Well, I think ideally you do. You want to target both the amyloid pathology and the tau pathology. Amyloid pathology starts very early. It starts well before the tau pathology. So if you want to prevent Alzheimer’s disease, then maybe you only need to target the amyloid pathology and prevent that from building up in the brain. Then you should be able to prevent the tau pathology from occurring...
Well, I think ideally you do. You want to target both the amyloid pathology and the tau pathology. Amyloid pathology starts very early. It starts well before the tau pathology. So if you want to prevent Alzheimer’s disease, then maybe you only need to target the amyloid pathology and prevent that from building up in the brain. Then you should be able to prevent the tau pathology from occurring. That is thought to be hard to do because people do not yet have symptoms, the memory and cognition symptoms, yet. It takes 20 years for that amyloid to build up before the tau pathology kicks off. Once the tau pathology starts, then people begin to have the memory problems that you associate with Alzheimer’s. So you don’t know who’s going to be building up this amyloid. But luckily what we have now are blood tests to be able to tell who’s building up amyloid in the brain versus those people who are not. And there are also brain scans that do that. So I envision a future where we’ll be giving people blood tests, maybe starting at the age of 50, and then every few years thereafter, you get another blood test, and you watch people, and hopefully they’ll start off low with their amyloid, and over time, if you see them begin to tick up with amyloid, then you start putting them on an amyloid drug like the A-beta immunotherapies that are out there now. And I think that’s one way of preventing Alzheimer’s disease. But, you know, some people may come in too late and they may already have tau pathology. So we’ll need to also have therapies that address the tau pathology as well. And those are now being developed. So I’m very hopeful for the future.
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