Abstract

Twenty percent of patients diagnosed with Alzheimer's disease by experts like me in fact don't have elevated amyloid and so, in fact, don't have Alzheimer's. What they do have is the subject of intense research, and there are many possibilities. A recent study of one thousand brain autopsies from older adults with a range of cognitive impairment showed at least 230 combinations of neuropathology. The point is that while the disease will be treatable, we're unlikely to defeat it as we did polio and smallpox. We're going to have to learn how to live with Alzheimer's as an at least somewhat treatable disease. To do so, we need to think outside the biomedical box.