I · Why this book exists
Noterad · 2025
Dementia is the most feared diagnosis of modern adult life. The science to address it has transformed. The books on the shelf have not caught up.
In the last five years the cognitive health field has undergone the most substantial transformation in its history. The 2024 Lancet Commission identified 14 modifiable risk factors accounting for ~45% of global dementia cases. Blood biomarkers like p-tau217 have moved from research to clinical use. Lecanemab and donanemab — the first disease-modifying anti-amyloid drugs — have reached the market.
And yet most consumer-facing books predate this entire era. The shelf is dominated by memoirs, supplement marketing, and "this one habit reverses Alzheimer's" framings that overstate the evidence, sell something at the end, or both. Prevagen built a billion-dollar business on a jellyfish protein. Daniel Amen markets SPECT scans of contested clinical utility. Lumosity settled with the FTC for $2 million over cognitive claims.
Calibrated. Honest. Current. Anti-grift but also anti-nihilism. The synthesis the conversation has been missing.
This is the field guide for the 45-year-old who watched a parent decline. For the APOE4 carrier trying to think clearly. For the partner evaluating treatments. For everyone determined to keep their mind sharp as long as possible — and willing to read something that doesn't sell them a supplement at the end.
