“Unfortunately, the most effective treatment for Alzheimer’s disease today is counseling the caregiver.”

This sober conclusion comes from Mary Mittleman, a leading researcher at NYU’s medical school. She explains why: “There is no effective drug that will stop or reverse the disease.”

Though it sounds grim, her statement does point toward an important response to the disease. In her research into caregiving for people with Alzheimer’s, the speaker has discovered what a difference it makes to have caregivers who are well-informed.

Dr. Mittleman was one of several experts who spoke about Alzheimer’s during a week-long seminar for journalists, including me, last month. All of them concurred in regretting the lack, as yet, of medication to avert onset of the disease or suppress its ravages.

Incidentally, that seminar was founded and directed by Robert Butler, a giant in the field of aging. As I write this column, word has come of Dr. Butler’s death, a great loss to this nation and to me personally. Colleagues everywhere are now mourning his unexpected death.

The experts think of AD as the prime disease of the twenty-first century. Already some five million Americans are afflicted with it. Barring a breakthrough by 2050, the number may rise as high as 14 million.

Currently, AD ranks as the number one cause of disability among elderly Americans and it costs this country something like 172 billion dollars a year. Unless ways are found of solving Alzheimer’s  or at least delaying its onset, it alone could bankrupt Medicare.

This economic threat reflects the gradual aging of the baby boomers, those who were born between 1946 and 1964. Their numbers make the research currently under way even more pressing .

Only rarely do I write about Alzheimer’s because it’s a subject most people including me don’t want to think about. The prospect of losing my brain power, along with all the mature forms of self-control that currently enrich my life is too grim to contemplate.

My hope is for scientists to discover soon ways of at least mitigating AD’s effects, if not eliminate it altogether.  As I recently discovered from researchers in the biological sciences, however, the road to any breakthroughs will continue to be long and difficult.

Scientists researching Alzheimer’s will tell you it’s tough work. They must bring to the task detailed knowledge of the human brain, with special attention to such things as plaques and tangles. Great patience is required because, despite years of research, so much remains unknown.

What adds to the challenge is the way some changes in the brain turn out not to be causes but rather what researchers call bio-markers. These markers indicate problems, but do not explain them.

One prime example is called amyloid. Though this protein deposit is a prime suspect, it is not altogether certain that it causes Alzheimer’s.

But even these deep uncertainties are a signs of progress.

Howard Fillit, a New York geriatrician deeply involved in research and the funding of research, recalls the day in 1970 when Alzheimer’s was recognized, not as a normal part of aging, but as a disease of aging. As he describes what it meant for himself and some others, he says:  “The whole world changed that day.”

Since I am not a biologist, I need to struggle to understand descriptions of complicated laboratory experiments. However, I feel awe when researchers perseverance.

It stirs my imagination to learn how chemists identify molecules appropriate for binding amyloid, and then manage to get them past the brain and blood barrier. It ranks as a major scientific feat to accomplish this passage.

In recent weeks, Gina Kolata of the New York Times reported on a successful method of looking into the brain for plaque. Using a dye and a scanner, researchers have managed to show the buildup of this telltale sign of Alzheimer’s. This procedure is not a cure, of course, but it is seen as an important step toward developing one.

Discovery of causes does not automatically assure a cure. The way to pharmaceutical success is also long and difficult. In fact drug discovery is considered a unique scientific field of its own.

One of our speakers said that “creating that little white pill is probably the most difficult thing to do.”  You can work a whole lifetime, he said, yet never see any medication that comes from your efforts.

Drug development is also difficult and expensive. One clinical trial for Alzheimer’s cost 300 hundred million dollars. For every 10 drugs approved by the Federal Drug Administration, only three make a profit.

Still, the cause remains worth all-out efforts. As Dr. Butler, America’s premier geriatrician, wrote: “Old age without dementia would be the medical conquest par excellence of the twenty-first century.”

Despite the odds, I hope to live long enough to see this conquest achieved.