Telocyte Newsletter, Q2 2022: A Revolution in Aging

Doing the same thing over and over, but expecting different results has – with Einstein often incorrectly given as the attribution – been said to define insanity. Whoever said it and whether it defines insanity or not, persistence in the face of failure is remarkably human. When it is successful and insightful, we call it perseverance; when it results in recurrent and predictable disaster, we call it stupidity.

Over the past century, we have struggled to treat the age-related dementias without success. Even our best results are embarrassing: in 2021, the FDA released aducanumab for clinical use, to less than rousing acclaim. There is no evidence that it stops clinical decline, let alone improves cognitive function. Worse, serious adverse effects occur in 40% of those patients – even those patients who have been carefully pre-selected to have low risk. Monoclonal antibodies – whether targeting amyloid or tau – have never been a winner in treating any of the dementias.

Yet big pharma, dozens of small biotech’s, and most major scientific funding organizations, whether governmental, academic, or private enterprise, continue to expect different results. To call it insanity is being polite, for we have wasted not only billions of dollars, but billions of lives. Biogen alone, the company backing aducanumab, has spent more than one billion dollars on a failed intervention. The NIH would like three times that annual budget to spend upon similar approaches that have – without exception – failed to show an effect. The problem, as with so many things, is that money does not equate to success. We waste money, we waste lives.

Extending the analogy of our opening quote, if you’re digging in the wrong place, then it doesn’t matter how many people are wielding shovels, it doesn’t matter how big your excavator, and it doesn’t matter how big your NIH, NHS, or big pharma budget is: you’re still digging in the wrong place. What you need is not more shovels, a bigger excavator, or more money; what you need is a map. The key question is not how much money you invest, but how much money you invest wisely.

To build another metaphor, imagine a house. As the house gets older, the roof begins to leak. You put a bucket under the first leak, but the first leak gets worse and the number of leaks multiplies daily. You put out more buckets, but you can’t keep up and the leaks grow worse. Do you buy more buckets? Do you buy bigger buckets? Do you pay for research to design the latest, biggest, and costliest buckets? Perhaps, rather than buckets, you might consider a different tactic: repair the roof.

Current research on dementia focuses on funding more, bigger, and costliest buckets; at Telocyte, we would rather repair the roof. We look at the problem more clearly: an effective cure for dementia does not require more funding, it requires clearer thinking.

We can cure dementia by thinking clearly and compassionately. We need just enough funding to repair the roof and, oddly enough, it turns out to cost far less than a collection of leaky buckets. Given one percent of the funding behind the current failures, we can give back a cure.

And keep out the rain.