I have a friend with Alzheimer’s so I was especially depressed to read Jesse Singal’s discussion of a new book, Doctored, claiming that research on both Alzheimer’s disease and drugs that purport to ameliorate is all badly flawed, even fraudulent. You can read Singal’s discussion below (free access by clicking on the headline), and access the book on Amazon by clicking on the cover below.
An excerpt from Singal:
In his book, Piller, an investigative reporter at Science magazine, presents copious evidence of severe fraud, negligence, and buck-passing in Alzheimer’s research. From fabricated images published in major research journals (many of them still unretracted) to data manipulation conducted by pharmaceutical companies to the complete negligence of federal watchdogs, Piller’s reporting demonstrates indisputably that the field of Alzheimer’s research is in sorry shape.
Things are so bad, in fact, that the dominant theory that has guided researchers’ efforts this century — that Alzheimer’s symptoms are caused by the buildup of proteins called “amyloid plaques” in the brain — is now in serious question. That might explain why, as Piller notes, a recent meta-analysis of the available research found no evidence that any of the available Alzheimer’s drugs cause noticeable improvements in the cognition or daily functioning of patients. We’re two decades and many billions of dollars into the modern era of Alzheimer’s research, and we have precious little to show for it — a particularly dire state of affairs given that this dread condition is only going to hit us harder as America’s population continues to age. Piller’s book, which was released February 4, tells the story of a wild and heartbreaking goose-chase.
While Doctored is gripping in its own right, it also serves as a warning about the collapse of trust in expert authority. Thanks to the capacious new markets for crankery carved out by social and “alternative” media — not to mention a worldwide populist revolt against “the establishment” in general — there’s more grifting and science-denial than ever before, and the worst purveyors of pseudoscientific sludge rake in millions precisely by positioning themselves in opposition to mainstream science.
The lesson for scientists is to clean up their act and to stop misleading people about their work. I mean, I never had any doubt whatever that Alzheimer’s was caused by plaques in the brain. Now that is not at all certain; the plaques could be a byproduct or a correlate and not a cause. If there’s that much uncertainty about it, why haven’t I heard about it. Of course, journalists are responsible for this, too, but good scientific journalism is a species going extinct.
I believe that Singal has already been demonized on BlueHairSky, though he hasn’t been banned. The reason: the place is full of immigrants from Twitter who are “progressive” liberals and couldn’t stand the free speech on X. Singal described his apostasy:
The background here is that a subset of users on Bluesky disagree with my reporting on youth gender medicine—a subject I’ve been investigating for almost a decade, and have written about frequently, including in The Atlantic and TheEconomist. (I’m currently working on a book about it, commissioned by an imprint of Penguin Random House.) I’m not going to go deep here, but I’d argue that my reporting is in line with what is now the mainstream liberal position: See this Washington Post editorial highlighting “scientists’ failure to study these treatments slowly and systematically as they developed them.”
But perhaps because I wrote about this controversy earlier than most journalists, and have done so in major outlets, I’ve become a symbol of bigotry and hatred to a group of activists and online trolls as well as advocacy orgs like GLAAD that push misinformation about the purported safety and efficacy of these treatments, and attempt to punish journalists like Abigail Shrier for covering the controversy at all.
Bluesky appears to have attracted a particularly high number of these trolls, and even before I arrived on the platform, some of them were making sure I wouldn’t feel welcome there. Nora Reed, an online influencer and cultural critic, wrote in November that “I think we need a plan for if Jesse Singal shows up here in advance.”
Back to his own Substack, though; Singal won’t win many friends by arguing that both scientists and liberals have exacerbated the problem, the former by acting precipitously or even duplicitously (the attempt to dismiss a lab-leak theory for the covid virus by scientific officials in the Biden ambit is a good example), while the left-wing public by always saying “trust the science” without realizing that a. scientists are human, with all the good and bad behavior that implies and b. science like investigating covid moves quickly, and what is true today could be false tomorrow.
But I shouldn’t exculpate the Right as well. After all, that’s the side of the political spectrum that still pushes creationism as well as quacks like RFK Jr. And Trump and his cronies are busy slashing scientific research almost willy-nilly. Singal, though, concentrates on the Left, perhaps because that’s where he resides:
At a time of such uncertainty and such dangerous overcorrection, it can feel awkward or difficult to point out, as Piller does in Doctored, just how broken some of our cherished mainstream scientific institutions are. Isn’t that playing right into Trump’s hands?
I don’t think so. The strategy adopted by many mainstream liberals in response to the populist surge — effectively, plugging our ears and chanting “trust the science” over and over — might be comforting, in that it offers a Manichaean worldview in which improving the world is a relatively straightforward matter of convincing people of their own ignorance so that they will board the science train with the rest of us.
But this effort has clearly failed. Some populist distrust of mainstream science is unwarranted and harmful, such as most strains of vaccine skepticism, but in plenty of instances, they are more or less correct not to automatically trust mainstream scientists, even if they arrive at that conclusion for reasons some of us might find uncouth. (Update: I added ‘automatically’ post-publication because I think it’s an important modifier here.)
In other words, while it’s easy to accuse those red-staters out there of exhibiting an alarming lack of faith in science, especially now that their wrecking-ball avatar is in power, it’s harder — and arguably just as important — to ask whether perhaps we have too much faith in it. The scientific establishment hasn’t exactly covered itself in glory in recent decades, given the replication crises that have roiled multiple fields, the data-fraud scandals popping up everywhere from cancer research to business-school psychology, and the frequently overconfident proclamations experts made about thorny Covid-era issues like mask mandates and school closures. And yet liberals tend to continue to reflexively trust many institutions that haven’t earned it, to the point where some of us have turned this sentiment into a mantra: “Science is real,” you will see on signs planted in front of many liberal homes.
I will read this book, as I’m particularly interested in how “fraud” was involved in Alzheimer’s research. Here’s one bit from Singal:
Piller’s book provides numerous damning examples of the difference between science as we idealize it and science as it is practiced by real-life human beings. For example, much of the data fraud in Alzheimer’s research, alleged and proven, involves doctored images. This fraud was uncovered not by journal editors or peer-reviewers — the individuals supposedly responsible for such quality-control — but by unpaid sleuths “who use pseudonyms to post comments” online, as he writes, in the hopes of someone who matters noticing and acting. (One notable exception is Elizabeth Bik, a Dutch microbiologist and legendary image sleuth who has taken on Alzheimer’s fraud.)
Who would have thought that we’d be catching so much fraudulent work by analysis of published images. One might conclude that reviewers of manuscripts aren’t doing their work, but I suspect that a lot of the fraud involves the same images repeated in different papers, and no reviewer has time to compare images in a submitted manuscript to other images by the same authors, but in different journals.
Doctored was released February 4 of this year.
To avoid making this post too long, I’ve put the book-publisher’s (Simon and Schuster’s) description below the fold. Click “read more” to see it:
Simon and Schuster description here
Nearly seven million Americans live with Alzheimer’s disease, a tragedy that is already projected to grow into a $1 trillion crisis by 2050. While families suffer and promises of pharmaceutical breakthroughs keep coming up short, investigative journalist Charles Piller’s Doctored shows that we’ve quite likely been walking the wrong path to finding a cure all along—led astray by a cabal of self-interested researchers, government accomplices, and corporate greed.
Piller begins with a whistleblower—Vanderbilt professor Matthew Schrag—whose work exposed a massive scandal. Schrag found that a University of Minnesota lab led by a precocious young scientist and a Nobel Prize–rumored director delivered apparently falsified data at the heart of the leading hypothesis about the disease. Piller’s revelations of Schrag’s findings stunned the field and the public.
From there, based on years of investigative reporting, this “seminal account of deceit that will long be remembered” (Katherine Eban, author of Bottle of Lies and Vanity Fair special correspondent) exposes a vast network of deceit and its players, all the way up to the FDA. Piller uncovers evidence that hundreds of important Alzheimer’s research papers are based on false data. In the process, he reveals how even against a flood of money and influence, a determined cadre of scientific renegades have fought back to challenge the field’s institutional powers in service to science and the tens of thousands of patients who have been drawn into trials to test dubious drugs. It is a shocking tale with huge ramifications not only for Alzheimer’s disease, but for scientific research, funding, and oversight at large.
I’m sure I’m not the only one very interested in your review of “Doctored.’
There’s an essay at The New York Times adapted from the book:
https://archive.ph/xUQG7
Blocked & Reported, Jesse Singal’s podcast, is great. I highly recommend.
I heard about it 20 years ago. I stay up-to-date on health news like this almost daily, and tons of other doctors have been saying the same things as this book is claiming. So, it’s not like it’s new news by any stretch.
Essentially, Alzheimer’s happens when a brain is over-exposed to glucose as metabolic fuel. The burning of glucose as fuel leaves a lot more metabolic waste products than fatty acids (or ketones) which burns very cleanly. The glucose waste products will overwhelm the brain’s ability to clean up over decades, effectively gunking up the brain and leaving it impaired. (This is the super layperson version.) Many doctors now refer to Alzheimer’s disease as type 3 diabetes, a term that’s been around now for at least two decades. For the most part, like type 2 diabetes, Alzheimer’s is preventable through a healthy, lower carb/sugar diet, with lots of healthy fats (meaning: avoid processed oils).
I was at a small math conference at Oxford in 2022 where some mathematicians had models for the growth of the “disease”. Like mentioned above, there is a balance between accumulation of undesirable material and the “clearing” of the material through natural processes (i.e. blood flow etc.) particularly during sleep. In this model there would be two opportunities: (1) reduce the accumulation and (2) make this “clearing” as efficient as possible. Experiments can test the models although it’s not easy. This was three years ago.
That’s not the whole story by any means.
Many cases are genetic. A common cause is APOE4 gene. Two copies and you’re getting it. One copy: increased likelihood
https://archive.ph/R1Hze
There’s zero evidence that diet can reverse the disease.
The Type 3 diabetes hypothesis is still well in its early days and is a minority viewpoint at this time. Glucose waste products can mean anything from lactic acid to glycated proteins. Type 2 diabetes appears to be a risk factor for AD. Why? It might have more to do with vascular impairment.
There are genetic risk factors for AD. The most well studied is the presence of the APOEe4 allele. Risk is increased with gene dosage and in homozygous individuals, the upper estimate is 15X greater chance of being diagnosed with AD. The biochemical reasoning behind the increased risk is not well known. A recent publication again implicates vascular dysfunction and compares the roles of the different alleles of APOE in AD. https://pubmed.ncbi.nlm.nih.gov/32211501/
It’s worth mentioning here the work of Dale Bredesen, who published two interesting papers in 2014 and 2016 (2014: “Reversal of cognitive decline: A novel therapeutic program” introduced… a comprehensive and personalized approach targeting the underlying pathogenesis of Alzheimer’s disease… 2016: “Reversal of cognitive decline in Alzheimer’s disease”…presenting data from 10 patients treated for 5-24 months.)
Note that his protocols do not involve the costly (i.e. profitable) drug regimens that are being researched by pharma. It follows of course, his research is “controversial.” I have personally observed some cognitive improvements that he has observed/claimed possible, having myself followed his protocol, more or less the past 10 years.
If you are interested in the Alzheimer’s debate, you owe it to yourself to read these papers and come to your own conclusions about them.
I have been hearing about this for a couple years now, and wondered why it wasn’t huge news. Finding fabrications in electrophoretic gels could be helped with AI image analysis.
Oddly enough, I have been aware that the amyloid plaque theory has been challenged for several years now. But there isn’t an alternative that is receiving funding. I read medical blogs and this topic comes up.
There was a drug approved by the FDA (can’t recall the name) for Alzheimers during the Biden administration that caused a great deal of controversy. The drug was insanely expensive, and of questionable efficacy. Journalists wrote that political pressure to provide the public with solutions influenced the approval. I will definitely read this book, though I don’t really need anything else to make me angry right now!
I also knew that the amyloid plaque theory was questioned, maybe because I read French newspapers, which would explain why you didn’t see it. The EU has just ok’d lecanemab (Leqembi) to tread Alzheimer’s. But the French Union des consommateurs (just like the American Consumers Union) is in arms against it, as it makes for an increased probability of cerebral bleeding or oedemas.
“political pressure to provide the public with solutions influenced the approval.”
Not the first time I’ve heard of that happening. I remember hearing about a “viagra for women” pill that was pushed onto the market because of pressure from feminists, even though studies showed it had basically no positive effect, and had a nasty side effect that, combined with alcohol, it acted as a date rape drug. And did I mention that, unlike actual Viagra, women were supposed to take this drug daily, so they were essentially always in danger if they were to drink alcohol. It’s probably been close to 10 years since I’ve heard the story. Don’t know what eventually happened to the pill. I wouldn’t be surprised if it’s still out there.
These types of stories are proof that it’s not just the right wing that is dangerous when it involves its politics in science.
The approval of drugs that are not ready for prime time is motivated by the political pressure generated by the suspicion or conviction that drug approvals are being unnecessarily delayed in general. For any administration that is swayed by public opinion these suspicions and convictions on the part of individuals and families suffering from heretofore incurable diseases can be hard to resist. It’s ridiculous (and untrue) that these pressures are generated by crazy people with blue hair.
I, too, was aware of the emerging doubt over the plaque theory. The problem with the plaque theory has come more to the fore now that the therapies formulated to remove/reduce plaques have not met clinical expectations. Also, I have read—but cannot remember where—that some people who present with severe plaques at autopsy had no clinical symptoms of Alzheimer’s and that, conversely, some people with clinical symptoms of Alzheimer’s were found at autopsy to have no or little plaque buildup.
Fraud is an entirely different matter than the failure of a prominent—and lucrative—research program. I’d be interested in learning more, particularly if fraud has slowed the race to an effective Alzheimer’s treatment. My maternal grandfather—a medical doctor—died of Alzheimer’s disease. My father died of Lewy Body Dementia (a close relative of Parkinson’s disease, which leads to Parkinson’s dementia. Lewy Body Dementia has no effective treatment, either.) Dementia is personal.
“You can read Singal’s discussion below (free access by clicking on the headline),…”
Currently does not work for me, clicking the headline just opens a bigger picture.
I think it is here: https://jessesingal.substack.com/p/trump-or-no-science-badly-needs-to
Well, scientific advances and successful engineering design are not straight lines nor even necessarily monotonic. Trolls seem to love to take advantage of the backward steps that enable later forward ones.
So if you think your schools were closed for too long, get off your tuchus and redouble your efforts now that they are open…stop the whining and acting like the discovery of someone’s possible imperfect judgement is an accomplishment.
I don’t think that is what the argument is. Seems like 1) there was massive fraud involved in supporting the amyloid plaque hypothesis and the drug therapies based on it and 2) it was very hard for alternative explanations or therapies to get going because of the skullduggery of the purveyors of the establishment theories of what causes the disease.
That’s a lot different than “backward steps” or “imperfect judgement”.
+1
The problem here is uneducated bystanders trying (and failing) to get a grip on a huge dementia research industry that includes tens (if not hundreds) of thousands of research projects. The great majority of researchers operate in good faith. There will always be some rogue researchers trying to cash in on a lucrative topic of great concern, and dementia is by far not the only one. Big Pharma, detestable as it is, isn’t the main villain here. The issue of a minority research malefactors must be addressed, but not by throwing the infant away with the dirty diapers.
If you believe the critics of String Theory, this is very similar…in the sense that a scientific establishment systematically protected an unsubstantiated hypothesis, sequestered massive resources to support it, and froze out or bullied any advocates of competing hypotheses.
The clause “If you believe” is doing an enormous amount of work here.
FWIW, there are a few hundred permanent researchers in strings worldwide, out of O(10^5) permanent researchers in physics writ large. We (I’m one of them) are a rounding error in the community. In terms of funding support, the average group of high energy theorists (so strings plus many more types of high energy physics) in the US supported by DOE/NSF will have 1 postdoc/3 PIs and 1 Ph.D. student/PI. This is a fraction of what you typically find in other subfields of physics.
So: when critics of string theory tell this tale about how we sucked up resources, and there’s a conspiracy to protect us, they’re telling you an easily verifiable lie.
They also tend to fail to mention that (a) there is a significant community of people in QG that are not stringy, a bit smaller than strings but only by a factor of 3-4 or so, and (b) that said community has simply been unsuccessful in their research goals. (Indeed a longstanding problem, formulating a discretized model that describes gravity in 2+1 dimensions, of interest to both communities, was screwed up in the LQG community and recently fixed up by a group of string theorists.)
Thanks for the info. I have heard from the likes of Eric Weinstein of the existence of a “String Theory Mafia”, but based on what you are saying this is pure bunkum and you are in a position to know. So that’s another reason for me to take anything Eric or similar critics say with a giant pinch of salt.
Last comment from me today (da roolz)
Sure thing. There’s a grain of truth buried in there, although IMO one that is not unique to string theory, but Weinstein’s failed career as a physicist
https://inspirehep.net/authors/983863?ui-citation-summary=true
might be more relevant to understanding his ire.
He’s the brother of Bret Weinstein.
Kristan has replied, but just to reinforce:
String theory is pure theory and so is thus cheap, it consists of paying a few dozen people (worldwide) to think about it, and most of those people will spend half their time teaching basic physics to undergrads, and half their research time on non-string-theory ideas.
(It’s the experimental side of physics that can be expensive, and, famously, string theory lacks direct connections to current experimental data. And note that string theory being talked about in newspapers and in high-profile popular books does not mean a lot of money is being spend on it, something like the James Webb Space Telescope is vastly, vastly more costly than the total worldwide amount ever spent on string theory.)
Everyone would welcome good alternatives to string theory for a theory of quantum gravity (which is what string theory is trying to achieve) — and most string theorists themselves also explore such ideas — it’s just that no-one has produced viable alternatives, hence why people keep plugging away at string theory.
Also, there’s no comparable element of fraud in string theory (over-hyping, perhaps, but not fraud), and there’s no implications for people’s health or counterpart to ineffective drug treatments, so really the whole thing is not at all comparable.
I’m surprised that I’ve known about the Alzheimer research fraud and you haven’t. But it is true as far as I can tell. I probably read about it in Livescience. It feels like old news to me, so probably at least a year old. Ever since, I keep shaking my head disapprovingly when I see new research being conducted regarding Alzheimer that keep following the same beta amyloid lead, instead of at the very least redoing the original research to at least double check if the plaque really is responsible or not. But I keep seeing research that automatically assumed amyloid plaque is the cause, and move on from there. I think Parkinson’s research is more promising, so at least we have that.
I’ve not read the book, so can’t comment on its accuracy. The Alzheimer’s Disease (AD) research field is affected by several non-scientific (per se) complications. Primary among them is that demand for a treatment by family members (and folks who haven’t yet developed the disorder) is intense. I am a physician and neuroscientist and, although I do not do AD research, I follow the field reasonably closely.
The base etiology of AD is currently not known and none of the treatments reverse the disease, although the newer anti-amyloid drugs appear to slow progression a bit. There is incredible pressure to find and approve a treatment. This led to the unfortunate FDA approval (later rescinded) of the monoclonal antibody aducanumab. More recently introduced anti-amyloid monoclonals (e.g., lecanemab) turn out to be excellent at clearing amyloid plaques (aggregates of a protein mis-processed in AD), but essentially ineffective at halting or reversing the disease. That doesn’t necessarily mean that amyloid accumulation does not cause the disorder, but it certainly means that there is more to it than just plaques. Efforts at finding a treatment that targets tau, a microfibril protein that is also mis-processed in AD forming ‘neurofibrillary tangles’ that cause cell death, have not been as promising.
It has been debated for a decade or more whether amyloid accumulation is causal to AD or secondary to a more primary disease process. This was an open question discussed at nearly every presentation of the neurobiology or treatment of AD. I certainly have never had any sense that there was an effort to suppress this debate. There is certainly massive interest in the pharmaceutical industry in being first to market with an AD drug. The peak interest is in a drug that will prevent AD (arguably the better way to go than trying to halt the progression of a disorder that has already caused damage). Once that drug is found, everyone (mostly) will take it!
Anyway, long post, but information about the issue is helpful when preparing to assess possibly sensational critiques.
Thank you.
Thanks. A lot of people have been following this. I’m wary — appreciate your final phrase: “possibly sensational critiques” — indeed. very wary.
One issue I see with the “trust the science” people is that they have politicized science themselves and turned it into an us vs. them situation by supporting things that are NOT science. They, the enlightened ones, supported BLM marches in the height of a pandemic, think that men can become women and thus should be treated as women in all aspects of society, think that mutilating children can change their sex, know that COVID originated in nature not in a lab, think that ivermectin is only horse wormer paste, etc., and if you disagree with us you are ignorant, backwards, evil, and should be banned. No discussion, just demonization and division. But then maybe this is the desired direction – create a us vs them dynamic.
As far as Mr. Singal and Dr. Coyne talking more about how the liberals / democrats have screwed up, I’m all for it. Let’s clean up our own house first (well, not mine exactly, but you get my drift) so that when we criticize others we don’t look like hypocrites or worse.
Re the Alzheimer’s research issues, I read about the issues with the photos some years ago. I thought this was indeed widely known, but the discussion of the book helped me to understand the situation better.
In the spirit of Feynman, reality can not be fooled, but people and institutions often fool themselves.
The “trust” crowd compounds this by refusing to admit error. The rare times that they do, it is done by claiming that the critics today are guilty of hindsight bias, and that all right-thinking people AT THE TIME would have made the same decisions that they did (or supported). Try to then show that, “no, your decisions at the time were either without evidence or against the preponderance of evidence, as we said then” and the ears and eyes are still stopped and covered. Best then to leave it alone—unless one fears they would launch us into the same mistakes all over again. After ten, twenty, sometimes thirty years, when most of the decision makers and their chief supporters have passed from the scene, and when emotions have dulled in others, it becomes nearly impossible to find anyone who disagrees on what should have been done, and one can be forgiven for wondering what all the fuss was about. The right wing had a particularly bad case of this during Vietnam and the Iraq War, the left wing during the last decade of Culture War and COVID. And both sides will fall into the trap again.
“The ‘trust’ crowd compounds this by refusing to admit error.”
Cf. the “arsenic life” post later today, in which almost 15 years later Felisa Wolfe-Simon still “stands by her work” and insists she was not wrong that some bacteria can use arsenic and not phosphorus in their metabolism and genetics.
Haha love the blue hair sky joke. It’s perfect.
I thought everyone knew the amyloid plaques was an unproven theory. Isn’t it a typical causation correlation dilemma?
There has been controversy regarding the plaque hypothesis for over 15 years, which is why current drugs show no improvement in people taking the medicine. The drug companies had to pick different endpoints to have the drugs approved.
https://www.science.org/content/blog-post/alzheimer-s-down-amyloid
Uh oh — Have you managed to make up your mind on this one? “(the attempt to dismiss a lab-leak theory for the covid virus by scientific officials in the Biden ambit is a good example)” The “covid virus” is SARS-CoV-2. The “lab leak” notion was at best a shaky preliminary hypothesis. It was indeed worth dismissing, but M. Worobey and others were thorough enough to look very carefully into the matter. Those papers a bit too much to read? I continue to be astonished and disappointed that the dark mutterings and grand speeches of “being censored by those liberals” carry so much weight. There is a real and substantial literature on this zoonosis mess, and there’s no more reason I might let it go than we should let the dismissal of sex binary and the miserable post-modern sex/gender crap going on that is so rightfully deemed a mess of the left.
But not SARS-CoV-2. Please try to disconnect this, though you may be friendly to self-styled heterodox “independent thinkers”. In the case of SARS-CoV-2 the overwhelming preponderance of evidence points to spillover via the wildlife trade at the Wuhan market and the “lab leak” is sheer politics.
Zoonotic spillovers are an important issue and problem for people interested in ecology and evolution. I’ve been thinking about this general question for a long time, and I can find for you arguments that HIV was formulated in Ft. Detrick (or, of course, that HIV is not an issue at all). You must have got an earful of how science was “censored” — sometimes those are just erudite cranks. Virtually every viral pandemic has been the source of conspiracy theory. This won’t end, since viruses are tricky and will always be around and people are people.
So far as the book, haven’t read it yet. Busy, so I don’t know if I will. But I’ve read a lot about he etiology of Alzheimer”s, and it sure is a vexing problem. No big surprise Pharma might cut corners in the desperate atmosphere of “right to try” (go research that scene), no surprise that some labs put a finger on the scale and it’s ripe for a sensationalist “expose”.
But I remain wary. There are legions of smart, dedicated, honest people toiling on this — the lights that burn all night, all week. They deserve some respect. In the meantime, all painted with the same brush, look for a big increase in infectious disease and crank treatment endorsed by the gumment.
I agree with you that (as best as I can assess) the evidence points to zoonosis rather than a lab leak, but that’s not the issue — the issue is the way that early suggestions of a lab leak were shut down and dismissed as a “racist conspiracy theory” when it was actually a viable possibility at the time.
This gave the impression that scientists were pronouncing based on what they wanted to be true, which is exactly what destroys trust in science.
+1
The establishment (medical, scientific, etc.) has burned down it’s credibility. Has anyone ever heard the acronyms AFAB and AMAB? Sex is observed at birth (mostly accurately), it is not assigned. For example, C. Semenya and I. Khelif were thought to be female at birth. Both are male (5-ARD with high probability). Of course, we also have ‘pregnant people’.
I would like to mention that the intermittent-fasting crowd claims IF can prevent Alzheimer’s. I have no ability to evaluate the science myself, but I do have an anecdote: Betty White lived to almost 100 with no dementia and she never ate breakfast.
As a drug development professional I had worked several years in the AD area. The amyloid hypothesis, such as it was presented, was always just that, an hypothesis. The clinical tests using anti-amyloid antibodies and protease inhibitors to gamma secretase and beta secretase were uniformly negative. All of the patient populations tested though were with overt AD or mild cognitive impairment. In other words the horse may have already left the barn. There was one study using solanezumab in patients that met criteria for not having clinical alzheimers or even mild cognitive impairment but did have plaques via PET scanning. The trial results are found in this paper. https://www.nejm.org/doi/full/10.1056/NEJMoa2305032 They too were negative and, at this point, the hypothesis should have been well and truly tested.
The Type 3 diabetes hypothesis is still well in its early days and is a minority viewpoint at this time. Glucose waste products can mean anything from lactic acid to glycated proteins. Type 2 diabetes appears to be a risk factor for AD. Why? It might have more to do with vascular impairment.
There are genetic risk factors for AD. The most well studied is the presence of the APOEe4 allele. Risk is increased with gene dosage and in homozygous individuals, the upper estimate is 15X greater chance of being diagnosed with AD. The biochemical reasoning behind the increased risk is not well known. A recent publication again implicates vascular dysfunction and compares the roles of the different alleles of APOE in AD. https://pubmed.ncbi.nlm.nih.gov/32211501/
I take the view that the evidence for misconduct in the area is true, but perhaps overblown. That said, being on the industry side, I can tell you many a tale of how collaborations with academic investigators ran afoul of data handling and quality control. Not outright fabrication but rather, a finger being put on the scale which is just as bad and harder to find. In industry your ultimate test is a clinical trial and the patients have the final say. No getting around that test.