Welcome to Unconfuse Me. I’m Bill Gates.
You’d think given how prevalent
Alzheimer’s is in our society,
that getting people signed up for trials
would be really easy.
Sadly, it’s not,
because the amount of tests you have to undergo
to know whether you fit a particular trial
is really quite grueling.
And because there’s no formal diagnosis,
finding all those people
and seeing who might be right for the trial
is very, very inefficient.
I think it’s all up against this massive
societal shift that needs to happen
as far as how Alzheimer’s is spoken about,
how it is dealt with.
The amount of money it receives
in comparison to cancer and things like that,
which are less costly, more treatable,
and exactly as deadly,
I think the only logical answer
is that people just don’t like talking
or thinking about Alzheimer’s.
It scares them, it makes them uncomfortable.
People are very weird about their brains,
that’s just a thing in general.
Mental health, brain health,
all that is a taboo thing
people don’t like to talk about.
All these things
are the things that need to be overcome.
I get to work on the science end,
which hopefully will reduce this problem,
and eventually eliminate it altogether.
That’s the dream.
I would actually, honestly, truly love
to hear more about clinical trial space.
What are you most optimistic about?
Obviously you know
so much more about that.
What are some of the things
you’re excited about?
About 10 years ago,
there was a generation of drugs
that they thought that interfering with the plaques
that would stop the disease and relieve the symptoms.
Although there are still a few of those
that may have some modest benefit,
by and large, that failed.
You’ve got to give the pharma companies credit.
Eli Lilly even did a movie about
all the people working hard
and the disappointment
when it didn’t come through.
Now they’re saying
you have to get in much earlier.
If you’re just getting in
when the tangles are there,
the brain cells are already dying.
So let’s get to younger people.
There are two big theories.
One is that the basic energy factory of the brain,
having run for fifty, sixty, seventy, eighty years,
that the parts of the brain
that are active all the time,
those cells, called the mitochondria,
which are the energy factories,
they develop these defects.
There are about six different companies
that have drugs that have to get
all the way up into the brain, that’s tricky,
but they’re much smarter about that now.
They’re in phase one or phase two trials.
So best case would be five years,
worse case would be like ten years.
Another theory, which is a fairly mainstream thing,
is that the way your immune system reacts
and creates inflammation,
that’s bad for your whole body.
Aging and inflammation are very related,
particularly if you’re in stressful conditions.
They see now that the part of the immune system
that’s in the brain, the so-called glial cells,
that for the people who get Alzheimer’s,
they’re more hair-trigger.
All these immune system things,
women sadly are slightly more subject to.
We see that with Alzheimer’s as well.
There’s a bunch of drugs,
some of which I think will work,
that interfere with that.
These trials have been really expensive
because you have people come in
and you take these cognitive tests,
and sometimes they get really good at the test.
So, it’s a very imprecise measure.
If we could really take a blood sample,
and there are now some diagnostics
that’ll come first,
and will make the trials a lot easier.
You’ll take the blood
and see a clear signal of
are you having an effect or not.
So even though the brain
is so much more complicated
than everything else,
these trials are very promising.
If you’d asked me four years ago,
I would have said it’s a little scary,
but during these four years,
new small companies have come along,
the big pharma people have largely stayed in,
they’ll be tie-ups between those,
so we have to stay healthy
for another at least five to ten years!
That’s why brain health is important!
That’s why living a brain healthy lifestyle matters.
Kick it down the road.
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