Faster Horses?

• Aging
• Alzheimer's
• beta amyloid
• Curing Alzheimer's
• Dementia

Often, when problems seem intractable, we’re asking the wrong questions.

We want to get to the moon: how can we jump higher? We want to get to the stars: how can we make bigger rockets? As Henry Ford once suggested, people wanted a better way to travel, so they wanted to know how to breed faster horses. Wrong questions.

Aging, and its multiple diseases are no different.

Without realizing it, we start by assuming that we already understand aging, then can’t understand why nothing cures the diseases of aging. Small wonder that Margaret Chan, the director of the WHO, stated we should “give up the curative model” of diseases of aging. In her report late last year, she urged us to focus on inequity and prejudice. If we had focused on inequity and prejudice in 1950 when polio was rampant, we would still have polio. Everyone would have an equal opportunity to have leg braces or access to iron lungs and we would have laws to prevent anyone “micro-aggressing” against those with a limp. Good things in their own way, but would you rather have equitable iron lungs or would you prefer to have a cure for polio? Equitable disease or disease prevention?

The WHO believes in political solutions – social band aids – rather than medical solutions. Frustration is understandable: so many approaches appear so futile. We can prevent polio, yet it seems impossible to prevent Alzheimer’s disease. Small wonder that few of us truly believe that we can do anything substantial and innovative. Like people determined to jump higher and higher, in hopes of reaching the moon on muscle power alone, we celebrate the tiniest elevation increase. Eli Lilly and company celebrated a possible 3 month delay (as their Alzheimer’s patients still progressed to an intractable death), and their stock price jumped higher as well. Yet, no matter how high we learn to jump, no matter how we learn to “breed faster horses”, we are still asking the wrong questions. Small wonder success appears impossible.

What is Alzheimer’s disease? Is it merely a slow, passive accumulation of amyloid and tau tangles? Or are those merely the effects of some more important upstream cause? We treat the symptoms, we treat the effects, then become frustrated when the disease continues its slow sweep of souls into oblivion.

Yet if we could understand what underlies a disease like Alzheimer’s, we might yet reach not only the moon, but the stars. To do so will take a far better way to travel than merely “faster horses”.

In order to cure, we first need to understand.