty years time,a diagnosis they must have requested off their doctor and PAID FOR, what is their doctor Mystic Meg off the end of the Pier then. If you have also got yourself a diagnosis of Autism,ADHD and Asperger’s as well,get the full range on a discount,then that’s your life well forked,still you can write a boring book about it and do radio interviews to promote it. This renaming of the natural shift into older then old age is not kind and compassionate,it’s a subtle DEMONIZATION. I resent it. It’s not caring. I only recently learned that the word Pharmaceutical is derived from an ancient word from the old days meaning “magic” but not nice magic,its for sleight of hand trickery magic, the sort that has an evil intent. I think that tells us a lot.

Martin Smith
Martin Smith
4 months ago
Reply to  jane baker

Similar things are being done with ‘childhood’ and ‘adolescence’ and the elevation, not of medicine, but of medical institutions above all others.

Alex Stonor
Alex Stonor
4 months ago

My father has so many prescriptions for so many medications that he confuses himself daily. It feels like he can be prescribed anything because it doesn’t matter what his lived experience is; he is old and grateful.
The experience of covid only seems to have strengthened the blind faith most have in the medical model, This article describes a state of affairs that is more like a game or a movie with a sinister guy (white, furry animal on lap), opening a ‘Brain Clinic’ to lure people who forgot why they went upstairs into a fantasy laboratory where they can watch their amyloids disappear before their bleary eyes while simultaneously offering themselves up for testing. Yikes.

UnHerd Reader
UnHerd Reader
3 months ago

Alzheimer’s is a reversal into childhood, just we grew aware off the world as infants as we reach our eighties Nature dims the lights. Not that detracts from its suffering, but until we find a cure for age, it must be a biochemical path, then dementia can’t be cured. We are a continuum, we must die for life to continue, fighting it is to pursue extinction. In case you think I have not had to face this reality and I don’t have any idea what I talking about I am 83 and a retired doctor. My mind is slowly falling apart but this morning I heard a thrush sing for a mate in my garden by the sea