[robwwilliams]

The major problem has been lock-in of the Abeta 42 peptide fragment as the cause. This monomaniacal focus was rewarded by grant awards to team players.

Karl Herrup has a terrific book on the topic How Not to Study a Disease — The Story of Alzheimer’s from MIT Press (2021, ISBN 9780262045902). He did not win many friends but I think he is right.

The consensus now is that many factors contribute to the heterogeneous diseases we now call Alzheimer’s.

[saghm]

The article (or I guess more accurately "podcast transcription") seems to be saying that this lock-in essentially happened due to fraud, since some of the data was intentionally doctored to get the intended result. One of the guests seems to be an author of a different book about this (with the other guest being the scientist who apparently uncovered this). I can't personally attest to the accuracy of anything they said, but they're at least alleging that it was a lot less benign than it sounds like you're describing.

[robwwilliams]

The focus is definitely on scientific fraud, but what makes the fraud so easy in this case is singing and selling the same song that the big teams are singing and selling. You can fly under the radar AND get funded, and if you are “lucky” become an ultra big shot like Masliah at NIA.

[hx8]

I don't buy the fraud explanation as the full explanation. Other areas of medicine (stem cell) has had bigger incidents of fraud on top of other major headwinds, and still has made more progress.

Fraud is everywhere and we still move forward in most arenas.

[hattmall]

In ALZ and the plaque cartel the fraud was foundational and the overwhelming source of funding for research was tied to supporting that hypothesis. The big issue, even if you have a competing theory, is that the diagnostic criteria relies heavily on the plaque and presence of indicators. So you get a group of people who have elevated plaque and MCI, but many people have elevated plaque without MCI, and just as many people have MCI without elevated plaque.

So if your cure is targeting something different but the group of people you have are selected from this cohort of maybe afflicted people then it's really hard to get a significant result. Plus you tend to be dealing with old people, that have other health issues that MCI isn't causing to get any better.

[stanford_labrat]

The stem cell field is also quirky. IMO it is one of the most cutthroat, competitive, ruthless fields of life sciences that is new enough in history to still have a bunch of pioneers fighting to be the figurative Oppenheimer. One PI’s fraud is quickly detected and fought over.

Meanwhile the Alz and Neuro field as a whole are well established, and the amyloid hypothesis was a foundational theory taken as a fact. Any initial questioning of this and they would brand you as a lunatic.

[SOLAR_FIELDS]

Reminds me of schizophrenia. A hodgepodge of different things lumped into a single label of "broad class of things we don't understand"

[eej71]

Some day autisim, neurodivergent and ADHD can join that illustrious list.

[chiefalchemist]

There’s another book mentioned in the podcast called “Doctored.” The gist is: bogus “science” led to loads of money / research going in a direction that was effectively fiction.

People love to praise “the science” when they mean the scientific method. What they always seem to forget is that method is executed by humans. Imperfect, sometimes ego driven humans.