在 2026 年 4 月的 WIRED Health 演讲中，前沿阿兹海默症研究者 John Hardy 说，阿兹海默治疗已经从实验室发现走向病人，但仅靠科学不足以完成转化。他认为进步取决于更有效的药物、更早且更准确的诊断，以及政治承诺，因为药物可及性、资金与照护系统决定突破是否能真正影响患者生活。

在 1990 年代，Hardy 帮助确立 amyloid 在阿兹海默症病理中的核心地位，他指出早期抗体可预防新的沉积，但未能清除大脑中已存在的 amyloid。较新的抗 amyloid 药物，尤其是 Lecanemab 与 Donanemab，可去除已形成的沉积。2022 年公布的 Lecanemab 临床试验是首次显示可降低认知恶化速度，但它只放慢疾病进程，并未停止疾病。Hardy 表示未治疗的阿兹海默病通常在约 8–9 年内进展，而 Lecanemab 可能把这一路径延长到约 11–12 年，临床上有意义，但仍不足。

Amyloid 假说仍有争议，但多数科学家现在承认它有一定角色。Hardy 认为以生物标记物与基因学改进诊断至关重要，类似心脏病使用胆固醇指标；他也强调服务落差：在英国仅有自费病人能使用 Lecanemab，而美国则有 FDA 批准且可由 Medicare 覆盖。误诊比例很高，约 60% 的失智诊断确实是 Alzheimer’s 病。Gantenerumab 在更高且持续更久的剂量下显示改善。Hardy 的结论是，仍需更有效的药物、更早诊断，以及对失智服务的投资。

In an April WIRED Health talk, pioneering Alzheimer’s researcher John Hardy said Alzheimer’s treatment has moved from laboratory discovery to patients, but science alone is not enough to make that transition complete. He argued that progress depends on more effective drugs, earlier and more accurate diagnosis, and political commitment, because access to medication, funding, and care systems determine whether breakthroughs can truly affect patients’ lives. (Key numbers: 2026, 4)

Hardy, who helped establish amyloid as central to Alzheimer’s pathology in the 1990s, said early antibodies could prevent new deposits but could not clear amyloid already present in the brain. New anti-amyloid medicines, especially Lecanemab and Donanemab, can remove already formed deposits. The 2022 Lecanemab trial was the first to show reduced cognitive decline, but it only slowed disease progression and did not stop the disease. Hardy said untreated Alzheimer’s usually progresses over about 8–9 years, while Lecanemab may extend that trajectory to about 11–12 years, which is clinically meaningful but still insufficient.

The amyloid hypothesis is still disputed, but most scientists now accept that it has a role. Hardy said improving diagnosis through biomarkers and genomics is essential, analogous to using cholesterol testing in heart disease; he also stressed service gaps: in the UK only privately paying patients can access Lecanemab, while in the US it has FDA approval and Medicare coverage. Misdiagnosis is substantial, with about 60% of dementia diagnoses actually being Alzheimer’s. Gantenerumab now appears improved with higher and longer dosing. Hardy concluded that more efficacious drugs, earlier diagnosis, and investment in dementia services are still needed.