Alzheimer's: 'Promising' blood test for early stage of disease

Personally, I want some solid tests so I can have reliable information to make sure I end my days as myself.

The breakthrough here is in a diagnostic test for Alzheimer's. You are making a generalization based on the assumption that this information will ultimately extend life rather than improve the quality of life. For jurisdictions that allow medical assistance with dying, this information can plausibly result in the opposite effect.

Today I'd argue that the growing lifespan is used as an argument to make people work longer, which means in worse physical conditions. The "Work until your death" motto (the curse of people living in poverty) is not great for a healthy and attractive society. Questioning it ends up in a heated political/societal/philosophical discussion pretty quickly. And we're definitely not heading in the healthy direction: not because we don't want to shift the medical institution, but because we need a more profound society change. From a purely economical PoV, it's great that people die before around the beginning retirement, from a societal PoV it's a disaster.

We're not close to fixing this, and barring some tectonic shift in our capabilities, probably won't see substantial change within our lifetimes. But to take the stance that death and aging are acceptable seems so medieval to me.

It's worth pursuing longevity science if we can help more people age this way.

You’re mistaking average for median life expectancy. People lived to older ages in the past. But lots of babies died, so the average life expectancy was way down. Add a lot of zeros to a number series and it gets pretty low.

Ancient comedy even had a stock character, sexex iratus: angry old man. Certainly there are many more very old people now, but it wasn’t something totally unknown.

The aging of people has also coincided with a decline in our physical health and diets. Strength is declining year on year: we have grip strength measures for college age students since the 1980s and it is a steady decline. Diets are worse, people are much fatter and with more health problems such as type 2 diabetes.

One of the theories of alzheimers is that it is a form of diabetes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/

Certainly it is correlated with type 2 diabetes, and with obesity in mid life. (Not in late life, but this may be because sudden weight loss is a precursor of alzheimers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205180/)

Have a look at this chart. Japan has one of the oldest populations in the world, and yet its alzheimers death rate is less than 6x that of the usa: https://www.worldlifeexpectancy.com/cause-of-death/alzheimer...

There is more to this than just age. Our lifestyles increasingly leave us hobbled by ailments at young ages, and the medical system patches it up and lets us live through them longer. But this expresses in much more old age morbidity than would otherwise be biologically necessary.

I wish I had more time to pull up references for you, but I believe that the answer to your question is "yes" -- extending people's life through intervention usually gives people more years of quality life and usually has little effect on the number of years of poor quality life.

We have a few factors that have greatly attributed to this increase in life and increase in mental illnesses: decrease in tobacco (specifically smoking) use, increase in processed food eating, increase in life sustaining medicines, decrease in overall activity.

Tobacco: on one hand we know that smoking raises chances of having a shorter life span as it really accelerates cellular inflammation and deterioration. (1) On the other the stimulant aspect of nicotine helps the brain continue to stay active and helps resist atrophy. Personally, I notice more and more people I interact with on antidepressants. My parents and grandparents generations probably suffered the same levels of depression (more or less) but moderated this with smoking.

Processed Foods: Modern processed foods started to flood grocery stores after the Second World War and became the staples of the American diet. Natural fats were replaced with unnatural and chemical based preservatives were put in many goods to increase shelf life. We know empirically that these foods also (like smoking tobacco) increase all cause mortality. Alzheimer’s prevention advice typically advocates for a diet removing such items. (2)

Better Medicine & Decrease in Activity: these two factors may need no introduction but we know that the older we get the less stem cells we have and the worse our cellular health is overall. Moderate Exercise helps slow the death of such cells. (3) Again, this is circumstantial, but all of the people I personally know with Alzheimer’s and other amyloid plaque based diseases did not lead active lifestyles and I would define their lifestyles as quite sedentary.

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098701/

(2) https://en.wikipedia.org/wiki/Alzheimer's#Epidemiology

(3) https://www.google.com/amp/s/time.com/4776345/exercise-aging...

As someone who has had to coordinate end of life care more than I’d like to have had to, this is invaluable.

Early identification absolutely matters, the question is HOW early. 5 years doesn't do much, 15 years? You can change your entire lifestyle and the changes can take effect with that much time.

“Early diagnosis is important because it could offer more opportunities to treat the disease. Dr Rosa Sancho, head of research at Alzheimer's Research UK, explained that previous clinical trials of drugs had failed because the patients enrolled in them were too far advanced in their illness, and by that time it was "too late".

- Whatever specific thing is being tested becomes a candidate for future interventions.

- It could give researchers a tighter pool of candidates for longitudinal studies.

- As others have mentioned: any treatments that require early intervention have a better chance of working. (Similar to cancer, I imagine.)

One of the basic problems is that we lack a fundamental understanding of how the disease works, so throwing more money at it gets diminishing returns beyond a point. It's like the war on cancer in the 1970s. We threw tons of money at cancer research which basically consisted of trying more newer combination chemotherapies in greater amounts and in new permutations trying to find the combination of chemicals that would eradicate all cancers. That only got us so far. However, at the same time, with a lot less funding and public support, scientists were making headway at understanding cancer not necessarily as a cellular disease, but as a genetic disease. By realizing that cancer is driven by genetic mutations, those scientists paved the way for the vastly more effective treatments and rush of immunoconcology/personalized/targeted therapies we see today. Throwing more money at Alzheimers at this point basically all but guarantees more trials of amyloid beta inhibitors at earlier stages and with bigger trials. We've already burnt tens of billions of dollars on that. The basic research to understand the disease is actually cheaper in the long run than running more of those clinical trials, but it's a stochastic, slow process with unclear goals and timelines.

Trying to actually pin down hard numbers is difficult (searches invariably lead you to the cost of Alzheimer's disease rather than the cost of Alzheimer's research), but it looks like we're already at several billion dollars a year on Alzheimer's research. If it hasn't cost more than the Apollo project already, it likely will by the end of this decade.

https://www.alzheimers.org.uk/about-dementia/risk-factors-an...

Despite this, quite a few people claim that Okinawa, Japan provides more than enough anecdotal examples of the effectiveness of turmeric in longevity. Additionally, the life expectancy of Okinawans has decreased as their diet has become more Westernized and similar to mainland Japan. Okinawans traditionally eat a lot of sweet potatoes, seaweed, soy, lean pork, fish, and a lot of turmeric, ginger, and green tea. The caveat is that each ingredient in isolation usually fails to show a measurable benefit.

https://en.wikipedia.org/wiki/Okinawa_diet

That's before taking into account potential differences in whether or not people are diagnosed.

That said, turmeric (and especially curcumin) is a subject of study. But these studies also suggest it is unlikely simply eating turmeric helps, as it's not absorbed well by the body and the amounts needed would be exceptionally high.

However from reading the abstract of the actual study, it seems the TLDR is "more accurate than current ways to test, and significantly cheaper too" - which would be a great step regardless of if it's not quite as perfect as a vague "high % accurate!" makes it sound.

https://jamanetwork.com/journals/jama/fullarticle/2768841

Heart problems are basically mechanical problems, we're guaranteed to fix them in the next 100 years, if only by printing new hearts and blood vessels. Cancer is a cluster of rogue cells, and just it's a matter of time before we can focus poisons, blades, irradiation, and nano-bots precisely enough before treatment becomes as routine as annual dentist visit. Similarly bacterial infection - it's just a foreign object that needs to be killed with some precision. Viruses are trickier but maybe not that much - killing infected cells seem like it would do the job.

Brains are complicated though, you can't just seek and destroy something that's wrong. It's not a given that we can fix them in the near future, and as all other diseases recede we will end up with close to 100% of people succumbing to brain disorders at the end of their lives.