Published: 00:59 BST, 18 August 2026 | Updated: 06:49 BST, 18 August 2026<\/p>\n
Ask a firefighter if you can put out a blaze by only tackling the smoke, and not the flames themselves, and you can imagine their response.<\/p>\n
Yet this is the same situation neurologists have been facing for decades when treating Alzheimer\u2019s disease: merely being able to temporarily treat the \u2018smoke\u2019 of the disease \u2013 the symptoms.<\/p>\n
I have been a neurologist for more than 40 years, and specialise in treating people with Alzheimer\u2019s and other neurodegenerative diseases.<\/p>\n
When I lecture around the world about the \u2018smoke, not fire\u2019 challenge, people ask me about the slow pace of research to find an effective treatment.<\/p>\n
Why, they ask, if drug companies have been pouring billions of dollars into Alzheimer\u2019s research, have scientists not yet found something to cure, or even prevent, this pernicious disease?<\/p>\n
The short answer I believe is because researchers have been focused on the wrong issue when it comes to Alzheimer\u2019s.<\/p>\n
We have been told effective treatment for the disease requires the removal of beta- amyloid plaques in the brain that are common in patients.<\/p>\n
But while beta-amyloid plaques do contribute to Alzheimer\u2019s, by increasing inflammation, they are not the root cause of it.<\/p>\n
Dr David Perlmutter, a\u00a0neurologist for more than 40 years, says researchers have been focusing on the wrong area when trying to treat Alzheimer's<\/p>\n
Dr Perlmutter argues\u00a0the fundamental cause of Alzheimer\u2019s lies in the activation of the brain\u2019s specialised resident immune cells, called the microglia<\/p>\n
Instead \u2013 as I discuss in my new book, Brain Defenders: Harness The Power Of Your Immune Cells To Protect Your Brain For Life \u2013 the fundamental cause of Alzheimer\u2019s almost certainly lies elsewhere: in the activation of the brain\u2019s specialised resident immune cells, called the microglia. They clean up dead cells, fight infections and help keep brain tissue healthy.<\/p>\n
But studies also show that chronic (rather than acute, i.e. short term) activation of these immune cells by, for example, having type 2 diabetes or obesity \u2013 can drive increased beta-amyloid production, as well as impair its clearance.<\/p>\n
So beta-amyloid build-up in Alzheimer\u2019s patients is a consequence of the behaviour of the microglia \u2013 and research, then, should have been focusing on ways to target this behaviour as a way to treat the condition effectively.<\/p>\n
Yet the \u2018amyloid hypothesis\u2019, as it is known, continues to wield incredible influence \u2013 something I find shocking considering the often serious side-effects caused by the medications created to \u2018treat\u2019 amyloid plaques, including brain bleeds and swelling.<\/p>\n