New blood tests, new insights, and new therapeutics are all creating a Golden Era of Brain Health. Among the exciting ramifications of this new era is making dementia a rare condition instead of the scourge it has been for centuries.
The most common cause of dementia is Alzheimer’s disease, and the statistics are sobering: whereas COVID-19 has taken the lives of over one million Americans, Alzheimer’s is set to take about 40 times that many of the currently living Americans.
Even more concerning is the recent finding that early symptoms may be detected in people as young as 24 (DOI: 10.1016/j.lana.2025.101087).
But so much can now be done so that virtually all of us may avoid these dire predictions:
- For the first time, blood tests are available that will allow all of us to “see it coming” so that we can identify early brain aging changes and undergo successful treatment virtually every time, thus avoiding cognitive decline. These blood tests reflect ongoing brain chemistry, so they offer very similar information to what one would receive from a spinal tap or a PET scan, without being invasive like a spinal tap or as expensive as a PET scan. These also allow us to follow our progress over years, so that each of us can optimize a personalized protocol to support our best brain health.
- These tests include p-tau 217, NfL (neurofilament light), GFAP (glial fibrillary acidic protein), and Abeta 42:40 ratio, and they provide complementary types of information. The p-tau 217 test detects an altered form of the brain protein tau—normally, tau stabilizes brain cell connections, but when we are exposed to infectious agents (such as the Herpes from cold sores, for example), the tau is altered biochemically, becoming p-tau, which changes its job from stabilizing connections to fighting infections. There are multiple sites for this alteration, but the one at 217 is most closely associated with Alzheimer’s disease, so it’s a good idea for all of us who are over 35 to know where we stand (I just had mine checked a couple of months ago). If you are 60 or under, you only need to check every five years or so, and after 60, it's a good idea to check every two years or so.
- GFAP gives us complementary information, disclosing ongoing brain inflammation and repair from any cause, and NfL reveals damage to the brain’s neurons, whether from an auto accident or other head trauma or any neurodegenerative condition. These all can be checked by a very sensitive test developed by Neurocode (getabrainscan.com). In addition, the Abeta 42:40 ratio reflects brain changes associated with Alzheimer’s. It is an early marker, but the magnitude of the change is far less robust than with p-tau 217.
- For the first time, multiple clinical trials have shown improvements in cognition in patients with Alzheimer’s (DOI:10.3233/JAD-215707), and a new randomized, controlled trial is now in full swing at six sites around the country, to be completed in late October 2025.
- For the first time, we have documented sustained cognitive improvements, in some cases for over a decade (DOI: 10.3390/biomedicines12081776). These patients were at the early or mid stages of Alzheimer’s disease when treatment began, and are continuing to do well. In fact, one of them, “Patient Zero,” the first patient to reverse her decline years ago, has sustained her improvement for 13 years and counting, and is now walking across the country to bring awareness to this work—you can see her at JudyWalks.org.
- For the first time, there is a precision medicine program for neurodegenerative diseases. This new program is being established at the Pacific Neuroscience Institute in Los Angeles.
- For the first time, there are communities in which, instead of focusing on dealing with inevitable decline, information on effective prevention and reversal of decline is shared widely. Apollo Health (apollohealthco.com) and ApoE4.Info are two excellent examples.
- For the first time, the approach we have taken to cognitive decline is being adapted to the unique biochemistry and genetics of other neurodegenerative diseases, such as Lewy body disease, chronic traumatic encephalopathy (CTE), and macular degeneration.
This is truly the dawn of a golden era: thanks to the many individuals and families whose courage, diligence, and open-mindedness have fostered these advances, we are all witnessing the transformation of brain aging and neurodegenerative diseases from hopeless to preventable, reversible, and ultimately optional.
BIO:
Dale E. Bredesen, M.D., Pacific Neuroscience Institute and Buck Institute
Dr. Dale Bredesen received his undergraduate degree from Caltech and his medical
degree from Duke. He was postdoctoral fellow in the laboratory of Nobel laureate Prof.
Stanley Prusiner, then held faculty positions at UCSF, UCLA, and UCSD. He was
Founding President and CEO of the Buck Institute for Research on Aging, and his
laboratory studied mechanisms of neurodegeneration and published over 230 scientific
papers, leading to the first report of the reversal of cognitive decline in Alzheimer’s
disease. He is the author of three New York Times bestsellers, and is currently Senior
Director of the first precision medicine program for neurodegenerative diseases, which is at the Pacific Neuroscience Institute.
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