Readers Write: Alzheimer’s research sidelined by groupthink

The Island Now

The article on the Long Island Alzheimer’s Foundation’s Golf Classic raising a substantial sum of money caught my eye, as it came on the heels of a piece in the medical news organ STAT, regarding what has been dubbed “The Amyloid Cabal.” Apparently, it appears that billions of dollars, and worse, precious time, have been wasted chasing down the wrong culprit for the affliction. And the reason for this is a strange mixture of the politics of research and some of the perverse incentives built into the American health care system, of which Long Island is a prime specimen.

Here’s the back story, courtesy of STAT medical journalist Sharon Begley: While not an organized cabal, or a deliberate conspiracy, it seems all of the research effort has been focused on trying to remove amyloid plaque that is found in dementia patients. There were only two problems with this line of inquiry: Not all dementia patients have amyloid plaque, and some people with perfectly normal cognition do.”

The author says even if the plaque was removed, the cognitive function still would be lost.  Nevertheless, the research into other causes has been sidelined since 1984, when the amyloid hypothesis was developed. Begley quotes George Perry, a neuroscientist at the University of Texas–San Antonio, as saying that scientists who didn’t go along with the amyloid hypothesis  “became roadkill on the highway to nowhere.”

How did this happen? Again, no conspiracy, but an example of rigid groupthink that manifested itself in different ways, which affects how funding is directed. Researchers who had developed other ideas about a path to a cure were often greeted with derision by the medical research establishment. Research papers dealing with non-amyloid theories were shunted into third tier medical publicationsand never reached the audience that JAMA or the New England Journal of Medicine gets. Lest anyone think that only the mass media warps the general public’s perception of reality, it can also do so for more obscure spheres of interest. These publications have an awful lot of power as to what gets seen (or not) by the profession. Since no one would give any alternative line of inquiry any exposure, or even credence, it became impossible to raise either private capital or public funding to explore them.

Even today, most of the NIH funding for Alzheimer’s is still going to amyloid-based research, despite the line of inquiry being discredited, after 30 years and billions of dollars squandered. The attention the STAT article has generated may be the trigger to finally turn the tide to more productive research.

I was happy to see that the fundraiser was exclusively dedicated to the care of those already afflicted, as opposed to funding research. At least the donors can rest easy knowing that their funds were far better spent at this point in the battle against this disease.

Donald Davret

Roslyn

 

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