This month marks one year since we lost my dad. It’s hard to believe that he’s already missed a full cycle of birthdays, holidays, and family get-togethers. My family is slowly learning how to adjust to life without him, although I don’t think things will ever feel normal again. I miss him every day.
这个月是我父亲逝世一周年。很难想象，他已经错过了一整年的生日、假期和家庭聚会。我的家人正在慢慢学着适应没有他的生活，然而我觉得一切都不可能回到往昔了。我每天都会想念他。
My dad died from Alzheimer’s disease, which means that my family’s grief is far from unique. More people die from Alzheimer’s every year than from breast cancer and prostate cancer combined, and millions are suffering from the disease. Today, one out of every nine people aged 65 or older has Alzheimer’s disease. Too many families are being forced to watch their loved ones go downhill and disappear. It’s a brutal way to lose someone, and right now, there’s no way to stop or even slow down the decline.
我的父亲死于阿尔茨海默症，这意味着我家庭的悲痛绝非特例。每年死于阿尔茨海默症的人数比死于乳腺癌和前列腺癌的人数总和都多，而且有数百万人正在遭受这种疾病的折磨。如今，每九个65岁以上的人中就有一人患有阿尔茨海默症。大量的家庭只能看着他们至亲的健康每况愈下，并最终离世。以这种方式失去亲人是残酷的，但到目前为止，人们还没有办法阻止，哪怕是延缓病情的恶化。
I’ve written a lot on this blog about why I’m optimistic that new breakthroughs may someday soon let us substantially alter the course of the disease. One of the areas where we’ve seen the most progress over the past couple years is diagnostics.
我在这个个人公众号上写了很多关于“为什么我乐观地认为新突破可能很快让我们大幅改变病程”的内容。在过去的几年里，我们看到其中一个进步最大的领域就是诊断方法。
The current process for diagnosing Alzheimer’s is a huge hurdle standing in the way of a breakthrough. If we’re going to find a game-changing treatment, we will need to test many different hypotheses, which would mean we need to conduct lots of clinical trials. That requires recruiting a lot of participants early enough in their disease that a drug might make a difference. But patients have to show signs of cognitive decline before they know to get tested—which means that their Alzheimer’s is already quite advanced—so many potential volunteers aren’t eligible. We need a cheap, non-invasive way to diagnose patients early before their symptoms get too bad.
目前，阿尔茨海默症的诊断严重阻碍了该病治疗技术的突破。如果想找到一种能够彻底改变现状的治疗方法，我们将需要测试许多不同的假设，这意味着需要进行大量的临床试验。完成相关临床试验需要招募大量处于病程早期的参与者，以使药物能够发挥作用。但通常患者在出现认知能力下降的迹象后才发觉需要去医院就诊，而这时他们的阿尔茨海默症已经相当严重了。所以许多潜在的志愿者无法符合参与临床试验的条件。因此，我们需要一种廉价、非侵入性的诊断方法，在病人的症状出现恶化之前进行诊断。
The good news is that there are a number of promising new diagnostic tests in the pipeline. I partnered with the Alzheimer’s Drug Discovery Foundation to develop a philanthropic fund called the Diagnostics Accelerator several years ago with the hope that it would kickstart a bunch of new research. We were then joined by Jeff Bezos, MacKenzie Scott, the Dolby family, and several others to expand the effort. The first round of funding is expected to be completed by the end of the year, and many of the award recipients are already making terrific progress.
好消息是，许多有前景的新型诊断测试正在研发中。几年前，我与“阿尔茨海默症药物发现基金会”合作，设立了一个名为“诊断法加速器”的慈善基金，希望以此启动一系列新的研究。随后，杰夫·贝索斯、麦肯齐·斯科特、杜比家族等人也加入了该基金，进一步提升了这项工作。第一轮资助预计将在今年年底前完成，许多获奖者已经取得了了不起的进展。
Some are working on diagnostics that may be available soon, like the simple blood test being developed at the University of Gothenburg in Sweden. Blood tests are the gold standard for diagnosing many diseases for a reason: they’re easy to administer and can be inexpensive to analyze. The test developed at Gothenburg looks for several indicators in the blood, including the presence of a protein called amyloid that can cause plaques in the brain. Samples are run through a common type of diagnostic platform developed by Roche, which means they can be analyzed at most labs.
部分研究专注于有望在短期内得以应用的诊断方法，比如瑞典哥德堡大学正在开发的简单血液检测。血液检测由于其易于实施和成本低廉的特点，是许多疾病诊断的黄金标准。哥德堡大学开发的这项测试目标是检测血液中的几项指标，其中包括一种名为淀粉样蛋白的蛋白质，这种蛋白质可导致大脑中出现斑块。血液样本使用罗氏公司生产的一种常见的诊断平台进行分析，所以大多数实验室都可以完成这一检测。
Having an accessible blood test for Alzheimer’s would be huge. Many of us get our blood drawn once a year during our physical, and it’s easy to imagine a future where your results tell you how your brain is doing, just like how you currently get updates on the state of your heart. I’m hopeful this test will be available within the next year or two.
开发出阿尔茨海默症可行的血液检测方法意义重大。大多数人每年体检时都会进行抽血，不难想象，未来的体检结果将包括对于大脑状况的报告，正如现在的每年的体检可以对心脏状况进行更新。我希望这种检测可以在未来一到两年内推出。
Other diagnostics in the pipeline use more unexpected methods to detect Alzheimer’s, like an eye test. Cecilia Lee—a researcher at the University of Washington here in Seattle—believes that your retina can provide a window into the brain. In 2018, she published a study showing that having an eye condition like glaucoma or macular degeneration doubles your risk for Alzheimer’s.
其他一些研发中的阿尔茨海默症诊断方法使用了更意想不到的手段，比如眼睛检查。西雅图华盛顿大学的研究人员塞西莉亚·李认为，视网膜可以提供了解大脑的窗口。2018年，她发表的一项研究显示，患有青光眼或黄斑变性等眼部疾病会使患阿尔茨海默症的风险增加一倍。
Ever since, she’s been looking for ways to use this link to diagnose Alzheimer’s. Cecilia and her colleagues are exploring different ways to scan your eyes for early signs of Alzheimer’s, including by using artificial intelligence to spot tiny irregularities that a human could never find. The UW team isn’t the only group hoping that the eyes are the key to a better diagnostic. Several companies including RetiSpec, Neurovision Imaging, and Optina Diagnostics are using new imaging techniques to look for amyloid plaques. We’re still years away from your annual eye exam including any test for Alzheimer’s, but I’m excited to keep following the research.
从那时起，她一直在寻找利用这种关联来诊断阿尔茨海默症的方法。塞西莉亚和她的同事们正在探索用不同的方法来扫描眼睛，以发现阿尔茨海默症的早期迹象，包括使用人工智能来发现人类难以发现的微小异常。华盛顿大学并非唯一一个希望通过眼睛实现更好的诊断方法的机构。包括RetiSpec、Neurovision Imaging和Optina Diagnostics在内的一些公司正在使用新的成像技术来寻找淀粉样斑块。距离实现在年度的眼科体检中包含阿尔茨海默症检测可能还需要若干年的时间，但我乐于继续关注这方面的研究。
All of the tests I’ve mentioned require a trained medical professional and specialized equipment—but what if all you needed to assess your brain health was your smartphone? Several companies are working on highly sophisticated apps that might one day become diagnostics that are accessible to anyone with a phone or tablet. They have tremendous potential, although it’s too soon to tell whether any of them will pan out.
上述提到的所有检测都需要专业的医疗人员和专业设备，但你能想象大脑健康评估可以仅依靠一部智能手机吗？有几家公司正在开发高度精密的应用程序，这些应用程序可能有朝一日为所有拥有手机或平板电脑的人提供诊断方法。这些研究具有巨大的潜力，尽管现在判断它们是否能取得成功还为时尚早。
Cogstate is working on a test that looks like a series of mobile games. Each one evaluates a different function of your brain, like your ability to recognize emotions or focus on a task. A different company called Altoida is developing an app for your phone or tablet that uses augmented reality games to assess your cognitive abilities. (If you’ve ever played Pokemon Go, you’ve used AR.) If you score below a certain threshold on either test, your doctor could then order another diagnostic—like a blood test—to confirm whether you have the disease.
Cogstate公司正致力于开发一项测试，这一测试看起来像系列手机游戏。每一个游戏都会评估你大脑的不同功能，比如你识别情绪或专注于某项任务的能力。另一家名为Altoida的公司正在为手机或平板电脑开发一款应用程序，利用增强现实游戏来评估认知能力。(如果你曾经玩过“精灵宝可梦Go”，那你就体验过增强现实技术。）如果在任一测试中得分低于特定阈值，医生就可以据此开具进一步的诊断，比如血液检测，以对阿尔茨海默症进行最终的确诊。
Nearly all of the tests I’ve mentioned are being supported by the Diagnostics Accelerator. The fund has invested in 25 candidates to date, and I’m hopeful that we have at least one game changer in the group. The Diagnostics Accelerator is also doing great work to make more samples and data available to researchers, which will hopefully speed up the time it takes to find a breakthrough.
刚才所提到的测试几乎都得到了“诊断法加速器”的支持。截至目前，该基金已经投资了25个候选项目，我希望这些项目中至少有一个能够彻底改变现状。“诊断法加速器”在向研究人员提供更多的样本和数据方面也做了大量的工作，这将有望加速技术突破的实现。
If we want to stop Alzheimer’s, one of the biggest things we need to develop is a reliable, affordable, and accessible diagnostic. I think we’re close to having one, and the developments we’ve seen over the past couple years make me more optimistic than ever that we can one day stop Alzheimer’s. I can’t wait to see what new progress is unlocked thanks to better tests.
要攻克阿尔茨海默症，最重要的事情之一就是开发一种可靠、可负担、可普及的诊断方法。我认为我们将很快研发出这一方法，而过去几年里所取得的进步让我对于攻克阿尔茨海默症比以往更加乐观。我迫不及待地期望见证更好的测试技术所能带来的新进展。
