by Patrick Cox
July 5, 2017
In the words of the virtuoso bluesman Henry Saint Clair Fredericks, “If you ain’t scared, you ain’t right.” We recognize that people who fear imaginary threats are irrational. On the other hand, it’s equally true that a complete lack of fear is irrational.
But being scared is not the same thing as being paranoid, phobic, or cowardly. Fredericks (better known as Taj Mahal) rightly points out that a complete lack of fear demonstrates irrationality.
The Very Real Fear of Alzheimer’s
I’m afraid to get in a car driven by someone who shows early signs of Alzheimer’s disease (AD). This is a rational fear based on several past instances of stark terror. Each involved an older driver experiencing cognitive decline.
In this case, the driver had no idea his driving was impaired. This is the nature of dementia. It may destroy the ability to perceive impairment.
This is why older people worry about minor lapses of memory. We fear they could be early symptoms of dementia.
The fear of losing your identity and memories is rational. Worse, AD is the most expensive disease, requiring extended and constant care. The emotional cost to families may be greater.
Those who believe that this problem can be solved by some government healthcare program may suffer from early stage dementia themselves. Our system is already overstretched and approaching bankruptcy. Demands to spend more money will accomplish nothing.
In fact, our financial problem is getting worse rapidly. The Alzheimer’s Association projects that the cost of AD will nearly quadruple by 2050, hitting $1.1 trillion per year in the US.
The rate of AD rises with the age of the population. A recent CDC report shows that death rates from AD increased 55% over the 15-year period from 1999 to 2014. The CDC study generated headlines such as “Alzheimer’s Deaths Are Skyrocketing.”
New Developments in AD Treatment
There are promising AD drugs in the pipeline now. I own stock in Anavex Life Sciences (*see disclosure below), a company with a drug in phase 2. Most experts agree, though, that drugs aren’t likely to end the AD threat.
I expect that the next generation of AD therapies will resemble cancer therapeutics. Multiple drugs will be used in combination therapies. They’ll work well for some people, marginally for most, and not at all for others.
As life spans increase, AD will become an even greater problem. In the end, the key to AD isn’t curing it. The key is not to get it.
An alternative approach to Alzheimer’s comes from anti-aging medicine. Biogerontologists want to prevent the conditions that lead to the disease.
One of those conditions is obesity. This is a major cause of accelerated aging. Obesity is linked to metabolic disorders such as type-2 diabetes as well as Alzheimer’s.
Researchers at Johns Hopkins Bloomberg School of Public Health found that obesity increases the risk of AD by 80% and vascular dementia by 73%. Obesity is defined as a body mass index (BMI) of 30 or more. This is not the same as “overweight,” which is defined by a BMI of 25 to 30.
BMI is, by the way, an imperfect measure of health risk. It’s skewed by a number of factors, including muscle mass and ethnicity. People with American Indian or Asian genes, for example, may suffer from elevated risks at a lower BMI than other groups.
Individual genomes also play a large role in the proclivity to become overweight. Similarly, it is much more difficult for some people to lose weight than others.
Fortunately, biologists have recently made major breakthroughs in the understanding of metabolic processes and disorders. Two of the most exciting involve brown adipose tissues and mitochondrial proteins. These discoveries are soon going to change the way that we treat obesity.
We’ve grown used to the absence of effective treatments for obesity. The best drugs on the market today are simply not very useful for those trying to lose weight. Fortunately, we’re on the verge of a revolution in metabolic science that will finally allow the most genetically challenged to approach optimal body weight. This will also help solve the Alzheimer’s problem.
(*Disclosure from Patrick Cox: The editors or principals of my employer have a position in this security. They have no plans to sell their position at this time. There is an ethics policy in place that specifies subscribers must receive advance notice should the editors or principals intend to sell.)