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Although billions of dollars have been poured into potential pharmaceutical cures for dementia, particularly Alzheimer’s disease, none so far have been proven to slow or stop the disease from progressing. Yet even without an effective drug, incidence rates of dementia in the United States and several other countries have decreased since 1998. Why? Social changes like lower smoking rates and better education, along with better population-level health, have improved brain health.

This week on the “First Opinion Podcast,” Penn State College of Medicine professor Daniel R. George explains how wealthy nations have been able to curb risks for dementia over the past few decades — but also how those advances in health may be slipping away from us. George argues that it is essential for the country to reorder and reprioritize population-level structures, institutions, and social processes to make healthier communities.

“Ultimately it’s healthier and just more honest to be truthful about what Alzheimer’s is and say: maybe this is something that’s not amenable to a full cure, and that doesn’t need to lead to nihilism,” George said. “Maybe there are other places that we can put our chips instead of just throwing billions and billions into this bottomless pit of amyloid research.”

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This conversation is based on a First Opinion by George and Case Western Reserve University neurologist Peter Whitehouse, “The brain health paradox: Dementia rates have fallen even as drugs have failed.”

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