7 ms·

This stifling of competing ideas, say a growing number of scholars, is a big reason why there is no treatment for Alzheimer’s. (The four approved drugs have no

This stifling of competing ideas, say a growing number of scholars, is a big reason why there is no treatment for Alzheimer’s. (The four approved drugs have no effect on the disease, providing only a temporary memory boost.) Those who championed the amyloid hypothesis truly believed it, and thought that focusing money and attention on it rather than competing ideas was the surest way to an effective drug. Or maybe the real problem is the excess emphasis on finding a drug in specific that can be commercially monetized. A single drug for a single cause of what is likely a complex process. Amyloid and another protein (tau) accumulate in the brain due to sleep deprivation. Helping people get a good night's sleep -- without drugs -- would likely help, if only to stave it off in those at risk. The problem is it won't create any razzle dazzle "unicorn" companies and newly-minted zillionaires. One of the researchers in the article found that herpes simplex infection promotes the accumulation of amyloid. Her research was not irrelevant to the amyloid hypothesis. It was only irrelevant to an agenda to find a drug to treat amyloid.

wins32767 4y ago
Drugs that can't be commercially monetized can't get through the rigorous and extremely expensive approval process that allows your doctor to write you a script for something you can fill at the pharmacy. As for other treatments, medicine basically boils down to surgery, drugs, and/or letting your body heal itself. The latter clearly doesn't work and for progressive diseases surgery generally isn't effective, so you're back to drugs.
- ClumsyPilot 4y ago
  Thats not true. Many conditions are well adressed by informing and training those at risk how to best take care of themselves. Current medicide really fails at this. In fact it fails in many arreas where a longterm and consistent influence is required. Getting diagnosis and treatment for vitamin defficiency, hormonal imbalance, stomach microbiome, psycology related issues, and many other conditions simply does not happen unless patient does his own reading and pesters the doctor for treatment.
  - wins32767 4y ago
    > Many conditions are well adressed by informing and training those at risk how to best take care of themselves. I had that bucketed in with letting the body heal itself. I fully agree that there is a big gap between how medicine is delivered and what kind of overall care people need to be maximally healthy. It's what my current company does actually! But with respect to diseases like Alzheimers, supportive care isn't going to cut the mustard in meaningfully impacting disease progression, you need drugs for that. And if you need drugs, the way the current regulatory regime operates, you need to have a shot at turning multiples of a billion in profit post-approval to pay back the development costs of the approved drug and all the drugs that failed to get approved.
jelling 4y ago
> Or maybe the real problem is the excess emphasis on finding a drug in specific that can be commercially monetized > ... > Amyloid and another protein (tau) accumulate in the brain due to sleep deprivation. Helping people get a good night's sleep -- without drugs -- would likely help, if only to stave it off in those at risk. People are dying right now. Giving them better sleep habits won't save them or meaningfully extend their lives. People are suffering in ways that I don't think you understand and I hope you never do.
- deleted 4y ago
  [deleted]
- vaylian 4y ago
  Do we need medication to cure or at least treat the disease? Hell yes! But preventing people from getting the disease in the first place is also very important.
pfisherman 4y ago
> Helping people get a good night's sleep -- without drugs -- would likely help, if only to stave it off in those at risk. Are doctors not already telling people to get good night’s sleep? Are healthy diet and exercise not already universally recommended? Do we not already warn people against smoking and excessive drinking? Have we not implemented sin taxes to disincentive these unhealthy behaviors? Obviously these efforts, while beneficial are not even close sufficient. Thus there is a large unmet need for therapeutic intervention. Whoever is able to meet that need will be handsomely rewarded, and rightly so, because they will have meaningfully improved the health and quality of life of many many people.
- eurasiantiger 4y ago
  Maybe part of the problem is that we consider these things ”sins”, with all the subconscious burden of suffering for all eternity in a fiery pit thanks to a belevolent god who made that place, and who also loves you.
- Teever 4y ago
  I hear the exact same hot takes wheb diacussing life extension. 'eat healtheir', exercise more' etc... None of these things are going to make anyone live to 150, and they sure arn't going to make you less frail at 90. What we want are definitive treatments to both prevent and cure alheimers and given the options available in medicine id sure as hell prefer an expensive pharmacutical than something like brain surgery or weekly and exhausting procedures like dialysis. People like to shit talk the pharma industry and theres a lot to shit talk it for but lets be clear here, a lot of pharmacutical solutions are god damned life changing miracles. if someone deserves to be rich for their efforts it sure as shit should be people inventing medicine and not people in marketing or real estate or whatever.
  - pwthornton 4y ago
    Diet, exercise, and good sleep are exactly the kinds of things that make people less frail at 90 (or 60 or 50). If you’ve ever met someone who isn’t frail when they are older it’s because they stayed active throughout their life. This doesn’t necessarily mean exercise, but it could mean doing lots of yard work, going on walks, etc. I’ve never met a chronic inactive person who moved well as they aged. We will need the pharma industry to treat Alzheimer’s and related conditions, but it is primarily lifestyle that we need to address to prevent it. Chronic lack of sleep will lead to all kinds of health issues, including dementia.
aaron695 4y ago
fsckboy 4y ago
> Amyloid and another protein (tau) accumulate in the brain due to sleep deprivation. isn't it still just a hypothesis that long term sleep deficits could be connected to dementia?
- DoreenMichele 4y ago
  I don't know. I do know for a fact that sleep is when the brain "takes out the trash" and lack of sleep leads to accumulation of stuff that shouldn't be there. https://news.ycombinator.com/item?id=25427090 https://news.ycombinator.com/item?id=25427090
nabla9 4y ago
The whole point is that amyloid hypothesis is wrong. Accumulation of beta and tau is not causing the daisies. (1) Pathological levels of amyloid-beta and tau are present in cognitively normal individuals, and (2) some individuals clinically diagnosed with AD do not have amyloid-beta pathology.
staticassertion 4y ago
"Just get some more sleep" doesn't help people who already have Alzheimers, who are at risk, who have sleeping disorders, etc.
XorNot 4y ago
So to be clear, you wrote this: > Or maybe the real problem is the excess emphasis on finding a drug in specific that can be commercially monetized. A single drug for a single cause of what is likely a complex process. And the proceeded to write this: > Amyloid and another protein (tau) accumulate in the brain due to sleep deprivation. Helping people get a good night's sleep -- without drugs -- would likely help And didn't see the irony at all?
- nosianu 4y ago
  Uhm... well, I (not the OP) don't. What issue do you see here?
bencollier49 4y ago
> Helping people get a good night's sleep -- without drugs -- would likely help, if only to stave it off in those at risk. Or reverse causation.

wins32767 4y ago

Drugs that can't be commercially monetized can't get through the rigorous and extremely expensive approval process that allows your doctor to write you a script for something you can fill at the pharmacy. As for other treatments, medicine basically boils down to surgery, drugs, and/or letting your body heal itself. The latter clearly doesn't work and for progressive diseases surgery generally isn't effective, so you're back to drugs.

ClumsyPilot 4y ago
Thats not true. Many conditions are well adressed by informing and training those at risk how to best take care of themselves. Current medicide really fails at this. In fact it fails in many arreas where a longterm and consistent influence is required. Getting diagnosis and treatment for vitamin defficiency, hormonal imbalance, stomach microbiome, psycology related issues, and many other conditions simply does not happen unless patient does his own reading and pesters the doctor for treatment.
- wins32767 4y ago
  > Many conditions are well adressed by informing and training those at risk how to best take care of themselves. I had that bucketed in with letting the body heal itself. I fully agree that there is a big gap between how medicine is delivered and what kind of overall care people need to be maximally healthy. It's what my current company does actually! But with respect to diseases like Alzheimers, supportive care isn't going to cut the mustard in meaningfully impacting disease progression, you need drugs for that. And if you need drugs, the way the current regulatory regime operates, you need to have a shot at turning multiples of a billion in profit post-approval to pay back the development costs of the approved drug and all the drugs that failed to get approved.

jelling 4y ago

> Or maybe the real problem is the excess emphasis on finding a drug in specific that can be commercially monetized > ... > Amyloid and another protein (tau) accumulate in the brain due to sleep deprivation. Helping people get a good night's sleep -- without drugs -- would likely help, if only to stave it off in those at risk. People are dying right now. Giving them better sleep habits won't save them or meaningfully extend their lives. People are suffering in ways that I don't think you understand and I hope you never do.

deleted 4y ago
[deleted]
vaylian 4y ago
Do we need medication to cure or at least treat the disease? Hell yes! But preventing people from getting the disease in the first place is also very important.

pfisherman 4y ago

> Helping people get a good night's sleep -- without drugs -- would likely help, if only to stave it off in those at risk. Are doctors not already telling people to get good night’s sleep? Are healthy diet and exercise not already universally recommended? Do we not already warn people against smoking and excessive drinking? Have we not implemented sin taxes to disincentive these unhealthy behaviors? Obviously these efforts, while beneficial are not even close sufficient. Thus there is a large unmet need for therapeutic intervention. Whoever is able to meet that need will be handsomely rewarded, and rightly so, because they will have meaningfully improved the health and quality of life of many many people.

eurasiantiger 4y ago
Maybe part of the problem is that we consider these things ”sins”, with all the subconscious burden of suffering for all eternity in a fiery pit thanks to a belevolent god who made that place, and who also loves you.
Teever 4y ago
I hear the exact same hot takes wheb diacussing life extension. 'eat healtheir', exercise more' etc... None of these things are going to make anyone live to 150, and they sure arn't going to make you less frail at 90. What we want are definitive treatments to both prevent and cure alheimers and given the options available in medicine id sure as hell prefer an expensive pharmacutical than something like brain surgery or weekly and exhausting procedures like dialysis. People like to shit talk the pharma industry and theres a lot to shit talk it for but lets be clear here, a lot of pharmacutical solutions are god damned life changing miracles. if someone deserves to be rich for their efforts it sure as shit should be people inventing medicine and not people in marketing or real estate or whatever.
- pwthornton 4y ago
  Diet, exercise, and good sleep are exactly the kinds of things that make people less frail at 90 (or 60 or 50). If you’ve ever met someone who isn’t frail when they are older it’s because they stayed active throughout their life. This doesn’t necessarily mean exercise, but it could mean doing lots of yard work, going on walks, etc. I’ve never met a chronic inactive person who moved well as they aged. We will need the pharma industry to treat Alzheimer’s and related conditions, but it is primarily lifestyle that we need to address to prevent it. Chronic lack of sleep will lead to all kinds of health issues, including dementia.

aaron695 4y ago

fsckboy 4y ago

> Amyloid and another protein (tau) accumulate in the brain due to sleep deprivation. isn't it still just a hypothesis that long term sleep deficits could be connected to dementia?

DoreenMichele 4y ago
I don't know. I do know for a fact that sleep is when the brain "takes out the trash" and lack of sleep leads to accumulation of stuff that shouldn't be there. https://news.ycombinator.com/item?id=25427090 https://news.ycombinator.com/item?id=25427090

nabla9 4y ago

The whole point is that amyloid hypothesis is wrong. Accumulation of beta and tau is not causing the daisies. (1) Pathological levels of amyloid-beta and tau are present in cognitively normal individuals, and (2) some individuals clinically diagnosed with AD do not have amyloid-beta pathology.

staticassertion 4y ago

"Just get some more sleep" doesn't help people who already have Alzheimers, who are at risk, who have sleeping disorders, etc.

XorNot 4y ago

So to be clear, you wrote this: > Or maybe the real problem is the excess emphasis on finding a drug in specific that can be commercially monetized. A single drug for a single cause of what is likely a complex process. And the proceeded to write this: > Amyloid and another protein (tau) accumulate in the brain due to sleep deprivation. Helping people get a good night's sleep -- without drugs -- would likely help And didn't see the irony at all?

nosianu 4y ago
Uhm... well, I (not the OP) don't. What issue do you see here?

bencollier49 4y ago

> Helping people get a good night's sleep -- without drugs -- would likely help, if only to stave it off in those at risk. Or reverse causation.