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Discussion (17 Comments)Read Original on HackerNews
The only thing you gain is giving people more time to worry and despair.
It would affect my financial and estate planning, and how I'd like to navigate the disease's progression.
Imagine the test is 100% accurate: if you gave it to a group of people, you could then try to make interventions earlier, capture more data about lifestyle before symptoms, etc.
Good as in scientifically proven. Not speculative fantasy.
As someone with family affected by this disease, it’s a very personal choice whether you want to know or not, but I wish people understood that there are many things you can do with it, particularly for those who will be there for you if/when it hits.
Taking care of a loved one with this disease is extremely hard, and it’s even harder when they haven’t had any chance to prepare for this eventuality. Stuff like written records of your history (health, life, etc.), clear powers of attorney, and so on.
It also makes things much easier for healthcare professionals.
Galantamine, which is mechanistically similar, is another option. Interestingly, it's a natural product, which you can extract from the common snowdrop flower, galanthus nivalis, and many other plants.
Benzgalantamine, a galantamine prodrug, was approved in 2024. This has been, like many recent FDA approvals, somewhat controversial: https://ebm.bmj.com/content/early/2026/02/26/bmjebm-2025-114...
These drugs are, at best, stopgaps. There are no real mitigation regimes.
https://www.nih.gov/news-events/news-releases/combination-he...
> Early detection of Alzheimer’s disease is important since the first treatments capable of slowing the progression of the neurodegenerative disease recently became available to patients, and these drugs are more effective when started sooner rather than later.
Clearly the goal is to be able to prevent the disease from progressing or slow it significantly, but are we really there yet even if we have a test?
The risk of dangerous side effects seems to be much higher for those with APOE4 — before approving the treatment they required among other things a genetic test ruling that out. (There are several other genetic variants that predispose to Alzheimer’s, fwiw.) We were lucky and saw none of the concerning side effects.
Are we “there” yet? Where’s there?
The prognosis after this treatment is a massive improvement over what it would have been at this stage of progression if it had been reached even 5 years ago.
If you can detect the disease even earlier and halt progress at a point where you retain more cognitive function, that’s a huge win — and gives you time to wait it out a bit longer in hope that we’re able to develop a treatment that doesn’t just pause but can reverse progression.
Yeah, I doubt we’re ready yet to administer these drugs to people who are asymptomatic (not to mention how pricey they currently are). But for someone who likely has the genes for it, just _knowing_ would in some ways be a relief.
In one recent study, people very high p-tau217 had a 38% chance of progressing to cognitive impairment within 5 years vs 12% for those with low levels. The current tests cost about $200-300, so they're not unreasonable as a screening test. PrecivityAD2 looks to be priced around $1,400-$1,500 so at that price, this specific test likely only makes sense for people with established disease.
But hopefully we'll start to have more options and wider approvals for things like anti-amyloid drugs.