THE BLOG
06/10/2009 05:12 am ET | Updated Nov 17, 2011

Alzheimer's: Maybe Not What You Think

With American culture hooked to HBO cable TV the way it is, this is Alzheimer's Week. Moanings and whimperings about the sorrows of dementia will be trotted out like a series of acts in a vaudeville show, but with only some minor time devoted to the reality that if we shift the money we spend on aircraft carriers and silly wars and spend it instead on training scientists and engineers and medical researchers we might cut plagues like Alzheimer's disease (AD) down to the size of treatable infections. Yes, it's possible, but only if we really want it to happen. It's unfortunate that too many people who moan about AD don't understand that we need to spend taxpayer money if we're ever to get rid of it.

Meanwhile, here are some facets of AD that many people don't know about or choose to ignore:

1) The brain of a patient with advanced AD does not look anything like an ordinary brain. There's tremendous atrophy -- loss of tissue -- with huge gaps as the folds of the brain have shrunk and narrowed and separated due to loss of brain cells. Anyone who still believes the human mind is something apart from the human brain should look at an AD brain and consider the behavior of the AD patient. The AD brain is a destroyed brain, and the behavior of the AD patient is the result of that destruction. The idea that the human mind is some magical entity that floats around inside the skull is romantic nonsense. The mind exists by the grace of biological tissue, and before long we will work out the details of how the brain produces every thought that's inside your head.

2) AD is only one form of dementia, but on autopsy about half the cases of dementia prove to be AD. The prevalence of AD for people 65 years old is 0.6 percent for males and 0.8 percent for females. But at age 90 the prevalence jumps to 21 percent for males and 25 percent for females, with about half of these cases moderate to severe. At age 95, the prevalence of AD is 36 percent for males and 45 percent for females. In America, more than half the beds in nursing homes are now occupied by patients with AD--about 2 million people. We need to consider the fact that if human life expectancy in America were to be extended a few decades without finding a prevention for AD, the majority of people who would live longer would be demented. That might be good for the nursing home business, but truly ridiculous for everyone else. Research to find a way to prevent AD should be an urgent priority.

3) So can AD be prevented? The answer is yes. AD is a neurodegenerative disease, and what we know about such diseases is that they usually involve the misfolding, aggregation, and accumulation of certain proteins in the brain. The evidence that we have suggests that accumulation of misfolded proteins interferes with events at synapses -- the connections between nerve cells -- and also causes the death of nerve cells. The ultimate result is destruction of the brain. So if we had a complete understanding of the molecular mechanisms involved in the production and aggregation of the relevant misfolded brain proteins, we would probably have a good shot at preventing AD altogether -- in addition to preventing a half dozen other important neurodegenerative diseases. We need more funds for research in relevant basic and clinical protein biochemistry -- and every dime of that money would feed back into the economy as costs for salaries, medical equipment, and laboratory overhead. An important way to pump money into an economy is to fund scientific and medical research: it does do something for everyone -- including people who have a billion in the bank.

So funding present research is of great importance. But my guess is that a way to prevent AD will be found by people who are now only in high school--our children. Can political blowhards come up with an argument against funding the education of the scientists, engineers, and medical researchers who will ultimately find a way to prevent AD? Is there any better way to spend taxpayer money than educating such people? We should be shouting in the streets to find a way to make certain that every kid who has a talent for it can have a free education right through to the moment when they start working in a laboratory. Such kids should not need to depend on charity and borrowed money. It's these kids that will make our future. Are we shouting?