Scrutinizing Alzheimer’s Science

A couple of weeks back, I wrote a post that offered some constructive criticism to Allen Power.  As I said then, I have great respect for Power as a leader in the efforts to change the culture of dementia care.  Today I want to applaud him for an insightful post on the need for critical scrutiny of science claims in the Alzheimer’s  field, which was picked up in post by by Howard Gleckman at Forbes.

Power asserts that in the magnitude of funding and the frenzied media hunger for reporting the big breakthrough in Alzheimer’s research has led too many scientists to ignore  some of the basic principles of good science. To his credit, Power does not just bash  pharma studies of drug treatments which he has criticized in his  highly regarded book. He starts instead by criticizing an inflated science claim by Dutch researchers and trumpeted in an email bulletin sent out by WebMD that the incidence of dementia has been falling as a result of  increased cardiovascular health—a theory of non-medical prevention that Power strongly endorses. But the findings in the study were not statistically significant; in other words, by the standard of sound science, it proved nothing.

Power then goes on to argue that a combination of  dodgy scientific claims  and groupthink have been the basis for much of the wide acceptance  in the Alzheimer’s field that anti-psychotics and cholinesterase inhibitors are safe and effective, and that amyloid clearance is the only rational route to pursue in treatment and prevention.

Gleckman’s piece in Forbes went even further, making an argument that many critics of the Alzheimer’s field agree with:

One consequence is that precious dollars are pumped into research aimed at a cure or prevention while almost no resources are available to help learn how to better care for people who already have dementia or for training or other assistance for their caregivers.

This battle over dollars has been going on for a long time. Drug companies, academics, and high profile advocacy groups such as the Alzheimer’s Association focus almost entirely on increasing research dollars for cure and treatment.”

Gleckman acknowledges the value of biomedical research on Alzheimer’s, but argues that it should not longer be virtually the only thing that the federal government will spend money on to address dementia:

So far, research is teaching us that these diseases are very complicated and progress towards cures or treatments is very slow. That’s why we should be working a lot harder to learn how best to care for people with these diseases.”