Stranded

While the pharma industry struggles to figure out why its Alzheimer's drugs have repeatedly fallen short, millions of people living with the disease have few clear paths forward

- Robert Langreth

Geri Taylor ran a large long-term care facility into her mid-60s when she started becoming forgetful. One time, she was in the middle of running a staff meeting and lost her train of thought, couldn’t get it back, and one of her deputies had to take over. Another time, she got off at the wrong Manhattan subway stop and had no idea why she was there or where she was going. Incidents like these led her to retire earlier than she might have, but she put off seeing a neurologist for years, until one day she went into the bathroom and couldn’t recognize her own face in the mirror. Finally, in 2012, came the diagnosis she’d feared: mild cognitive impairment, likely due to Alzheimer’s disease.

In 2015, Taylor enrolled in a clinical trial for a drug meant to slow cognitive decline. Tests confirmed that her brain, like those of most Alzheimer’s patients, contained an unusual buildup of a protein called amyloid. For a large part of the past three decades, amyloid clumps, called plaques—a hallmark of the disease—have been the prime target for most Alzheimer’s researchers. Rid the brain of enough clumps or prevent their buildup, the consensus goes, and you could slow cognitive decline, perhaps indefinitely. This was the great hope of the trial Taylor joined for the compound Aduhelm. Made by Biogen Inc., Aduhelm was the latest in a long line of experimental anti-amyloid drugs that never quite seemed to work. But this one, the researchers said, was the biggest amyloid reducer yet, and it might open a whole new era of Alzheimer’s treatment, improving each patient’s quality of life for years or more.