I enjoyed your timely article. Conspicuously absent, however, was any mention of the possibility that the disease is a vascular disorder with neurodegenerative consequences, rather than the other way around. The involvement of several dozen risk factors for Alzheimer’s disease that all reduce or impair cerebral perfusion in the Alzheimer’s brain adds ammunition to this alternative explanation to plaques and tangles. This is only fair since there has been little or no progress in the area of Alzheimer’s disease management and treatment for the past 30 years, due to a great deal of self-investment in a theory that simply does not make sense but somehow continues to find support from the National Institutes of Health, academic institutions, and the private sector. I hope Science News continues its coverage of Alzheimer’s research by occasionally presenting more controversial ideas related to this disorder.

Jack de la Torre
University of California, San Diego
Escondido, Calif.

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