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Dan Agin

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Alzheimer's: Maybe Not What You Think

Posted: 05/10/09 01:38 PM ET

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?

 
 
 
 
 
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NickHP
engineer, human, humane
08:11 PM on 05/10/2009
Free education to doctors, scientists, biologists, engineers, all the 'useful professions'. And might as well give free educations to artists and actors and movie directors -- those people who serve to make our lives more pleasant and enjoyable. And free education to historians, and english majors and poets -- because they hold on to the essence of our civilizations.

That covers almost everybody. Hey, free higher education to all those who are able to handle the material and who want to do this -- assistance to the self selecting group in our population that can and will learn more. It will pay off in the production and creations from the next generations.

The put the classes online, in recorded form for everyone else to audit - self improvement at one's fingertips.
03:55 PM on 05/10/2009
As a part of "THE ALZHEIMER'S PROJECT" and the leading source of information and support for people touched by this disease, the Alzheimer's Association appreciates your help in shedding light on Alzheimer's. The Association and its 77 local chapters nationwide are available with information, including risk factors, diagnosis and treatment, and services such as support groups. Visit us at http://www.alz.org for more information on the disease, HBO documentary or to find services in your area.
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DiogenesOfAlaska
Mitt Romney for president - of the Cayman islands!
02:35 PM on 05/10/2009
What a relief to read such determination. Why not go further?

Require large corporations - where large means those who need to make sure they can survive a couple of decades for their business model to make sense .- to invest in research or alternatively explain how they sustain themselves in a business environment where twice as many or three times as many potential customers are being nursed because they suffer from dementia.

Obviously this is only an example, that's why it sounds strange. What's needed is the whole nine yards: business leaders and investors must be held accountable to where they think we're going. Having no vision is not an option. Freedom requires that we make use of it.

We need grillings for boardrooms as in the banking crisis. Yes we want free markets to do everything they can do. But that requires a lot of scrutiny for everything with an investment horizon of decades, such as education, health care, retirement. There's a lot of explaining to do and a lot of infrastructure to set up before markets can do that. And it doesn't help to denounce that infrastructure as 'government intervention'. Actually, it could also help to think again about what taxes are - given that there are public goods, such as preventing collective dementia. It's not exactly spreading the wealth around.
01:15 PM on 05/10/2009
"... a way to prevent AD will be found by people who are now only in high school--our children. ... every kid who has a talent for it [should] 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."

Beautiful. Thank you.