Did the World Just Gain Hundreds of Millions of Alzheimer's Patients?

Did the World Just Gain Hundreds of Millions of Alzheimer's Patients? A new definition of Alzheimer's includes people without symptoms. Experts are fiercely divided over whether that makes sense--and whether the new drugs really help. Many have heralded a golden age of Alzheimer's research, excited by the promise of new amyloid-targeting antibodies. Yet a large meta-study of such antibodies concluded that they probably result in "little to no difference" in the decline of memory and of cognitive ability. This July, some ten thousand people descended on London for the Alzheimer's Association International Conference. Another three thousand of us joined virtually. I'm an anthropologist, accustomed to conferences where croissants at coffee breaks count as a luxury. This one opened with six trumpeters dressed as Buckingham Palace guards, followed by dancers who discoed, vogued, and high-kicked through the history of British pop. After the first day's sessions, participants dispersed to parties; at one, singers in sequins belted out covers while someone played an illuminated, transparent violin. One night, the London Eye was lit purple to honor the people in attendance. The mood matched the spectacle. Joanne Pike, the Alzheimer's Association's president and C.E.O., announced that recent advances had brought the campaign against the disease to a "pivotal moment." Maria Carrillo, its chief science officer, hailed a groundswell of progress. That optimism followed decades of disappointment. Between 1974 and 2020, the U.S. government spent roughly twenty billion dollars on Alzheimer's research without seeing the approval of a single treatment designed to act on the disease's underlying biology, let alone stop or reverse its course. Today, Alzheimer's afflicts roughly one in nine Americans over sixty-five and, along with related dementias, has been estimated to cost the economy about three-quarters of a trillion dollars a year. In surveys, it ranks with cancer as the disease people fear most. It typically starts by robbing patients of recent memories--conversations they just had, where they put important objects--before corroding the basic functions of adult independence, from paying bills to managing medications. Eventually, it leaves patients unable to speak, move, swallow, or recognize close relatives.