5 ms·

Why diagnosing Alzheimer’s today is so difficult, and how we can do better

32 points by uptown 8y ago

melling 8y ago
I didn’t realize Bill Gate’s dad has Alzheimer’s. I’m not sure why this disease gets relatively little funding. If Gates’ funding leads to early detection, say 10-15 year early, maybe it’ll raise awareness so it gets more government funding.
- robotkdick 8y ago
  My Mom is showing early signs of dementia, and every neurologist we talked with said the same thing Gates suggests: get an early baseline test. There's only one problem. Neither she or my dad will get one... Hopefully, Bill Gates can throw some weight behind acceptance of these tests as both dementia and Alzheimer's seem to show signs of responsiveness to simple changes in behavior...like walking every day. It might be that simple or not... without access to the test data over time it's hard to make solid arguments. "Mom, you need to go for a walk today," just doesn't sound very scientific, but "Mom, Bill Gates says you need to go for a walk today," might just work.
  - JamesBarney 8y ago
    The problem is it's kind of a catch 22. It's hard to get drugs to work without early diagnosis and there's no real point in early diagnosis without there being drugs that work.
    - u801e 8y ago
      > and there's no real point in early diagnosis without there being drugs that work. A lot of health issues can be managed through lifestyle modifications if they're detected early enough.
      - JamesBarney 8y ago
        Alzheimer's isn't one of them.
- aaavl2821 8y ago
  Alzheimer's actually gets a lot of funding, but mostly for therapeutics, not diagnostics: it gets a lot of funding from NIH, and neurodegenerative disease treatments get the third or fourth most VC and big pharma funding (after cancer, rare disease and maybe infectious disease) However none of the drugs really work, and ppl think one reason is bc patients are diagnosed too late Diagnostics get very little funding in general, not just in Alzheimer's. Calling yourself a "diagnostics" company is a good way to get ignored by VCs. You have to do a lot of expensive studies to prove that they work, the bar is quite high to getting insurers to pay for them, and pricing power is low. Most insurers will only pay for a novel diagnostic if it saves them money. So you have high development cost and low profit potential
  - CamelCaseName 8y ago
    >Calling yourself a "diagnostics" company is a good way to get ignored by VCs. [...] So you have high development cost and low profit potential What can regulatory agencies do to alleviate this?
    - aaavl2821 8y ago
      The regulation for many diagnostics is actually fairly light. There's a class of diagnostics called "lab developed tests" that essentially aren't regulated by FDA The development cost is high because you need good data to convince doctors that tests work, and also to convince payers. Payers have proven to be the real gatekeepers for many diagnostics rather than FDA
- jonwachob91 8y ago
  The NIH has a $1.9B budget for alzheimer's dementia research for 2018, That's including the $400MM+ budget increase that congress gave them this year. There is nothing small about government funding in this area, and Gates additional funding will be a drop in the bucket to what the government is already doing. It's good that he's putting up his own funding, as it'll give a different set of eyes and money to the problem. But don't get that confused with the government and the NIH not putting some serious research funding behind the problem.
dweekly 8y ago
What if you could diagnose with an eye scan? http://optinadx.com http://optinadx.com Disclaimer: I'm an investor in Optina Diagnostics
- tuxguy 8y ago
  interesting ! could you describe the key technology behind optinadx to a layman, in some more detail ?
  - jnicholasp 8y ago
    I'm not affiliated with Optina and I don't know specifically what they're doing, but the classic symptom of Alzheimer's is the formation in the brain of amyloid plaques - and it appears to be the case that they also form on the retina, and can thus be detected by appropriate optical scans.

32 points by uptown 8y ago

I didn’t realize Bill Gate’s dad has Alzheimer’s. I’m not sure why this disease gets relatively little funding. If Gates’ funding leads to early detection, say 10-15 year early, maybe it’ll raise awareness so it gets more government funding.

robotkdick 8y ago
My Mom is showing early signs of dementia, and every neurologist we talked with said the same thing Gates suggests: get an early baseline test. There's only one problem. Neither she or my dad will get one... Hopefully, Bill Gates can throw some weight behind acceptance of these tests as both dementia and Alzheimer's seem to show signs of responsiveness to simple changes in behavior...like walking every day. It might be that simple or not... without access to the test data over time it's hard to make solid arguments. "Mom, you need to go for a walk today," just doesn't sound very scientific, but "Mom, Bill Gates says you need to go for a walk today," might just work.
- JamesBarney 8y ago
  The problem is it's kind of a catch 22. It's hard to get drugs to work without early diagnosis and there's no real point in early diagnosis without there being drugs that work.
  - u801e 8y ago
    > and there's no real point in early diagnosis without there being drugs that work. A lot of health issues can be managed through lifestyle modifications if they're detected early enough.
    - JamesBarney 8y ago
      Alzheimer's isn't one of them.
aaavl2821 8y ago
Alzheimer's actually gets a lot of funding, but mostly for therapeutics, not diagnostics: it gets a lot of funding from NIH, and neurodegenerative disease treatments get the third or fourth most VC and big pharma funding (after cancer, rare disease and maybe infectious disease) However none of the drugs really work, and ppl think one reason is bc patients are diagnosed too late Diagnostics get very little funding in general, not just in Alzheimer's. Calling yourself a "diagnostics" company is a good way to get ignored by VCs. You have to do a lot of expensive studies to prove that they work, the bar is quite high to getting insurers to pay for them, and pricing power is low. Most insurers will only pay for a novel diagnostic if it saves them money. So you have high development cost and low profit potential
- CamelCaseName 8y ago
  >Calling yourself a "diagnostics" company is a good way to get ignored by VCs. [...] So you have high development cost and low profit potential What can regulatory agencies do to alleviate this?
  - aaavl2821 8y ago
    The regulation for many diagnostics is actually fairly light. There's a class of diagnostics called "lab developed tests" that essentially aren't regulated by FDA The development cost is high because you need good data to convince doctors that tests work, and also to convince payers. Payers have proven to be the real gatekeepers for many diagnostics rather than FDA
jonwachob91 8y ago
The NIH has a $1.9B budget for alzheimer's dementia research for 2018, That's including the $400MM+ budget increase that congress gave them this year. There is nothing small about government funding in this area, and Gates additional funding will be a drop in the bucket to what the government is already doing. It's good that he's putting up his own funding, as it'll give a different set of eyes and money to the problem. But don't get that confused with the government and the NIH not putting some serious research funding behind the problem.

dweekly 8y ago

What if you could diagnose with an eye scan? http://optinadx.com http://optinadx.com Disclaimer: I'm an investor in Optina Diagnostics

tuxguy 8y ago
interesting ! could you describe the key technology behind optinadx to a layman, in some more detail ?
- jnicholasp 8y ago
  I'm not affiliated with Optina and I don't know specifically what they're doing, but the classic symptom of Alzheimer's is the formation in the brain of amyloid plaques - and it appears to be the case that they also form on the retina, and can thus be detected by appropriate optical scans.