Alzheimer's Disease: New Perspectives

Alzheimer's Disease:New PerspectivesAbstractAlzheimer's disease (AD) continues being a scourge of modern humans. Undue emphasis on the Amyloid hypothesis has crowded out research on and use of alternate non-amyloid treatments.This paper discusses the deficiencies of the amyloid hypothesis while recognizing the tangible though quite limited benefits of anti-amyloid treatments, even in the face of frequent and sometimes severe toxicities, with associated major expense.I discuss the data suggesting a role of toxic exposures in AD risk. I also discuss a method of decreasing the impact of toxic exposures, and the early evidence of safety and potential for benefit in decreasing the impact of toxic exposures.I discuss the risk of APOE alleles in AD risk, and the mechanisms by which this risk is created. The role of APOE in susceptibility to toxic exposures and infections is discussed.The physiology of acetylcholine is discussed along with the rationale for increasing its levels through the inhibition of the enzyme that degrades it, acetylcholine-esterase (AChE). The new inhibitor of AChE, MSF, with its superior efficacy is discussed along with the hurdles in the MSF approval process.I discuss the role of herpes simplex infections in AD risk and the means of mitigating this risk.I discuss the role of herpes zoster (VZV) in chicken pox, shingles, and AD risk. Vaccine for limitation of that risk is discussed.Traumatic brain injury as an etiology for AD is discussed.The need for and means of risk stratification is discussed.Possible means of AD prophylaxis in higher risk populations is discussed along with rationale for use of prophylaxis.The concepts and methods of evaluation and treatment presented in this paper are straightforward, safe, inexpensive, with a significant probability of benefit, based on new perspectives.