Why Can’t We Prevent Alzheimer’s?

We got the human genome a decade ago. Where are the drugs?

My grandfather was found wandering shoeless in the town where he was born, 50 miles from home. That was the first day we knew. Or, it was the last day we could pretend. A stranger placed a call to my father at his apartment in Evanston, Illinois, after finding my grandfather on those wintery streets, untucked and empty-eyed.

On a regular day, hed take the L from Evanston into Chicago and place some bets at the track. He liked to play the ponies, and he whittled down his paychecks at the bar. My grandfather kicked alcoholism at age 65. He didnt touch a drop for 16 years until his death, something he was proud of; but in the last decade, he was vanishing. On this day, alcohol couldnt explain his disappearance. By the afternoon, something was amiss. Hours later, into the night, the telephone rang. Did we know an Anthony Kozubek?

He was a child raised in the depth of the Great Depression. He could fix anything. Repair your front steps. Fix your plumbing. Install new gutters. One time he visited our house, and within an hour was upon our roof. We didnt have a ladder so he built us one. A few hours later, he built us a back staircase. He told us, maybe to build the lore of his hardscrabble life, that as a child he recycled his sisters shoes for his by cutting off the heels.

The son of Polish immigrants, my grandfather grew up on a polyglot street, and he began drinking with purpose in his teens. My grandmother stowed money in cans so that he wouldnt spend it. He was a boxer. Tall and lithe, he fought amateur Golden Gloves bouts in his Chicagoan youth in the 1930s. (His brother Joe traveled to New York and sparred with heavyweight champ Jack Sharkey). He fought and he drank, inside the ring and outside, and it continued while he served the U.S. Armys Engineer Corp.

He didnt talk about WWII, but years later we learned of his station transfers through the jackbooted continent based on records of his stints in the brig. The poor arent born into this world; they come crashing into it. When he learned he was having a son, my grandfather and his brother-in-law celebrated with drinking, stumbling and shattering a store-front display window, landing in a heap of plate glass.

He would later suffer from late-onset Alzheimer's disease. (Jim Kozubek)

Years later, my father would scribble down notes in journals, detailing those past events, documenting hard lives that built the foundation for us. We had recovered my grandfather from those slippery streets, but his faulty memory couldnt be rescued. In fact, his lack of recognition was jarring. When my father was preparing to remove his clothes from a dresser, he recalls, my grandfather protested, "You can't take those clothes, they belong to my son." Alzheimers "moments" drop like chasms.

And yet, this is not one elegiac story, it is many. Five million people in the United States have Alzheimers disease. This number will double in a decade. If any of us live to be 85, the chances of having the disease or some form of dementia is about one in three. The explanation for why some of us get it and some dont is a largely unsolved genetic riddle. My grandfather eventually died from it. My grandmother is now 96-years-old, writes me cards with lacy cursive, and regularly beats me at Scrabble.

Recently, my father subscribed to a service that allowed us to mail in a cheek swab to learn about our genetic ancestry. I learned that I belonged to Haplogroup Ra type of ethnic branch on our genetic treethat I am German and Polish (which I knew), and by a small fraction Ashkenazi Jewish (which I didnt know), and I received a colorful map of my ancestors probable traipses through Europe. But though it was an option on the test, my father did not want to know about our risk for Alzheimers, it turns out. And for good reasonthere is not a single meaningful drug to treat Alzheimers.

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Why Can't We Prevent Alzheimer's?