8 ms·

Alzheimer's: 'Promising' blood test for early stage of disease

101 points by elorant 6y ago

melling 6y ago
I watched The Bit Player last week. https://en.wikipedia.org/wiki/The_Bit_Player https://en.wikipedia.org/wiki/The_Bit_Player Claude Shannon had Alzheimer’s. Nothing protects us from the disease. We should be doing a lot more research into this disease.
- FabHK 6y ago
  And it is such an ignominious end, even more so when you were identified with your intellect so much.
- vikramkr 6y ago
  The scientific field is already doing a ton - Neuro is one of the most active areas of research right now. Behind COVID that is, currently pretty much everything is on hold for COVID. Pre-COVID however oncology and neuroscience were already among the biggest focus areas of research. One of the basic problems is that we lack a fundamental understanding of how the disease works, so throwing more money at it gets diminishing returns beyond a point. It's like the war on cancer in the 1970s. We threw tons of money at cancer research which basically consisted of trying more newer combination chemotherapies in greater amounts and in new permutations trying to find the combination of chemicals that would eradicate all cancers. That only got us so far. However, at the same time, with a lot less funding and public support, scientists were making headway at understanding cancer not necessarily as a cellular disease, but as a genetic disease. By realizing that cancer is driven by genetic mutations, those scientists paved the way for the vastly more effective treatments and rush of immunoconcology/personalized/targeted therapies we see today. Throwing more money at Alzheimers at this point basically all but guarantees more trials of amyloid beta inhibitors at earlier stages and with bigger trials. We've already burnt tens of billions of dollars on that. The basic research to understand the disease is actually cheaper in the long run than running more of those clinical trials, but it's a stochastic, slow process with unclear goals and timelines.
- jcranmer 6y ago
  > We should be doing a lot more research into this disease. Trying to actually pin down hard numbers is difficult (searches invariably lead you to the cost of Alzheimer's disease rather than the cost of Alzheimer's research), but it looks like we're already at several billion dollars a year on Alzheimer's research. If it hasn't cost more than the Apollo project already, it likely will by the end of this decade.
  - melling 6y ago
    The healthcare costs for Alzheimer’s will be in the trillions, if we don’t cure it.
hprotagonist 6y ago
The meta-problem is that early identification only matters if we have an effective therapy which can seriously slow or halt disease progression. we do not.
- brain5ide 6y ago
  It matters for digging into that, doesn't it?
- toomuchtodo 6y ago
  Early identification allows you to better plan what the remainder of your life looks like for you and your loved ones, even if a protocol is not available. As someone who has had to coordinate end of life care more than I’d like to have had to, this is invaluable.
  - wdb 6y ago
    Based on the experience of my uncles, and my dad, grandma have had it. I am not sure that I want to know early that I am might have Alzheimer's years in advance. Personally, I think Alzheimer's is a horrible illness and worse than cancer.
    - scottLobster 6y ago
      To each their own, based on my experiences being a part-time caretaker for my mom for 10 years as she slowly lost her mind and various organs to cancer/cancer treatments (narcotic painkillers and crazy liver enzymes from dying liver), I'd like to know I have a degenerative disease as soon as possible so as to make preparations to minimize the financial and psychological impact on my family. You try every available treatment, maybe hold out for some experimental treatment, but there may come a time where you've tried everything there is and you're just dragging people you love down with no hope of recovery, and exchange all productivity/ability for meaningless pain and torture with no end in sight. At that point I'd like enough saved up to make one last visit to Hawaii, among a few other potential states.
    - WrtCdEvrydy 6y ago
FuckButtons 6y ago
My mum was diagnosed with it last week. My gran had it too. Its by far the worst disease I’ve encountered, it takes away everything that makes a person who they are and leaves them with nothing. The sooner we understand what’s causing it and the fewer people have to deal with it’s horrendous consequences the better.
coldpie 6y ago
I have an idea that's been floating around in my head for a while, and I don't know how I feel about it. So I'll float it here with a note that I am not strenuously advocating for the position I'm about to express, and instead wish to have it discussed. I have the feeling that our modern medical obsession with keeping the body alive for so long is leading to negative outcomes. The rate of Alzheimer's diagnoses increases dramatically after about age 70[1]. In the US, we began to see the average life expectancy increase past 70 in the 1950s, and is now approaching 80[2]. As a result, I think the current crop of people who are alive are among the first to see the effects of truly advanced age. Prior to the 1950s, longer life was always seen as a good thing: you had more time to enjoy relative good health. Since few people lived into their 70s and beyond, we didn't see the "bad things" coming. Now that people are living into their 70s and beyond, we start to see the horrible effects of advanced age. So the question, which again I don't put forward with much conviction: is continuing to put forward the preservation of life worth it given the extreme decline in quality of life that we see past the age of 70? The gut answer is "obviously yes," but I think we are the first people to have to truly grapple with this question, as we watch our elders mentally fall to pieces while their bodies chug along. Is that gut answer just the result of centuries of trying to get past year 70? Now that we're past it, should we re-evaluate? I have a very close relative in his late 60s going through Alzheimer's right now. Would it truly be worse if he had passed away a couple years ago? I don't know. [1] https://en.wikipedia.org/wiki/Alzheimer's#Epidemiology https://en.wikipedia.org/wiki/Alzheimer's#Epidemiology [2] https://www.macrotrends.net/countries/USA/united-states/life-expectancy https://www.macrotrends.net/countries/USA/united-states/life...
- sradman 6y ago
  > is continuing to put forward the preservation of life worth it given the extreme decline in quality of life that we see past the age of 70? The breakthrough here is in a diagnostic test for Alzheimer's. You are making a generalization based on the assumption that this information will ultimately extend life rather than improve the quality of life. For jurisdictions that allow medical assistance with dying, this information can plausibly result in the opposite effect.
- tcbawo 6y ago
gzer0 6y ago
Unfortunate that we have thrown billions upon billions and not a single viable treatment has made it out the pipeline. Truly one of the diseases that has escaped humans, thus far.
- DenisM 6y ago
  Age-related mental disorders are the final frontier for the human species. Heart problems are basically mechanical problems, we're guaranteed to fix them in the next 100 years, if only by printing new hearts and blood vessels. Cancer is a cluster of rogue cells, and just it's a matter of time before we can focus poisons, blades, irradiation, and nano-bots precisely enough before treatment becomes as routine as annual dentist visit. Similarly bacterial infection - it's just a foreign object that needs to be killed with some precision. Viruses are trickier but maybe not that much - killing infected cells seem like it would do the job. Brains are complicated though, you can't just seek and destroy something that's wrong. It's not a given that we can fix them in the near future, and as all other diseases recede we will end up with close to 100% of people succumbing to brain disorders at the end of their lives.
pubby 6y ago
Both of my grandparents were diagnosed with Alzheimers a few weeks ago. The disease had brewed inside them for several years, but nobody in my family knew they had it until it became severe. Unfortunately, neither of my grandparents understand how dysfunctional their brain is. They still have the mindset that they are spry 70-year-olds, when in reality they are in their mid 80s and incapable of caring for themselves. We'd like to move them into a nursing home, but they reject the idea because they don't think anything is wrong with them. I'd like to imagine this wouldn't be an issue had we detected the disease early enough. Early detection might not prolong life, but it certainly makes the transition to death easier for those involved.
- entangledqubit 6y ago
  I watched my father fade away from Alzheimers over the course of 5 years before he passed. Based on anecdotal stories in a support group, we were very lucky that he realized early on that something was wrong and he was very cooperative throughout. Other families in the support group experienced everything from lighthearted denial to emotions running amok. Personally, I want some solid tests so I can have reliable information to make sure I end my days as myself.
m463 6y ago
A friend of mine has a parent with Alzheimers, and he swears the symptoms have improved via tumeric supplements. He said apparently the prevalence of alzheimers is less in india, where tumeric is found in much of the food. (andecdotal evidence, but interesting)
- cowmoo728 6y ago
  There is limited scientific evidence about turmeric and alzheimers. https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/turmeric-and-dementia https://www.alzheimers.org.uk/about-dementia/risk-factors-an... Despite this, quite a few people claim that Okinawa, Japan provides more than enough anecdotal examples of the effectiveness of turmeric in longevity. Additionally, the life expectancy of Okinawans has decreased as their diet has become more Westernized and similar to mainland Japan. Okinawans traditionally eat a lot of sweet potatoes, seaweed, soy, lean pork, fish, and a lot of turmeric, ginger, and green tea. The caveat is that each ingredient in isolation usually fails to show a measurable benefit. https://en.wikipedia.org/wiki/Okinawa_diet https://en.wikipedia.org/wiki/Okinawa_diet
  - DoofusOfDeath 6y ago
    That's really interesting. I'd assumed turmeric was only (traditionally) popular in the vicinity of India.
- graeme 6y ago
  India indeed does fairly well, though I’d love to see incidence rate by age and also incidence rate rather than death rate: https://www.worldlifeexpectancy.com/cause-of-death/alzheimers-dementia/by-country/ https://www.worldlifeexpectancy.com/cause-of-death/alzheimer...
- vidarh 6y ago
  Life expectancy in India is about 10 years shorter than e.g. the US and other developed countries. As such you'd expect to see far less Alzheimers for the simple reason that most people get diagnosed at an advanced age. That's before taking into account potential differences in whether or not people are diagnosed. That said, turmeric (and especially curcumin) is a subject of study. But these studies also suggest it is unlikely simply eating turmeric helps, as it's not absorbed well by the body and the amounts needed would be exceptionally high.
donatzsky 6y ago
A previous article and discussion on the state of Alzheimers research: https://news.ycombinator.com/item?id=21911225 https://news.ycombinator.com/item?id=21911225
MikeCapone 6y ago
96% accuracy may be a problem... Depends how many false positives and false negatives, but if there's 4% of false negatives and there's, say, 1% of the tested population that has the disease, then even a positive test may mean you have only 20% chances of being actually positive. (someone double check my math, but the general idea stands, I think)
- corin_ 6y ago
  The actual data is more complicated than "96% accurate", but I'm not the best person to deep dive on the numbers and give a better analysis. However from reading the abstract of the actual study, it seems the TLDR is "more accurate than current ways to test, and significantly cheaper too" - which would be a great step regardless of if it's not quite as perfect as a vague "high % accurate!" makes it sound. https://jamanetwork.com/journals/jama/fullarticle/2768841 https://jamanetwork.com/journals/jama/fullarticle/2768841
0d9eooo 6y ago
Maybe I read the original research article incorrectly, or maybe this BBC piece is discussing something additional, but my impression after reading about it more closely was that this test is actually discriminating Alzheimer's from other forms of dementia, not Alzheimer's vs no dementia. I haven't thought this through yet but it seems interesting and important but also not quite how it's being portrayed in the media, and not quite as significant in some ways.

101 points by elorant 6y ago

I watched The Bit Player last week. https://en.wikipedia.org/wiki/The_Bit_Player https://en.wikipedia.org/wiki/The_Bit_Player Claude Shannon had Alzheimer’s. Nothing protects us from the disease. We should be doing a lot more research into this disease.

FabHK 6y ago
And it is such an ignominious end, even more so when you were identified with your intellect so much.
vikramkr 6y ago
The scientific field is already doing a ton - Neuro is one of the most active areas of research right now. Behind COVID that is, currently pretty much everything is on hold for COVID. Pre-COVID however oncology and neuroscience were already among the biggest focus areas of research. One of the basic problems is that we lack a fundamental understanding of how the disease works, so throwing more money at it gets diminishing returns beyond a point. It's like the war on cancer in the 1970s. We threw tons of money at cancer research which basically consisted of trying more newer combination chemotherapies in greater amounts and in new permutations trying to find the combination of chemicals that would eradicate all cancers. That only got us so far. However, at the same time, with a lot less funding and public support, scientists were making headway at understanding cancer not necessarily as a cellular disease, but as a genetic disease. By realizing that cancer is driven by genetic mutations, those scientists paved the way for the vastly more effective treatments and rush of immunoconcology/personalized/targeted therapies we see today. Throwing more money at Alzheimers at this point basically all but guarantees more trials of amyloid beta inhibitors at earlier stages and with bigger trials. We've already burnt tens of billions of dollars on that. The basic research to understand the disease is actually cheaper in the long run than running more of those clinical trials, but it's a stochastic, slow process with unclear goals and timelines.
jcranmer 6y ago
> We should be doing a lot more research into this disease. Trying to actually pin down hard numbers is difficult (searches invariably lead you to the cost of Alzheimer's disease rather than the cost of Alzheimer's research), but it looks like we're already at several billion dollars a year on Alzheimer's research. If it hasn't cost more than the Apollo project already, it likely will by the end of this decade.
- melling 6y ago
  The healthcare costs for Alzheimer’s will be in the trillions, if we don’t cure it.

hprotagonist 6y ago

The meta-problem is that early identification only matters if we have an effective therapy which can seriously slow or halt disease progression. we do not.

brain5ide 6y ago
It matters for digging into that, doesn't it?
toomuchtodo 6y ago
Early identification allows you to better plan what the remainder of your life looks like for you and your loved ones, even if a protocol is not available. As someone who has had to coordinate end of life care more than I’d like to have had to, this is invaluable.
- wdb 6y ago
  Based on the experience of my uncles, and my dad, grandma have had it. I am not sure that I want to know early that I am might have Alzheimer's years in advance. Personally, I think Alzheimer's is a horrible illness and worse than cancer.
  - scottLobster 6y ago
    To each their own, based on my experiences being a part-time caretaker for my mom for 10 years as she slowly lost her mind and various organs to cancer/cancer treatments (narcotic painkillers and crazy liver enzymes from dying liver), I'd like to know I have a degenerative disease as soon as possible so as to make preparations to minimize the financial and psychological impact on my family. You try every available treatment, maybe hold out for some experimental treatment, but there may come a time where you've tried everything there is and you're just dragging people you love down with no hope of recovery, and exchange all productivity/ability for meaningless pain and torture with no end in sight. At that point I'd like enough saved up to make one last visit to Hawaii, among a few other potential states.
  - WrtCdEvrydy 6y ago

FuckButtons 6y ago

My mum was diagnosed with it last week. My gran had it too. Its by far the worst disease I’ve encountered, it takes away everything that makes a person who they are and leaves them with nothing. The sooner we understand what’s causing it and the fewer people have to deal with it’s horrendous consequences the better.

coldpie 6y ago

I have an idea that's been floating around in my head for a while, and I don't know how I feel about it. So I'll float it here with a note that I am not strenuously advocating for the position I'm about to express, and instead wish to have it discussed. I have the feeling that our modern medical obsession with keeping the body alive for so long is leading to negative outcomes. The rate of Alzheimer's diagnoses increases dramatically after about age 70[1]. In the US, we began to see the average life expectancy increase past 70 in the 1950s, and is now approaching 80[2]. As a result, I think the current crop of people who are alive are among the first to see the effects of truly advanced age. Prior to the 1950s, longer life was always seen as a good thing: you had more time to enjoy relative good health. Since few people lived into their 70s and beyond, we didn't see the "bad things" coming. Now that people are living into their 70s and beyond, we start to see the horrible effects of advanced age. So the question, which again I don't put forward with much conviction: is continuing to put forward the preservation of life worth it given the extreme decline in quality of life that we see past the age of 70? The gut answer is "obviously yes," but I think we are the first people to have to truly grapple with this question, as we watch our elders mentally fall to pieces while their bodies chug along. Is that gut answer just the result of centuries of trying to get past year 70? Now that we're past it, should we re-evaluate? I have a very close relative in his late 60s going through Alzheimer's right now. Would it truly be worse if he had passed away a couple years ago? I don't know. [1] https://en.wikipedia.org/wiki/Alzheimer's#Epidemiology https://en.wikipedia.org/wiki/Alzheimer's#Epidemiology [2] https://www.macrotrends.net/countries/USA/united-states/life-expectancy https://www.macrotrends.net/countries/USA/united-states/life...

sradman 6y ago
> is continuing to put forward the preservation of life worth it given the extreme decline in quality of life that we see past the age of 70? The breakthrough here is in a diagnostic test for Alzheimer's. You are making a generalization based on the assumption that this information will ultimately extend life rather than improve the quality of life. For jurisdictions that allow medical assistance with dying, this information can plausibly result in the opposite effect.
tcbawo 6y ago

gzer0 6y ago

Unfortunate that we have thrown billions upon billions and not a single viable treatment has made it out the pipeline. Truly one of the diseases that has escaped humans, thus far.

DenisM 6y ago
Age-related mental disorders are the final frontier for the human species. Heart problems are basically mechanical problems, we're guaranteed to fix them in the next 100 years, if only by printing new hearts and blood vessels. Cancer is a cluster of rogue cells, and just it's a matter of time before we can focus poisons, blades, irradiation, and nano-bots precisely enough before treatment becomes as routine as annual dentist visit. Similarly bacterial infection - it's just a foreign object that needs to be killed with some precision. Viruses are trickier but maybe not that much - killing infected cells seem like it would do the job. Brains are complicated though, you can't just seek and destroy something that's wrong. It's not a given that we can fix them in the near future, and as all other diseases recede we will end up with close to 100% of people succumbing to brain disorders at the end of their lives.

pubby 6y ago

Both of my grandparents were diagnosed with Alzheimers a few weeks ago. The disease had brewed inside them for several years, but nobody in my family knew they had it until it became severe. Unfortunately, neither of my grandparents understand how dysfunctional their brain is. They still have the mindset that they are spry 70-year-olds, when in reality they are in their mid 80s and incapable of caring for themselves. We'd like to move them into a nursing home, but they reject the idea because they don't think anything is wrong with them. I'd like to imagine this wouldn't be an issue had we detected the disease early enough. Early detection might not prolong life, but it certainly makes the transition to death easier for those involved.

entangledqubit 6y ago
I watched my father fade away from Alzheimers over the course of 5 years before he passed. Based on anecdotal stories in a support group, we were very lucky that he realized early on that something was wrong and he was very cooperative throughout. Other families in the support group experienced everything from lighthearted denial to emotions running amok. Personally, I want some solid tests so I can have reliable information to make sure I end my days as myself.

m463 6y ago

A friend of mine has a parent with Alzheimers, and he swears the symptoms have improved via tumeric supplements. He said apparently the prevalence of alzheimers is less in india, where tumeric is found in much of the food. (andecdotal evidence, but interesting)

cowmoo728 6y ago
There is limited scientific evidence about turmeric and alzheimers. https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/turmeric-and-dementia https://www.alzheimers.org.uk/about-dementia/risk-factors-an... Despite this, quite a few people claim that Okinawa, Japan provides more than enough anecdotal examples of the effectiveness of turmeric in longevity. Additionally, the life expectancy of Okinawans has decreased as their diet has become more Westernized and similar to mainland Japan. Okinawans traditionally eat a lot of sweet potatoes, seaweed, soy, lean pork, fish, and a lot of turmeric, ginger, and green tea. The caveat is that each ingredient in isolation usually fails to show a measurable benefit. https://en.wikipedia.org/wiki/Okinawa_diet https://en.wikipedia.org/wiki/Okinawa_diet
- DoofusOfDeath 6y ago
  That's really interesting. I'd assumed turmeric was only (traditionally) popular in the vicinity of India.
graeme 6y ago
India indeed does fairly well, though I’d love to see incidence rate by age and also incidence rate rather than death rate: https://www.worldlifeexpectancy.com/cause-of-death/alzheimers-dementia/by-country/ https://www.worldlifeexpectancy.com/cause-of-death/alzheimer...
vidarh 6y ago
Life expectancy in India is about 10 years shorter than e.g. the US and other developed countries. As such you'd expect to see far less Alzheimers for the simple reason that most people get diagnosed at an advanced age. That's before taking into account potential differences in whether or not people are diagnosed. That said, turmeric (and especially curcumin) is a subject of study. But these studies also suggest it is unlikely simply eating turmeric helps, as it's not absorbed well by the body and the amounts needed would be exceptionally high.

donatzsky 6y ago

A previous article and discussion on the state of Alzheimers research: https://news.ycombinator.com/item?id=21911225 https://news.ycombinator.com/item?id=21911225

MikeCapone 6y ago

96% accuracy may be a problem... Depends how many false positives and false negatives, but if there's 4% of false negatives and there's, say, 1% of the tested population that has the disease, then even a positive test may mean you have only 20% chances of being actually positive. (someone double check my math, but the general idea stands, I think)

corin_ 6y ago
The actual data is more complicated than "96% accurate", but I'm not the best person to deep dive on the numbers and give a better analysis. However from reading the abstract of the actual study, it seems the TLDR is "more accurate than current ways to test, and significantly cheaper too" - which would be a great step regardless of if it's not quite as perfect as a vague "high % accurate!" makes it sound. https://jamanetwork.com/journals/jama/fullarticle/2768841 https://jamanetwork.com/journals/jama/fullarticle/2768841

0d9eooo 6y ago

Maybe I read the original research article incorrectly, or maybe this BBC piece is discussing something additional, but my impression after reading about it more closely was that this test is actually discriminating Alzheimer's from other forms of dementia, not Alzheimer's vs no dementia. I haven't thought this through yet but it seems interesting and important but also not quite how it's being portrayed in the media, and not quite as significant in some ways.