Hitting a Nerve

A cure for dementia? Not so fast


 

“Diabetes drugs may cure dementia.”

How many of you saw that headline (or similar) earlier this year, before the pandemic took over the news?

Dr. Allan M. Block, a neurologist is Scottsdale, Ariz.

Dr. Allan M. Block

My patients sure did. And their families. And people who aren’t my patients but found my name in the phone book after reading the headline. Of course, all of them wanted to be put on diabetes drugs to cure or prevent dementia, like the headline said.

The key word in the headline, though, is “may,” which promises nothing. Not only that, but if you actually read the story you quickly learn that the study was done in people who have diabetes, and lowers the risk of dementia.

While there could, possibly, maybe, be something interesting underlying the finding, it could also be as simple as controlling your vascular risk factors, which is good for you.

Of course, the lay public rarely reads past the first few paragraphs. To the nonmedical reader, the cure has been found, and they want it. Where’s the phone?

I’m sure this is good for business in the lay press. People see the headline and don’t bother to read the story but they immediately forward it to friends, family, Facebook and Twitter groups ... That’s a lot of clicks and advertising.

The study might genuinely mean something, but that’s a big “might.” A lot of common drugs have been hyped as being treatments for dementia – statins, ibuprofen, estrogen patches, to name a few – only to quietly die in larger controlled trials. But that part of the research never seems to make the news, only the first small, preliminary, results.

People want us to find answers. Isn’t that what doctors and scientists are supposed to do? I understand that. But by the same token, it’s generally not that easy. And if we try to explain the difficulty, then we’re often accused of being part of “them,” some secretive group trying to hide inexpensive miracle cures from the public to keep Big Pharma in business.

The real truth is that a lot of things initially seem to be good (or bad) and these things change like the seasons. Everyone should be on daily aspirin, oops, maybe not. Saccharine causes bladder cancer, wait, I take that back. And so on.

While diabetes treatments may indeed lower the risk of dementia in patients who have diabetes, people too often extrapolate that to everyone, and wishfully think the headline says “does cure” instead of “may cure.”

I have nothing against research. Everything we have now came from it. But preliminary results are just that – preliminary. Like many other things in this world, they have to be taken with a grain of salt.

Dr. Block has a solo neurology practice in Scottsdale, Arizona. He has no relevant disclosures.

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