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Living to old age is quite literally the best thing that any of us could hope for, given the alternative. It’s a cruel irony, then, that many of us who make it that far will begin to lose our sense of who we are due to dementia. If you’re 65, you’ve got about a one in 20 chance of developing the most common form, Alzheimer’s disease, in the next decade. At 75, it’s about one in seven, while those fortunate enough to reach 85 face a one in three chance.
Given the toll this illness takes on sufferers and those around them, hundreds of millions of families around the world are desperate for a medical breakthrough – and for years, headlines have suggested that it might be imminent. Scientists had identified the cause of Alzheimer’s, they promised, and potential cures were already being tested.
The subtitle of Doctored – Fraud, Arrogance and Tragedy in the Quest to Cure Alzheimer’s – serves as a spoiler as to how that story ends, at least for the moment. The fraud uncovered by a rag-tag group of researchers into academic integrity and extensively documented here by Charles Piller, an investigative journalist for the magazine Science, feels like the kind of scandal that should have had wall-to-wall coverage. And yet, outside scientific circles, it remains relatively low-profile.
The story is complicated, but a summary might go like this: for decades, something called the amyloid hypothesis has dominated research into Alzheimer’s, determining how billions of dollars of public and private funding into new drugs was spent. The brains of people who had died with it showed clumps of sticky protein – called amyloid plaques – between neurons. It seemed logical that these might be responsible for the disease’s symptoms. And while this became the main line of inquiry, it never quite delivered on its early promise. Many people with amyloid plaques didn’t have signs of Alzheimer’s, for example. Something seemed to be missing.
And then came what seemed like decisive proof: a 2006 paper from the University of Minnesota, which went on to become one of the most cited in the field, showed that a sub-type of amyloid led to memory impairment. It wasn’t until 2022 that scientific sleuths suggested that key images on which the research relied might have been Photoshopped to better fit the hypothesis. At first, the scientists fought back against the claims, but the 2006 paper has now been retracted, as have others based around the same findings. As the book explains, investigations continue and several key figures involved deny any knowledge of wrongdoing.
The implication is that years of work and billions of dollars spent on Alzheimer’s research may have been carried out on the basis of fraudulent evidence. The scale of the harm caused and damage done is likely to be incalculable.
Piller handles the difficult material patiently and meticulously, as you would expect of an experienced specialist reporter. As the book continues, it becomes an ever more uncomfortable read: the tale starts with the alleged fakery of images by one, or a handful, of scientists. By the end, we’re left wondering if any research can really be trusted.
Doctored is clearly the result of brilliant and dogged journalism, but at times all of this work is easier to admire than it is to read. Piller tries to humanise his narrative with pen portraits of key figures, but his habit of doing several of these in a row – and formulaically telling us everyone’s place of birth and what their parents and grandparents did – gets repetitive and frustrating.
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That’s a pity, as the scandal at the book’s heart is one that more people should know about. The scientists behind the fraud may have set back the quest to find treatments for Alzheimer’s by many years. For those making decisions on the future of scientific and medical research, this book should be compulsory reading.
