Newsweek magazine announced this week that the latest advance in treating Alzheimers disease is the novel (!) thought of preventing the disease rather than treating it. Prevention is of course a better approach, for most diseases better than treatment after the fact. Ultimately, though, I am disheartened by what I see not as Big Pharma’s enlightenment, but rather their capacity to distract us from seeing clearly.
For many of our modern epidemic and non-contagious illnesses, there have evolved two competing camps:
- Lifestyle proponents believe that the genesis of a problem is multi-factorial and so must be its solution. Heart disease is not just high cholesterol: statins aren’t the solution. Within that world, each reliance on a pharmaceutical solution runs the risk of missing the bigger picture. Taking a hypertensive to normalize blood pressure misses the opportunity to find out why it’s high and to correct an underlying mechanism that will eventually cause other problems besides blood pressure.
- Pharma believers and manufacturers on the other hand love the concept of a broken switch, a single genetic error, a single physiological mis-step. Don’t get me wrong: there are many good uses for many prescription drugs. If strep bacteria are causing your sore throat, one simple drug that kills the bacteria is an excellent tool in the acute setting. (After you’re better you can work on your general immune resistance.) Pharma, however, also hopes that our chronic illnesses have a similarly simple cause and solution. For Alzheimer's the broken switch is the production of amyloid beta and they now are working on a drug that might prevent its accumulation in the brain.
What if amyloid is not the problem? What if some perfectly normal people are found to have significant amounts of amyloid beta but maintain normal cognitive function? (C'mon, Pharma, you know that's the case.)
What if your brain has a complex method of self-balancing, and is constantly trying to maintain and regenerate neurons to maintain cognitive performance? What if the complexities of your life are responsible for assaults on your neurons and the amyloid beta is merely a response to injury?
If the origins of neuron loss are complex and amyloid beta is the bandage to the wound, preventing the bandage from doing its job will not be helpful, particularly if the cause of wound is still present.
Dr. Dale Bredesen’s program, the only intervention to reverse the cognitive decline associated with Alzheimers disease, is betting on the Lifestyle model. Some day the Pharma folks will probably echo the words we heard on the news this week, “Who knew it could be so complicated?” Complicated, yes, and often better managed with physician support, but a program that in large part people can initiate and manage on their own.
Those folks ready to tackle and optimize the complexities of their lifestyle can be rewarded with the prevention of Alzheimers, and—while they’re at it the prevention or reversal of pre-diabetes, high blood pressure, and heart disease—and the rewards of optimized weight, sleep, mood and energy levels.