I think as you work backwards from the very end stages of all of these diseases, there are so many similarities, more commonalities as people approach the end of their condition. As has been already said, as you move upstream the disabling effects are broadly similar, so we have to have comparable programs for supporting caregivers, no matter what the diagnosis.
As you then move back upstream toward the clinical type of research, of course the differences become very considerable. When you move even further back upstream within one condition, we suddenly discover the thing we had been calling Alzheimer's disease suddenly starts to get much more complicated and there are many sub-categories. When you start to look at the etiology, as Mr. Walton already commented with a couple of illustrations for ALS, there can be lots of different causes that lead to the very same disease process.
So the further upstream you go in trying to design a strategy ultimately to manage, prevent, treat, and so on, the more diverse the strategy has to be at the upstream end. We have to pay attention to the fertilizers that we do or don't put on our gardens that our children play in and may absorb, and so on. That is of course being done. It's all part of a brain strategy. But that only affects a tiny fraction of the eventual cases that may develop ALS, or Alzheimer's, or whichever disease. So we have to have multiple upstream strategies to protect health. It's very much like a public health type of approach. The more we learn, the more we understand, the more we can point the finger at these various hazards.
Of course there is a tremendous political balance, then, between protecting a tiny fraction of the people who are susceptible to those agents versus the convenience of being able to keep our lawns nice and green and so on and so forth. That's evidently in your domain. I think our domain as researchers is obviously to supply the information that would allow us to model—just to continue with the pesticide example—if we were to ban pesticides, this is the likely number of cases we might be able to prevent and suggest what would be the net cost-benefit of all that sort of a strategy.
It gets very fascinating. I think that ideally a brain strategy should have a clear model of how we think about this entire nationwide process of approaching neurological disorders, that in some ways they're very comparable and in some ways they're hugely different.
The last comment is that when you get right upstream, in fact the same etiological agents are hazards for multiple conditions. Pesticides may well be damaging for ALS; they're sure bad for your Alzheimer's; they're bad for your brain in general.