Article by: Harper Mason, on 09 July 2023, at 08:35 am PDT

The recent approval of new Alzheimer's drugs by the Food and Drug Administration has sparked a glimmer of hope for the millions affected by this devastating disease. However, amidst this progress, there is a puzzling shadow that looms.

These drugs, while offering a brief respite in the pace of cognitive decline, come at a high cost with relatively limited benefits. This raises an important question: Are we overly fixated on marginally effective treatments at the expense of more promising preventive measures?

The pharmaceutical industry stands to gain substantial profits from these drugs, which are projected to bring in billions. It's no wonder that stock prices surged after positive trial results were announced. Yet, the efficacy of these drugs remains contested. Scientists have even resigned from FDA advisory committees due to the lack of evidence supporting their effectiveness. The role of the drugs' main target, amyloid plaques, is still subject to debate.

Beneath the surface of these pharmaceutical victories, the potential of prevention remains largely untapped and underreported.

The prevailing narrative surrounding Alzheimer's portrays it as an unstoppable force, overshadowing the preventive strategies that are not only affordable but effective. Prevention offers the opportunity for years of cognitive health, rather than just fleeting moments of slowed decline.

Preventing a fall is easier than trying to pick up the pieces afterward. Similarly, preserving healthy brain cells is far more feasible than attempting to regenerate them after they have been lost. Prevention and late-stage reversal are two completely different challenges.

The bias against prevention reflects a larger issue within our biomedical-industrial complex, which primarily focuses on managing diseases rather than promoting health. Our reactive healthcare system is designed to patch up problems after they arise, rather than actively addressing risks and prioritizing prevention. This approach is costly and fails to prioritize healthy living.

We should champion a healthcare system that prioritizes extending health rather than responding to disease. In the case of Alzheimer's, this means prioritizing prevention strategies that can preserve cognitive health at a fraction of the cost of late-stage drug interventions.

So, what does prevention entail? Several often-overlooked precautions can play a crucial role in preventing dementias like Alzheimer's. Maintaining brain oxygenation, ensuring proper nutrient intake, managing stress, reducing inflammation, controlling diabetes, preventing head injuries, minimizing air pollution exposure, addressing hearing impairments, maintaining a healthy weight, engaging in mentally stimulating activities, and fostering strong social connections are all important aspects.

Many of these preventive measures are straightforward, cost-effective, and sometimes even free. Regular aerobic exercise, for example, promotes cardiovascular health and efficient brain oxygenation. Research has shown that diets rich in certain nutrients can lower the risk of dementia. Ensuring adequate levels of vitamin D, often obtained from spending time outdoors, has also been linked to a reduced risk of dementia.

Lifestyle modifications such as quitting smoking, moderating alcohol consumption, and managing hypertension can have a significant impact on prevention. A balanced diet, sufficient sleep, and avoiding chronic infections can help control inflammation.

While the impact of each measure might be modest, when combined, they can significantly delay cognitive decline.

The effectiveness of prevention-based strategies has been demonstrated in studies like the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). This landmark trial tackled dementia prevention from multiple angles, incorporating nutrition, physical activity, mental stimulation, and social engagement. After two years, participants in the prevention group performed significantly better on cognitive assessments compared to the control group. They also experienced broader health benefits, with the side effects of prevention being positive rather than negative.

The success of trials like FINGER has inspired further research worldwide, including studies like the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (POINTER). The global scientific community recognizes the value of prevention.

The fight against Alzheimer's is at a critical juncture. Prevention and treatment should not be seen as mutually exclusive but rather as complementary components of a comprehensive approach to this formidable disease. However, the emphasis we place on each path has far-reaching implications not only for the millions directly affected but also for the trajectory of our healthcare system.

While it remains crucial to continue developing innovative treatments, we already have a range of accessible and cost-effective preventive measures supported by scientific research. These measures won't drain our resources; they simply require us to recalibrate our lifestyles and priorities.

Individuals, healthcare providers, policymakers, and society as a whole need to redirect more focus and resources toward Alzheimer's prevention. This shift could save billions in healthcare costs and, most importantly, preserve the memories and identities of countless individuals for longer.

In a world where Alzheimer's poses an increasing threat, we have the opportunity to rewrite the narrative. Rather than accepting the inevitability of the disease, we can see it as a challenge that we have the tools to combat. Let's strive to have as few affected loved ones as possible.