COMMENTARY

Bill Gates Funds Alzheimer Research, but Was an Opportunity Missed?

Richard S. Isaacson, MD

Disclosures

March 01, 2018

Hello. I am Dr Richard Isaacson, a neurologist and director of the Alzheimer Prevention Clinic at Weill Cornell Medicine and the NewYork-Presbyterian Hospital in New York City.

You may have heard the news that Bill Gates has thrown his hat into the ring to find a cure for Alzheimer disease. Just recently, he came out and said for the first time that his father suffers from Alzheimer disease. He wants to help make a dent in the outlook for this condition. He has committed about $100 million of his own funds as a first round toward doing something exciting.

Although this is a really invigorating piece of news for those who are in the Alzheimer disease research community, when I heard the news and when I saw the press, a part of me wondered whether this great opportunity could be a missed opportunity. By that I mean, this is a great effort, and it is super vitally important that we put a lot of heads together, put a lot of money into the ring, and fight for the cure. We need a cure as soon as possible.

But while we wait for the cures of tomorrow, using basic science research and a multipronged attack from a variety of companies and philanthropic and commercial partners, I believe we should realize that perhaps we can do something today. This is when I think about prevention.

Four of my family members on my father's side have Alzheimer disease. And although I am invested in Alzheimer disease research and I am enrolling patients with Alzheimer disease in clinical trials as we speak, I also focus my day-to-day practice on the possible prevention or risk reduction for people such as me and Mr Gates, who have a family history of Alzheimer disease.

There is no magic pill, potion, or blueberry that can prevent or reduce the risk for Alzheimer disease by itself. I do believe that there are several evidence-based interventions that can protect cognitive health over time and possibly not only reduce risk but prevent the disease altogether. In fact, a study published in Lancet Neurology[1] in 2014 suggested that 1 out of 3 cases of Alzheimer disease may be preventable if that one person does everything right. That is exciting.

The other 2 out of 3 cases may not be preventable, but if we could delay the disease by 6 months, 1 year, 2 years, or 5 years, and in that time that blockbuster cure comes along, then that person, through lifestyle and other changes, prevented their own Alzheimer disease.

Sometimes people are reluctant to use the words "Alzheimer" and "prevention" in the same sentence. I believe today we can do that. I believe more people like Bill Gates and others should do that.

When it comes to semantics, can anyone definitively prevent a heart attack or a stroke 100% of the time? No, we cannot. In the case of Alzheimer disease, I believe we can use the term "Alzheimer prevention." Just as we say "heart attack prevention" and "stroke prevention," we can say "Alzheimer prevention."

I hope that one day a public figure will stand up and say, I have a family history of Alzheimer disease, and I am doing A, B, C, D, X, Y and Z to reduce my risk. Thanks very much. This is Richard Isaacson for Medscape.

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