In a recent newsletter, we highlighted a preprint of data analyzed on mortality rates associated with monoclonal antibodies used in the treatment of Alzheimer’s. Since then, the preprint we cited has been withdrawn amid much controversy.
I had found the preprint through a Science article and the nature of the conclusions made it feel urgent to share. Karl Herrup, author of the book How Not to Study a Disease, The Story of Alzheimer’s, was listed as an author. He is someone in the field who I find rational, fair, and unbiased. Additionally, I saw the preprint referred to in the New York Times. I trusted those sources. As it turns out, Dr. Herrup is one of the authors who has withdrawn his name from the preprint.
Over the past few years, research around our understanding of Alzheimer’s has been fraught with confusion, retracted papers and even fraudulent research. The publication and withdrawal of this analysis is the latest in this saga. I’m sure it will continue. My concern remains. Monoclonal antibody medications have minimal benefits that for many people considering them do not outweigh the risks and costs. My hope is that as we learn more, safe and effective medications will come to market and reduce the suffering associated with Alzheimer’s and other dementias.
Science is messy. It isn’t perfect but I will continue to look to science to inform how to best serve my patients and the wider community suffering from Alzheimer’s and dementia. There is so much at stake as for those suffering with cognitive decline and as risk of developing dementia. I feel privileged to be having these respectful conversations within our community, sharing information, constantly updating our understanding, and forever coming back to common sense.
It’s with strong and mixed emotions that I write to you today.
Recently, I came across a news article discussing the latest Alzheimer’s medications—Leqembi and Kisunla—currently in clinical trials. While these drugs are designed to address some of the known risk factors for dementia, they are also surrounded by controversy and concern.
For me, it’s a bittersweet moment.
I long for the day when we have medications that reduce the risk of Alzheimer’s and other dementias effectively, making them rare… But this recent article also served as a painful reminder of how far we are from that goal. New analyses of patients taking these drugs show an alarming 3- to 4-fold increase in mortality risk compared to those in the untreated Alzheimer’s population.
As I read this, my heart sank. It’s disheartening to see the limits of the current pharmaceutical approaches, particularly those based on the Amyloid hypothesis. This was supposed to be the breakthrough that would change everything. But the reality is that a “blockbuster pharmaceutical cure” for Alzheimer’s—at least based on this singular approach—seems unlikely.
Finding Hope in New Approaches
While this news is difficult to digest, I find a sense of hope in the bigger picture. The recognition that the path we’ve been pursuing for years—focusing narrowly on amyloid plaques—may not be the answer opens up space for alternative solutions. This is where we can shift our focus, not just on medications but on lifestyle changes and a multi-pronged, precision-based approach to cognitive health.
Dr. Dale Bredesen’s work is a beacon of hope in this regard. His precision-based approach considers multiple factors that influence brain health, from diet and exercise to hormone balance and inflammation. It’s a comprehensive way of looking at Alzheimer’s—not as an inevitability, but as something we can influence with the right tools.
I believe there’s a real chance for prevention and even reversal of cognitive decline when we focus on lifestyle interventions. If we look at the well-documented modifiable risk factors, we have so much power in our hands, no matter what stage of cognitive decline we’re facing.
What You Can Do Right Now
I’m not going to sugarcoat it—Alzheimer’s is a heartbreaking and devastating disease. But what’s most exciting right now is the opportunity we have to take charge of our brain health and slow cognitive decline. Even if we can’t undo all the damage done, we can certainly optimize the brain we still have.
Here are the 14 modifiable risk factors from the 2024 Lancet Commission Report. Take a moment to read through them and see if there’s one area you can focus on this week. Can you make a small change to improve your brain health today?
- Education
- Hearing loss
- High LDL cholesterol
- Depression
- Traumatic brain injury
- Physical inactivity
- Diabetes
- Smoking
- Social isolation
- Hypertension
- Obesity
- Alcohol consumption
- Air pollution
- Untreated visual loss
😴 Bonus: While not officially listed, sleep plays a huge role in cognitive function, and improving sleep quality is one of the most powerful changes you can make.
These risk factors are modifiable, meaning we can actively make choices that can support our brain health at any stage of life. Small shifts, like incorporating more movement into your day, addressing sleep concerns, or managing stress, can have a profound impact on cognitive function over time.
What’s Going On: Hope in Action
At Solcere, we’re continuing to support individuals in optimizing brain health through a personalized, functional medicine approach. It’s not about waiting for the “magic pill” that may never come. It’s about empowering you to take control of your health today, with a focus on the preventive measures that science is continuing to affirm.
If you’re looking for more guidance on how to implement these changes, I’d love to work with you directly. Together, we can create a personalized plan to support your brain health in a way that’s tailored to your life and needs.
Warmly,
Dr. Heather Sandison
P.S. – If you’re a caregiver for someone with dementia, it can often feel like you’re alone. This podcast is a great reminder that you’re not!
