19 ms·
Alzheimer’s enigma: Why is incidence falling 16% a decade in richest countries?
- briefcomment 5y ago> The researcher displays an image of a Siberian tiger brain, full of amyloid beta. “We have seen changes similar to Alzheimer’s in many mammals, but the disease never develops,” Rábano explains. Interesting
- TaupeRanger 5y agoIt's well known that the amyloid hypothesis has failed to find any solid support as a cause (rather than an effect or co-occurrence) of other Alzheimer's processes. That's why the recent Biogen drug is so controversial.
- treeman79 5y agoWhat medications are more commonly prescribed then before? Ones that are used more in richer companies.
- marricks 5y ago“Falling 16% per decade since 1988” I wonder why! Maybe tied to the phase out of leaded gasoline around the same time??
- etempleton 5y agoI always wonder how many toxins are we currently unknowingly afflicting upon ourselves. Lead has been linked to a number of neurological and societal issues. The spike in anxiety and depression in the past decades makes me wonder if there is something going on there or if it is more of a reaction the social environment.
- reedjosh 5y agoEstrogenic Chemicals for one. https://www.amazon.com/Estrogeneration-Estrogenics-Making-Sick-Infertile/dp/1946546011 https://www.amazon.com/Estrogeneration-Estrogenics-Making-Si... Pretty much 90% of plastics.
- throwaway384028 5y agoI agree - I think we'll realize in our lifetimes that plastics have a lot to do with rises in some of those mental issues alongside the decline in average testosterone levels in males.
- zapdrive 5y agoBoo fucking hoo. Nobody gives a damn about males. This is the age of feminism. Isn't testosterone a leading cause for toxic masculinity anyways? I forgot the /s, but I'm going to get downvoted either way.
- astrange 5y agoThere isn't such a decline. https://twitter.com/lymanstoneky/status/1372192564053430279 https://twitter.com/lymanstoneky/status/1372192564053430279
- fighterpilot 5y agoThe first factual claim on miscarriages is false. He says early pregnancy failures have increased ten percent. The graph he links shows no such increase according to line of best fit. It only shows it if he cherry picks the largest observation in the data. Even if I grant this false assumption, his inference that late miscarriages have declined doesn't even follow, the data he's presented is fully consistent with an increase in late miscarriage of a few percent. Regarding the testosterone question. The data in the tweet you mention actually does show such a decline - of almost 50 percent in young US males. His point is that the decline has stopped and levels have increased by an extremely small amount in the last 10 years, although that could easily be statistical noise since it is such a tiny increase. Overall, his data shows a large decrease over 50-100 years in the US.
- alfon 5y agoIndeed, every measure that helps decreasing the overall heavy metal burden is welcomed. One of such is the Minamata convention on Mercury [1]. "Studies also confirmed that neurotoxic metals, including lead, mercury, aluminum, and manganese, are measurably more harmful in combination than separately" [2] One researcher that has been advocating for the link between mercury toxicity and Alzheimer's is Dr. Boyd Haley [3]. Lastly, here is a cool video showing how Mercury causes neuron degeneration: https://www.youtube.com/watch?v=bpC17nfZVvU https://www.youtube.com/watch?v=bpC17nfZVvU [1] https://en.wikipedia.org/wiki/Minamata_Convention_on_Mercury https://en.wikipedia.org/wiki/Minamata_Convention_on_Mercury [2] DOI:10.1588/medver.2005.02.00070 [3] https://www.youtube.com/watch?v=8AQxkIcXrt0 https://www.youtube.com/watch?v=8AQxkIcXrt0 [4]
- adrianN 5y agoParticulate pollution has also improved since then. Makes you wonder what other ailments will mysteriously become much less prevalent when we finally get rid of ICE cars, and perhaps reduce car traffic in general.
- amarant 5y agoYeah a lot of particles come from the road/tyres, so if we want to be rid of all of them I guess switching to EVs isn't really enough (but it's a damn good start). Long term(as in multiple decades) we might want to switch maglev railways, as there is no friction to stir particles in the air from that. That would also remove the need for batteries whose production is probably harmful to some degree. Infrastructure costs are gonna be fun though...
- DoingIsLearning 5y ago> I guess switching to EVs isn't really enough For completeness EV apply regenerative braking for a large proportion of use, which is for all practical purposes particle free. Obviously tire wear still applies but brake pad wear is largely reduced So with EV you are getting rid of ICE particulates, CO2, CO, and NO2 (particularly on Diesel engines) and also drastically reducing brake particulate from brake pad wear. And to be fair my intuition is that the health impacts of CO and NO2 is likely far more harmful then tire and brake pad particulates. Having said all of that we would still be better off just having everyone using electric buses or trains within Metro areas at least.
- dcolkitt 5y agoMy understanding is that most particulate emission isn’t from brake pads, but from asphalt on the road. Regen braking should only have a de minims impact.
- RobertoG 5y ago>>"Yeah a lot of particles come from the road/tyres," It seems some people is working on that too: "The Tyre Collective designed a simple device that collects microplastics as they fly off a car tire. As the group of designers explains it, their device helps on the path toward zero emissions by using electrostatic and airflow around the tire to capture the microplastics and other small particles that are shed over the lifetime of a tire." https://www.ecowatch.com/microplastics-car-tires-james-dyson-award--2647697441.html https://www.ecowatch.com/microplastics-car-tires-james-dyson...
- unishark 5y agoCould be a combination of things, some worse but others better: > A commission organized by medical journal The Lancet last year calculated that modifying a dozen risk factors could prevent or delay dementia in 40% of cases. These 12 variables are lack of education, hypertension, auditive disability, smoking, obesity, depression, lack of physical activity, diabetes, social isolation, excess consumption of alcohol, blows to the head and atmospheric contamination.
- DyslexicAtheist 5y agoI remember one of my generation's hobbies especially on the country side was drinking copious amount of booze at every opportunity. You could buy beer in most work canteens. People still drink but it is nowhere close to the frequency that people drank in the 90ies and before: https://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/data-and-statistics/alcohol-country-fact-sheets-2019 https://www.euro.who.int/en/health-topics/disease-prevention...
- wolverine876 5y agoIs there any evidence connecting that to Alzheimers? Regardless, based on your description, the current elderly are the people who grew up drinking heavily.
- thrower123 5y agoMostly this boils down to stupid people who would in previous times have died before dementia was an issue.
- inter_netuser 5y agoSleep apnea is being fixed from roughly that year. CPAP invented in 80s, commercialized in 1989. "ResMed was established in 1989 by Peter Farrell in Australia." Apnea treatments have improved big time since then, and will keep improving, as most are misdiagnosed.
- refurb 5y agoHN loves it leaded gasoline theories. Could also be the shift towards digital encoding of cell phone calls versus the old analogue?
- NavinF 5y agoHonestly can't tell if you're being sarcastic or just going for a hot take
- f6v 5y agoThat’s also the year when table tennis became an Olympic sport.
- dempseye 5y agoI know you're making a joke about spurious correlations, but proposing that a link may exist between the reduction in incidence of a neurodegenerative illness and the removal of a substance with proven neurodegenerative effects from the environment is quite reasonable. At the very least, it passes the sniff test for plausibility and it is worth looking into.
- amelius 5y agoCurious, how do you find these kinds of correlations?
- bsder 5y agoMore likely smoking bans. Richer countries have been trying very hard to reduce smoking since about 1990.
- alexfromapex 5y agoIs it because rich people sleep more? Sleep has been shown to influence AD
- coldtea 5y agoThat wouldn't explain a 16% general drop over a decade where more and more working and middle class masses became less rich and more anxious...
- jobigoud 5y agoMaybe the explanation is that people die of something else before developping Alzheimer.
- Tenoke 5y agoLife expectancy has (mostly) risen during that time, not dropped.
- LatteLazy 5y agoCareful: fewer and fewer people work. It's under 50% now. So you can work those workers harder and still see the average person sleep more and have less stress.
- colordrops 5y agoLess smoking, transfat bans, more awareness around physical and mental health and diet
- s1artibartfast 5y ago>more awareness around physical and mental health and diet Is this true? Diabetes, obesity, anxiety, and depression continue to to climb
- irjustin 5y ago> However, in the words of neurologist David Pérez of Madrid’s Hospital 12 Octubre, thinking that these proteins are responsible for Alzheimer’s is like arriving at the scene of a crime and believing the blood committed murder. I keep reading so much about the mis-folded proteins that it's easy to forget that's not the target? But at the same time, I can't help but think that if we stop the mis-folding we stop the problem? Or am I just thinking about it all wrong?
- colechristensen 5y agoThere is evidence that the misfolding may be a side effect not a cause.
- virgilp 5y ago> arriving at the scene of a crime and believing the blood committed murder. It's more like "believing the death was caused by loss of blood" though, right? As in, it's not completely unreasonable to believe that if you could somehow stop (& compensate) the loss of blood in a timely manner, the person might live, even with a bullet in their body.
- inciampati 5y agoIf you want to specify the metaphor more, it would be like believing that the blood clots committed murder. The protein aggregations apparently serve the same purpose, and are often generated in response to damage/infection.
- kinjba11 5y agoThe 'amyloid hypothesis' as the protein being the cause of Alzheimer's has been the most popular for a few decades, so it's not surprising you've read so much about it. But there hasn't been much success in drugs targeting the protein. New evidence suggests that there could be an underlying cause. I'm a fan of the theory that bacteria/viruses are a cause and that the proteins we see are an overkill immune response to that (wouldn't be the first time - influenza/covid kill some not directly but via the immune system over-doing it). See https://www.nature.com/articles/d41586-018-05719-4 https://www.nature.com/articles/d41586-018-05719-4 for more details.
- adminscoffee 5y agoit's gotta be something to do with some process we are doing differently, there is so many variables to take into consideration, i know people are super privacy these days but we really could benefit if we allow some of our data to be cross referenced in order to find more connections between what we eat and what medicines we take, it's probably already being done somewhere but think of all the grocery stores that have pharmacies, our eating habits may reflect a deeper health issue, connect that with opt in pharmacy data and possible geographic location we might be able to pin point causation.
- f6v 5y agoIt’s tempting to see more data as the solution to everything. Yet, a lot of data creates a high-dimensional space where all the points are really far apart(aka the curse of dimensionality). That’s one of the reasons genome-wide association studies are often frowned upon. With many genetic variants making a tiny contribution to a disease it’s challenging to find the cause.
- aaron695 5y agoClimate Change. Cardiovascular health has been improved because of CO2 emissions. Or, if not playing the blame everything on climate change game - Less smoking, less PM 2.5 pollution, better climate control in buildings have all also helped cardiovascular health. (Missing from the article - declining incidence is more pronounced among men than women)
- HPsquared 5y agoHas average cardiovascular health improved though? I'd have thought it must be worse, with the obesity epidemic and all.
- aaron695 5y agoMortality is dropping in the richer countries https://www.cdc.gov/pcd/issues/2016/16_0211.htm https://www.cdc.gov/pcd/issues/2016/16_0211.htm (2014) Smoking and medicine. People seemed to think smoking was lung cancer, when it was always about cardiovascular health. (It was also about smoke not tobacco) Poorer countries climbing, a lot due to other diseases lowering. You'd need to really drill down to find where to link it to Alzheimers, assuming this best guess from the researchers is correct. It seems a very good guess, it fits in a few places.
- contingencies 5y agoMy hypothesis: more brain stimulation due to media saturation and an increase in nominally personalised and interactive entertainment experience.
- rafaelero 5y agoStatins.
- dm319 5y agoI havent read the article yet, but just to point out that Alzheimer's as a diagnosis is quite a specific one that requires a brain biopsy to prove. This doesn't generally happen. More common is probably vascular dementia - a disease of the small vessels of the brain that have the same risk factors as coronary artery disease (male, age, smoking, obesity, diabetes etc). More work has been done targeting these risk factors for the general health of populations.
- f6v 5y ago> Alzheimer's as a diagnosis is quite a specific one that requires a brain biopsy to prove That’d mean you have a reliable biomarker. But as I read comments here it seems that protein buildup may be unrelated.
- cutthegrass2 5y agoCould there also be a sugar connection? Alzheimer's is referred to as "Type 3 Diabetes" where insulin resistance plays a role in a person developing the symptoms. Do the populations of richer countries consume less sugar per head than poorer nations?
- SturgeonsLaw 5y agoQuite the opposite, per capita sugar consumption in developed countries is over 50% higher than developing countries, and 300% that of the least developed countries (35.5kg vs 21.6kg vs 11.4kg per person per year) https://www.oecd-ilibrary.org/docserver/agr_outlook-2015-table135-en.pdf?expires=1625222668&id=id&accname=guest&checksum=4D9B8392075F275DC0357ADAFAF37615 https://www.oecd-ilibrary.org/docserver/agr_outlook-2015-tab...
- tsjq 5y agoWow! That's lot of opportunities for selling high-margin sugary drinks and snacks to the Billions of hungry people in least developed countries.
- callmeal 5y agoIt's also been linked to gingivitis: https://www.newsweek.com/dementia-gum-disease-alzheimers-linked-gingivitis-1301552 https://www.newsweek.com/dementia-gum-disease-alzheimers-lin... DNA tests on three brains with Alzheimer's disease and six healthy brains also had the gene associated with P. gingivalis in their tissue. The team also examined the cerebrospinal fluid and saliva of 10 patients believed to have Alzheimer's disease, and found the P. gingivalis gene hmuY in seven, and P. gingivalis itself in all of them. And in an experiment on mice, those dosed with gingipains had higher levels of the hallmark Alzheimer's protein, amyloid beta, and greater damage to their neurons than those who didn't. What's more, when mice were treated with a drug blocking the enzymes, the neurodegeneration stopped. ... However, he said the study was limited because the team has not yet determined if different strains of P. gingivalis are more virulent than others in causing brain infection. "This remains an area of active investigation," he said.
- m-i-l 5y agoIt's not all good news - although the percentage of instances per age group have been decreasing, as the article says "the overall number of dementia cases is on the rise, due to the increase in life expectancy and the fact there are a greater number of old people".
- _Microft 5y agoThat depends on what the information is needed for, I would say. If you need to care for these people, the total number might be more important. If you are getting old yourself and are wondering whether you might get it, then the incidence might be more interesting.
- rawoke083600 5y agoOk Im going to guess. The advent and popularity the keto diet. Assumptions 1) Alzheimers has been postulated to be a metabolic disease of the brain and the keto diet via ketones provide a cleaner-fuel with less by-products. 2) The richer countries has more people able to afford the keto-food. Generally more expensive. Fatty beef cuts, cheese, salmon etc. Just a stab in the dark or another guess. I'm not a scientist !
- porb121 5y agoIf you're not a scientist, and have basically no clue what you're saying, why even comment?
- rawoke083600 5y agoI have a degree in biochemistry and microbiology, but I'm not in that field anymore. So a a little more than just "no clue"
- lm28469 5y agoVirtually no one is on a life long (or even just long) keto diet
- dcolkitt 5y agoA lot of interesting hypothesis in this thread. But I’ll offer the simplest, and unfortunately least optimistic: This is simply downstream of the Flynn effect. There were serious gains in IQ between the cohort aging into Alzheimer’s 30 years ago and today. This was mainly due to improvements in childhood nutrition, healthcare, and education in the post war period. It’s well known that Alzheimer’s rates tend to be much lower in the high IQ. Not because the incidence of disease is lower, but because it’s harder to diagnose. John von Neumann would have to experience some serious mental decline before he started failing the standard cognitive batteries. This is less hopeful for two reasons. Number one the disease still exists and is having an effect. It’s still bad if you experience mental decline even if you start at a high baseline. And if life extends far enough, eventually it will get you in a real bad way sooner or later. Number two IQ gains, like height, started seriously after this cohort. So we wouldn’t expect to see continued declines at the same rate.
- kqr 5y agoThis is a good point. As the traditional wisdom goes: when your data indicate a signal, first suspect the validity of your data.
- alexgmcm 5y ago>Not because the incidence of disease is lower, but because it’s harder to diagnose. While it's seems true that "High IQ can mask early Alzheimer’s symptoms"[1] I would be surprised if that could explain such a large decline in incidence as they mention in that report that while it did mask the early symptoms, that just made the decline appear more sudden. The cognitive decline is really incredible, I saw it happen to my grandmother and she went from being a perfectly normal person to not recognising family members and becoming increasingly confused and aggressive all within a few years. So I think even more educated/intelligent people would eventually be diagnosed (perhaps a few months later) and thus any effect on the incidence would be small (due perhaps to these people dying prior to diagnosis). Furthermore, the Flynn effect is quite small, no - around 14 IQ points over more than half a century and now some talk of a decline, the "reversed Flynn effect" so it's not even clear how substantial an IQ difference we could expect. If the decline is due to "improvements in childhood nutrition, healthcare, and education" then I think that's quite good though, as those are things we can control. [1] https://www.heraldnet.com/news/high-iq-can-mask-early-alzheimers-symptoms/ https://www.heraldnet.com/news/high-iq-can-mask-early-alzhei...
- michaelcampbell 5y ago> It is the first time a drug that attacks the suspected causes of Alzheimer’s has received approval from the Food and Drug Administration (FDA): ... but is has not yet been proven that this implies clinical benefits for patients. It is still unknown if the treatment works. It's been approved, ... for what, then?
- nottorp 5y agoLooks to me like aducanumab publicity packed in some fluff. Possibly to paint a positive picture in hope of influencing the EU authorization?