America’s wary approval of an Alzheimer’s drug offers hope to millions

NEWS THAT America’s Food and Drug Administration (FDA) has granted conditional approval to a new drug, aducanumab, to be marketed as Aduhelm, for the treatment of Alzheimer’s disease, has understandably been greeted as a huge breakthrough. For millions of people with Alzheimer’s, a remorselessly degenerative illness leading eventually to utter helplessness—and for those caring for them—it is a ray of hope. But the benefits it will offer remain uncertain, and the FDA’s decision is controversial.It was 115 years ago that Alois Alzheimer, a German psychiatrist, conducted the autopsy that helped him identify the disease now known as Alzheimer’s. It is much the most common of the dozens of causes of dementia. It accounts for 60-80% of cases of a debilitating condition that affects an estimated 50m people around the world, and—as the risk of dementia increases with age, and the world is getting older—is spreading fast. The costs in human misery are incalculable. In terms of expenditure in caring for people with the condition, they are estimated at over $1trn now, and forecast to reach $2trn by 2030.