Talk:Alzheimer's disease

FAR needed

Version reviewed

This is a 2008 Featured article that averages 3,000 daily pageviews whose main writers have not edited since 2012 (OrangeMarlin) and 2013 (Garrondo). It has fallen out of standard and will need to be sent to WP:FAR unless someone takes on the issues, including a comprehensive update. Wherever one glances there are issues:

• The Further reading section contains only dated entries. FAs are supposed to be comprehensive, so items listed there need explanation.
  • Trimmed (t · c) buidhe 21:27, 29 July 2020 (UTC)
• A consistent citation style (the Boghog/Diberri format with vancouver-style authors) has not been maintained.
• The WHO and NIH sources have been considerably used, rather than sourcing to the more authoritative, underlying published literature.
• Many of the sources used are considerably dated-- it does not seem that the article has been routinely updated to newer sources, or is sourced to the highest standards per WP:WIAFA and WP:MEDDATE.
• The Research directions section is particularly problematic, and has become a catch-all (which may work for most articles, but not for the high standards required of a Featured article). That section is using lay sources and has very dated sources as well ... if something in research is significant, it will eventually be mentioned in a secondary review. The Research directions section needs a complete rewrite, using the latest high quality secondary reviews, rather than a catch-all reflecting the popular press.
• The considerable overlap between Dementia with Lewy bodies and Alzheimer's is not developed, with one passing sentence.
• There is a graph of deaths in ... 2012!
• Epidemiology has very dated sources.
• Sourced to 2008! Huperzine A while promising, requires further evidence before its use can be recommended.[189]
  • Removed, no longer promising (t · c) buidhe 21:27, 29 July 2020 (UTC)
• Sourced to 2010! The oldest hypothesis, on which most currently available drug therapies are based, is the cholinergic hypothesis,[52] which proposes that AD is caused by reduced synthesis of the neurotransmitter acetylcholine. The cholinergic hypothesis has not maintained widespread support, largely because medications intended to treat acetylcholine deficiency have not been very effective.[53] Either this hypothesis panned out, or it didn't. If it did, new source. If it didn't, remove, UNDUE. This is similar to what is found throughout the article, which is grossly outdated and needing a comprehensive rewrite.
• The lead has not been kept in sync with the body of the article-- there is information in the lead which is nowhere to be found in the article.
• This statement in the lead doesn't even belong in this article ... it is not about AZ, rather all dementia. In 2015, dementia resulted in about 1.9 million deaths.[9]
• Sourced to 1998 and 2005!! In developed countries, AD is one of the most financially costly diseases.[19][20]
• There are 2,000 reviews in the last year alone listed for Alzheimer's, yet the article stagnates.
• The spoken Wikipedia link is 12 years old ... should be removed from article and placed on talk.
  • Done (t · c) buidhe 21:27, 29 July 2020 (UTC)

I will put this forward to FAR in about a month unless someone is able to rewrite and update. The list above is samples only-- a top-to-bottom rewrite and update is needed, and SandyGeorgia (Talk) 19:30, 29 July 2020 (UTC)

May I also note inconsistent spellings: ageing and aging are both used. (t · c) buidhe 19:43, 29 July 2020 (UTC)

And page numbers or section names are needed on lengthy journal articles. SandyGeorgia (Talk) 19:55, 29 July 2020 (UTC)

This is going to take a ton of work to clean up. Alzheimer's disease hypotheses change almost weekly. I'm going to recruit a neurobiologist that I know to do some redlining offline (she has no interest in editing Wikipedia), and maybe I'll give it a stab. I often refer to this article as one of the best medical articles on Wikipedia, if not the best. It has become stale. I think the original authors went on to other things once this became an FA. :( SkepticalRaptor (talk) 21:04, 29 July 2020 (UTC)

Remind your off-Wikipedia friend that they need to find the latest and highest quality secondary reviews (not primary sources) and rewrite the article to them. SandyGeorgia (Talk) 21:06, 29 July 2020 (UTC)

Citation style

This is the version that passed FAC, using the long and well established Diberri format of vancouver style author names with more than six authors truncated to three et al, to avoid chunking up the text in edit mode with 6,500 bites of template parameters that one has to edit around. I have restored the original citation style, per WP:CITEVAR, which should never have been changed. SandyGeorgia (Talk) 06:10, 6 September 2020 (UTC)

Planned work underway

See note here, and welcome User:Celmck! SandyGeorgia (Talk) 18:05, 31 December 2020 (UTC)

@Ajpolino and Celmck:, no edits since January 8; shall we move forward with a Featured article review? This article is quite badly dated. SandyGeorgia (Talk) 17:34, 12 March 2021 (UTC)

Initial suggestions for FAR

Hello all! I have been invited to help with this article and am working with User:Ajpolino and User:SandyGeorgia to try to adhere to standards and rules. Here are my notes on how I would edit this article. I will preface this by saying that really every section needs updated references, so I'm not going to repeat that for all of my notes below. I am happy to help find updated references for any sections that others are interested in working on, but could use help formatting them and inserting them where needed. Here, I mostly tried to focus on what content stands out to me as outdated, questionable, or inappropriate, and noted that I can start on the Causes, Pathophysiology, and Research Directions.

• Signs and Symptoms: This section is probably written okay but needs to be looked over and given updated references.
• Causes: I can work on this section. I think it needs slight reorganization and some cutting down to the most relevant information. Also I would like to present only the most well-known and supported hypothesis since there are so many listed now that sound a little random.
• Pathophysiology: I can work on this section. I may reorganize some of this information with the Causes and Research Direction sections to provide better flow, as well as clarify and elaborate on some points of the disease mechanism which are unclear.
• Diagnosis: I'm less familiar with all of this but definitely needs to be fact checked to see if diagnosis criteria are up to date. For example the main criteria it says were designed in 1984 and updated in 2007, so it's possible a lot has changed about AD diagnosis since then.
• Prevention: I think the organization and sections for this are probably good, but needs heavy updating. For example, this section mentions a lot of "potential" preventative measures that have since probably either been debunked or much further elucidated. Personally I would also add a heavy dose of sleep literature in the lifestyle section here.
• Management: Similar to the diagnosis section I am unfamiliar with this but can help with getting it more up to date. Considering there are no cures for AD, I doubt much of this will have changed.
• Prognosis: This could use a little reorganizing, but also an update to the risk factors for poor prognosis. Is there new information on disease features or risk factors that correlate with faster disease progression after onset? Also, needs fact checking for existing claims and updated references.
• Epidemiology: I think this should just be rewritten as a much shorter version based on a few newer references. It just needs to get across "there is a lot of AD everywhere, depends on age, sex, and location."
• History: This only describes the definition of Alzheimer's and its discovery, which looks fine as is. I would add history of research and clinical trials since there has been so much work on the disease now. There have been some major clinical trial failings over decades that really explain why it is hard to understand and treat this disease as well. Some of these are in the research directions but are over a decade old now, so I think it would be better to introduce them as history which will give context to why current research directions and trials have shifted towards different ideas.
• Society and culture: Not sure I'll have time to work on this, so at the least references could be updated.
• Research Directions:  I can work on this section. I think the following subsections should exist but will organize after consulting some reviews.
  1. Models:
     • Rodents
     • Cell lines: neurons, glia, ipscs
     • Biochemistry of abeta and tau
  2. Drug discovery (or Medication)
  3. Diagnostics: imaging, biomarkers
  4. Clinical trials: ongoing or planned

Other sections that currently exist: behavioral prevention, possible transmission, and infections. If anything these could be deleted.

• Further reading/external links: If it were up to me, I would probably delete the further reading and just go with external links that haven't been cited in the article, perhaps such as these.
  • Alz.org
  • NIH Alz data sheet
  • Alzforum
  • Alzfdn.org
  • Jackson labs alzheimer's page
  • Some book chapters from pubmed

So for now I can start on the Causes, Pathophysiology, and Research Directions sections. I can easily work on External links and eventually on the History section as well, and provide some help with finding updated references. Celmck (talk) 17:58, 8 January 2021 (UTC)

Hi, Celmck and welcome again! This is on my list, and I will catch up as I am able. (For an explanation of my editing style and "issues", see this thread.) So happy to have you on board! SandyGeorgia (Talk) 18:46, 8 January 2021 (UTC)

Celmck, apologies for the delay (such is the world of Wikipedia, where it can be hard to stay abreast of all of one's projects). I think your list above is amazingly comprehensive and shows remarkably quick adaption to how Wikipedia works. I am always willing to do the citation cleanup, so don't let that part concern you. Put in what you have, add the page number as a Template:Rp where you have it, and I will adjust (and you will learn as you go as you review my changes). I can certainly do the Society and culture part, but that is last priority. Best regards, SandyGeorgia (Talk) 16:58, 13 January 2021 (UTC)

Semi-protected edit request on 17 February 2021

Change "can be mistaken for normal age." to "can be mistaken for normal aging." OwenBOSSMan (talk) 07:08, 17 February 2021 (UTC)

 Done Zupotachyon (talk) 07:38, 17 February 2021 (UTC)

Society and Culture

I think it is important to expand upon the health disparities known to be present in the context of Alzheimer's disease. Racial/ethnic identity (e.g., Black, Latinx), for example, is a significant risk factor but is also a sociocultural umbrella term that has been outlined with substantial supporting literature to actually describe the disparities faced by these persons rather than their racial/ethnic identities. --Jcl11 (talk) 21:49, 22 February 2021 (UTC)

Do you have sources? It sounds like there is overlap in the content you suggest between Epidemiology, and Society and culture; which affects whether we need WP:MEDRS sources or just plain WP:RS. It is not clear to me if you are referencing caregiving, prognosis, epidemiology, or which factor ... SandyGeorgia (Talk) 21:54, 22 February 2021 (UTC)

confusion on is it genetic or not

The wiki page in summary claims:

"About 70% of the risk is believed to be inherited from a person's parents"

and then in causes in 2.1 under genetics it says:

"Only 1-2% of Alzheimer's cases are inherited"

So this is huge difference. One of the stats are true. Why is summary not aligned with the facts? — Preceding unsigned comment added by Gulabani17 (talk • contribs) 05:12, 14 March 2021 (UTC)

Made some changes with different ref. Thanks --Iztwoz (talk) 13:43, 14 March 2021 (UTC)

Heritability and inherited are two different things. SandyGeorgia (Talk) 13:51, 14 March 2021 (UTC)

Would it be beneficial to define the differences between the two to help the reader understand and not become confused between the two?Ambebeck (talk) 21:55, 3 May 2021 (UTC)

Aluminium

From Alzheimer's disease#Other hypotheses:

The majority of researchers do not support a causal connection with aluminium.

From Immunologic_adjuvant#Humans:

Aluminium salts used in many human vaccines are regarded as safe by Food and Drugs Administration, although there are multiple studies suggesting the role of aluminium, especially injected highly bioavailable antigen-aluminium complexes when used as adjuvant, in Alzheimer's disease development

Shouldn't the statements be synchronized?

References

--Error (talk) 16:06, 12 April 2021 (UTC)

All of the sources, in both articles, are old, and there are numerous newer secondary reviews that should be used. SandyGeorgia (Talk) 16:29, 12 April 2021 (UTC)

Monoclonal antibodies

A systematic review and meta-analysis concluded that monoclonal antibodies against beta-amyloid induced clinical improvements of small effect sizes and biomarker improvements of large effect sizes. Among individual drugs, aducanumab produced the most favorable effects followed by solanezumab.

Reference https://pubmed.ncbi.nlm.nih.gov/33831607/ 84.205.241.2 (talk) 16:22, 11 September 2021 (UTC)