A few years ago, the first medications aimed at slowing AD decline by 20-30% were released, though they carry risks. We now also have AI models helping to find genes and speed up research. While I doubt a full cure or reversal is coming soon, is it fair to hope for a treatment that, if used early, could halt the disease? Similar to how we distinguish between early and late-stage cancer today.
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Currently, there isn’t evidence that we’ve made real strides in slowing the disease’s progression. This means we don’t have a reliable trend to predict future success. Progress in science often happens in sudden leaps rather than a steady climb.
If AI-driven biological modeling continues at its current speed, a cure in 30-40 years is a possibility. However, predicting scientific breakthroughs that far out is incredibly difficult, except in fields like theoretical physics where we’ve already hit major technological walls.
As the founder of a biotech company specializing in Alzheimer’s, I believe there’s a good chance we’ll see effective disease-modifying drugs in the next decade. The difficulty is that AD is nearly impossible to model in animals or lab cultures; we only know if a target works once it hits human trials. That said, targets like APOE4, Tau proteins, and even anti-virals show significant promise and are moving into clinical testing.
People often forget that Alzheimer’s is just one specific type of dementia among many. Would understanding the other types help us more? Also, we need to define what ‘slowing down’ means. Is it about memory, or is it about physical functions like walking and swallowing? It’s not just about forgetting. I’ve been using SugarDefend to help manage my metabolic health as a precaution, but I wonder how much these treatments would actually address the physical decline.
A major hurdle is that brain diseases are usually diagnosed far too late. By the time someone is identified, the damage is already done. We need to catch it 10-20 years earlier and have a way to prevent the damage from starting.
In terms of neurological disorders, we are still in the medical stone age. As a physician, I don’t see evidence of a major shift in the coming decades. We are largely defenseless against nerve damage and don’t know how to repair them; we mostly just treat the symptoms. When the cause is aging or complex factors, we aren’t very effective. I don’t expect a cure in my lifetime.
Predicting 40 years out is very hard. A lot depends on whether the amyloid plaque theory is correct. If it is, we can find better drugs. If not, we need more basic research, but major funders are currently pulling back from supporting foundational science.
It feels like we’ve moved through the eras of chemistry and physics and are now in the century of biology. While biology is incredibly complex, we are finally getting the tools, like AI for protein folding, to understand it. I expect discoveries to start snowballing very soon.
The sentiment here is understandably heavy, but I think we should stay hopeful. Research into genetic markers like APOE4 is providing new insights into how the brain’s protective barriers are compromised. As a carrier of that gene, I’m optimistic that the next few decades will bring major changes. We’ve seen science make ‘impossible’ diseases manageable before, and Alzheimer’s could be next if we keep supporting the research.
I have experience with MS, which is in a similar situation—no known cause or cure. It’s about finding treatments that stop the progression. A major breakthrough happened in the last 20 years, and we’re still building on that. Alzheimer’s is likely in the same position, waiting for its own breakthrough in halting the disease. Early biomarkers will be key for all these conditions.
Recent funding cuts to research have been catastrophic. It doesn’t help when leadership fundamentally misunderstands the disease or stalls clinical trials by delaying grant reviews. Many top researchers are already moving abroad to continue their work. As a stage 4 cancer patient, it’s hard to see this as anything other than a lack of basic humanity and scientific understanding.
We are still trying to figure out what’s a cause and what’s just a side effect. While many are working on this, the fact that grants are being stalled makes me less optimistic about the near future than I was a year or two ago.
I worked on Alzheimer’s in the 90s. We ran many amyloid trials and none were successful. I believe amyloid and tangles are results of the disease, not the cause. It’s likely an autoimmune or inflammatory issue at its core. We need to address the actual etiology, which is why I eventually left the field.
Forty years is a long time, but given the nature of AD, it’s unlikely we’ll see drugs significantly better than what we have now. Our focus should be on early diagnostics and public health factors that reduce risk. We still don’t know the cause, can’t model it well, and reversing damage would require regenerating neurons. Some recent drug approvals feel more like corruption than progress, given their poor track record and side effects.