When I first heard about The Alzheimer's Project through the preliminary ads hawking it on HBO, I was so alarmed I immediately contacted a friend who is responsible for the website The Tangled Neuron, which has been the source of and guide for almost all my dementia information for the past few years.  My concern was particularly about the almost-there claims being made for scientific advances in the fields of Alzheimer's research and treatment.  After meticulously transcribing and listing all the blurbs for her, I asked:  "My understanding is that we aren't actually that close to understanding, let alone treating, let alone curing dementia of any type, let alone all types.  Is my understanding correct?  If so, WHY IS THE PROGRAM MAKING IT SOUND LIKE WE'VE PRACTICALLY CURED ALL TYPES OF DEMENTIA????  What advantage would anyone in or out of the field gain from misrepresenting the issue like this???  Isn't it, in fact, dangerous if this program is insinuating something that is downright wrong?"

     Since neither of us had seen any of the programs, her response was guarded but optimistic that at least the Momentum in Science episodes would present the issues from a stance closer to reality than the advertising does.

     Did they ever.  Part 1 (Alzheimer's 101a) talks mostly about the biological pathology of not only Alzheimer's but other types of dementia.  Part 2 (Alzheimer's 101b) focuses on treatment and cure approaches that our knowlege about the pathology have elicited.  Although the mood, throughout, attempts to remain sunny and hopeful, punches are not pulled in either segment.  Knowledge gaps in research are discussed along side knowledge gains.  Drug and other treatment trials that have failed sit beside those that have the appearance of succeeding or, at least, helping.  That word "appearance" is important to remember.  Every time Aricept is mentioned it is followed by what may as well be a disclaimer that its effects are uneven, unmeasurable at this time, unpredictable, apparently available only to those in the initial stages of dementia and, at best, last only a few years.  Part 1 also meticulously discusses a vaccination that showed promise in trials but was pulled out of consideration when some study participants developed transient encephalitis.  Even when it comes to life style changes that may promote delaying or short circuiting the onset of Alzheimer's and other dementias, scientists are hopeful but admit that there is, at this time, no clear evidence that any of them work or, for that matter, don't, primarily because studying the effects of life styles is much more dicey than studying the effects of drugs and other medical treatments.  All in all, the promising part of Alzheimer's science is the quantity of information we've discovered in the last 25 years regarding the pathology of the disease.

     This, however, is not the only baseline story in these two episodes.  The research, so far, makes it clear that the further we fish for information, the more we are likely to catch.  It's hard not to notice, as one watches the programs and many of the 15 supplemental films (Alzheimer's 101c), that the confusion this creates within the discipline of science is considerable.  As a viewer I was left with exactly the same impressions that my prior knowledge of Alzheimer's information offered me:  We are not yet close to the top of the climb and we've got a long way to go before before we begin anything resembling a downhill slide.  This does not necessarily mean that we are multiple decades away from useful treatment, even a cure.  Discoveries piggyback on one another, each one increasing the speed of the approach toward bringing any disease, Alzheimer's and other types of dementia included, under control.  The films are clear that multiple scientists in multiple disciplines are pursuing in depth research and working between disciplines to come up with theory after testable theory regarding pathology and treatment.  The episodes also subtly underscore the proposition that participating in any kind of treatment and research boosts the hopefulness of those with Mild to Moderate Cognitive Impairment and/or dense histories of dementia in their families and that this optimism, according to the participants, is better than pessimism.

     Still and all, well, watch this video (class requirement) at The Tangled Neuron, a short review of a book, circa 2008, which debuted around the time that The Alzheimer's Project was being filmed.  In addition, consider that an as yet small, largely unadvertised segment of the medical community is beginning to suggest that we need to spend less time looking for what the author of The Tangled Neuron calls in her video a "silver bullet cure" and more time focusing on how to improve the quality of life of those in various stages of dementia, including redirecting money away from exotic research and toward improving the environments, in multiple ways, of those with dementia.  The supplemental film I found most interesting (and least repetitive of information already contained in the television episodes), Searching for an Alzheimer's Cure:  The Story of Flurizan, brings much to bear on these attitudes by dramatizing the final journey of a very promising medication that not only failed its Phase III trial but, as it failed, strongly suggested to scientists that its failure "prolongs uncertainty about the wisdom of targeting amyloid to treat or even prevent Alzheimer’s."   At the end of the HBO supplemental video three scientists are agreeing that turning away from beta amyloid plaque theories is avisable.  It is sobering to watch this video after hearing so much in both Momentum in Science episodes about the suspected role of beta amyloid plaque in the development of Alzheimer's Disease.  Also, for me, surprising.  Considering the advance blurbs of the advertising, I didn't expect this type of honesty from the series.  Both of the Momentum in Science films, though, contain almost as many theory "farewells" as theory "hails".  There is a concerted attempt, of course, to keep spirits high. Mention is made, at least once, of how important failures are to the process of invention and that each failure brings "us" that much closer to success.  I think the producers, though, deserve kudos for refusing to gloss over the pitfalls currently inherent in Alzheimer's research although, frankly, considering all the information that was "out there" before the series debuted, it would have been hard for them to get away with including only information stamped with a happy face.

     I tried to find something about audience share for HBO's The Alzheimer's Project before writing this installment of my reactions to the episodes in the series.  I couldn't find anything specific, only that the first episode, The Memory Loss Tapes, first broadcast May 10, 2009, didn't land in the top 20, not even of purely cable listings.  Since that episode was the most watchable of the five, I have low hopes for the others, particularly episodes 3 and 5, Momentum in Science Part 1 and Part 2.  These two episodes were TV classroom programming at its best and TV entertainment programming at its worst.  This is not to say that I didn't like these episodes.  Being an info-geek, I enjoyed watching both shows and ran each twice in order to more deeply brand some of the information in my mind.  Today, as well, I worked my way through 14 of the 15 supplemental films (one, The Demoe Family:  Early-Onset Alzheimer's Genetics, hasn't, as of this writing, been uploaded to the site),  almost all of which repeat or elaborate on information in the Momentum in Science episodes.  All of my technical information about dementia has come to me over the last few years from reading.  There was much I thought I understood that the stunning visuals of these programs and the carefully measured audio explanations clarified for me.  The complexity of the field of dementia research is staggering; this is obvious from watching these two episodes.  It's hard for me to imagine how the programs could have been altered for entertainment value without seriously compromising this fact, which is probably, at this time, the most important piece of information about dementia research.