Alzheimer’s enigma: Why is incidence falling 16% a decade in richest countries?

“Falling 16% per decade since 1988” I wonder why! Maybe tied to the phase out of leaded gasoline around the same time??

&gt; However, in the words of neurologist David Pérez of Madrid’s Hospital 12 Octubre, thinking that these proteins are responsible for Alzheimer’s is like arriving at the scene of a crime and believing the blood committed murder.<p>I keep reading so much about the mis-folded proteins that it&#x27;s easy to forget that&#x27;s not the target?<p>But at the same time, I can&#x27;t help but think that if we stop the mis-folding we stop the problem? Or am I just thinking about it all wrong?

A lot of interesting hypothesis in this thread. But I’ll offer the simplest, and unfortunately least optimistic: This is simply downstream of the Flynn effect.<p>There were serious gains in IQ between the cohort aging into Alzheimer’s 30 years ago and today. This was mainly due to improvements in childhood nutrition, healthcare, and education in the post war period.<p>It’s well known that Alzheimer’s rates tend to be much lower in the high IQ. Not because the incidence of disease is lower, but because it’s harder to diagnose. John von Neumann would have to experience some serious mental decline before he started failing the standard cognitive batteries.<p>This is less hopeful for two reasons. Number one the disease still exists and is having an effect. It’s still bad if you experience mental decline even if you start at a high baseline. And if life extends far enough, eventually it will get you in a real bad way sooner or later. Number two IQ gains, like height, started seriously after this cohort. So we wouldn’t expect to see continued declines at the same rate.

&gt; The researcher displays an image of a Siberian tiger brain, full of amyloid beta. “We have seen changes similar to Alzheimer’s in many mammals, but the disease never develops,” Rábano explains.<p>Interesting

I havent read the article yet, but just to point out that Alzheimer&#x27;s as a diagnosis is quite a specific one that requires a brain biopsy to prove. This doesn&#x27;t generally happen. More common is probably vascular dementia - a disease of the small vessels of the brain that have the same risk factors as coronary artery disease (male, age, smoking, obesity, diabetes etc). More work has been done targeting these risk factors for the general health of populations.

It&#x27;s not all good news - although the percentage of instances per age group have been decreasing, as the article says &quot;the overall number of dementia cases is on the rise, due to the increase in life expectancy and the fact there are a greater number of old people&quot;.

Could there also be a sugar connection? Alzheimer&#x27;s is referred to as &quot;Type 3 Diabetes&quot; where insulin resistance plays a role in a person developing the symptoms.<p>Do the populations of richer countries consume less sugar per head than poorer nations?

it&#x27;s gotta be something to do with some process we are doing differently, there is so many variables to take into consideration, i know people are super privacy these days but we really could benefit if we allow some of our data to be cross referenced in order to find more connections between what we eat and what medicines we take, it&#x27;s probably already being done somewhere but think of all the grocery stores that have pharmacies, our eating habits may reflect a deeper health issue, connect that with opt in pharmacy data and possible geographic location we might be able to pin point causation.

&gt; It is the first time a drug that attacks the suspected causes of Alzheimer’s has received approval from the Food and Drug Administration (FDA): ... but is has not yet been proven that this implies clinical benefits for patients. It is still unknown if the treatment works.<p>It&#x27;s been approved, ... for what, then?

Looks to me like aducanumab publicity packed in some fluff. Possibly to paint a positive picture in hope of influencing the EU authorization?

My hypothesis: more brain stimulation due to media saturation and an increase in nominally personalised and interactive entertainment experience.

Less smoking, transfat bans, more awareness around physical and mental health and diet

Is it because rich people sleep more? Sleep has been shown to influence AD

Statins.

What medications are more commonly prescribed then before? Ones that are used more in richer companies.

Climate Change.<p>Cardiovascular health has been improved because of CO2 emissions.<p>Or, if not playing the blame everything on climate change game - Less smoking, less PM 2.5 pollution, better climate control in buildings have all also helped cardiovascular health.<p>(Missing from the article - declining incidence is more pronounced among men than women)

Ok Im going to guess. The advent and popularity the keto diet.<p>Assumptions 1) Alzheimers has been postulated to be a metabolic disease of the brain and the keto diet via ketones provide a cleaner-fuel with less by-products.<p>2) The richer countries has more people able to afford the keto-food. Generally more expensive. Fatty beef cuts, cheese, salmon etc.<p>Just a stab in the dark or another guess. I&#x27;m not a scientist !