Science
Dementia May Not Always Be the Threat It Is Now. Here’s Why.
Joan Presky worries about dementia. Her mother lived with Alzheimer’s disease for 14 years, the last seven in a memory-care residence, and her maternal grandfather developed dementia, too.
“I’m 100 percent convinced that this is in my future,” said Ms. Presky, 70, a retired attorney in Thornton, Colo.
Last year, she spent almost a full day with a neuropsychologist, undergoing an extensive evaluation. The results indicated that her short-term memory was fine — which she found “shocking and comforting” — and that she tested average or above in every cognitive category but one.
She’s not reassured. “I saw what Alzheimer’s was like,” she said of her mother’s long decline. “The memory of what she went through is profound for me.”
The prospect of dementia, which encompasses Alzheimer’s disease and a number of other cognitive disorders, so frightens Americans that a recent study projecting steep increases in cases over the next three decades drew enormous public attention.
The researchers’ findings, published in January in Nature Medicine, even showed up as a joke on the Weekend Update segment of “Saturday Night Live.”
“Dementia is a devastating condition, and it’s very much related to the oldest ages,” said Dr. Josef Coresh, director of the Optimal Aging Institute at NYU Langone Health and the senior author of the study. “The globe is getting older.”
Now the findings are being challenged by other dementia researchers who say that while increases are coming, they will be far smaller than Dr. Coresh and his co-authors predicted.
Using data from about 15,000 Americans over age 55, collected at four research clinics around the country from 1987 through 2020, Dr. Coresh’s team projected a lifetime dementia risk much higher than previous studies had: 42 percent, though most of that risk didn’t emerge until after age 85.
The higher lifetime number probably reflected the study’s reliance on a more diverse sample than earlier researchers had used, Dr. Coresh said, and more dementia cases identified through in-depth questionnaires, regular phone calls, medical records and death certificates.
The researchers applied their risk calculations to the U.S. population and estimated that the number of people who would develop dementia each year would roughly double, to about a million by 2060, from 514,000 in 2020.
Eric Stallard, an actuary and co-director of the Biodemography of Aging Research Unit at Duke University, read the study and thought the team “seemed very competent at their analysis” of individual risk.
But when it came to the projection that cases would double, which assumed that the incidence of dementia would remain stable over the next 40 years, “I don’t believe it,” Mr. Stallard said.
“The notion that the number of people with dementia will double over the next 25, 30 or 35 years due to the aging of baby boomers is widespread, it’s pervasive — and it’s wrong,” he added.
He and two other Duke researchers recently published a commentary in JAMA pointing out that the age-specific prevalence of dementia in this country had steadily declined for 40 years.
“If your risks are lower than your parents’ risks and this trend continues, you won’t see the doubling or tripling of dementia that’s been projected,” said Dr. Murali Doraiswamy, director of the Neurocognitive Disorders Program at Duke and a co-author of the JAMA article.
To be clear, experts agree that the number of people with dementia will climb in coming decades, simply because the disorder rises so steeply with age and the number of older adults in the United States will increase.
But Mr. Stallard estimates that the increase will be more like 10 to 25 percent by 2050. “It will still be a significant challenge for the health system in the U.S.,” he said.
The Duke group relied on its own long-term study of people over age 65, with more than 21,000 respondents in 1984 and about 16,000 in 2004, plus later data from the national Health and Retirement Study and the National Health and Aging Trends Study.
Their analysis found that among 85- to 89-year-olds, for instance, the proportion with dementia was about 23 percent in the cohort born in 1905. In those born 10 years later, the figure had dropped to about 18 percent.
By the time Americans born in 1935 reached their late 80s, about 11 percent had dementia; the projection for those born from 1945 to 1949 is now about 8 percent.
To Dr. Coresh, whose primary interest was in individual risk, the assumption that past declines would continue at about the current rate “would be great, but is quite an optimistic, dramatic decrease,” he said in an email.
Yet in another longitudinal study of older adults in England and China, published in Nature Aging last year, “we also found these quite marked improvements in more recently born cohorts,” said the lead author, Dr. John Beard, a medical epidemiologist at the Mailman School of Public Health at Columbia University.
“You would expect the increase in the absolute numbers of people with dementia in the U.S. will be less than we feared,” Dr. Beard said.
What has led to the decrease in dementia, also seen in several European countries? Often cited explanations include rising education levels, reduced smoking and improved treatment for high blood pressure and high cholesterol.
The Lancet Commission on dementia, intervention and care has developed a list of 14 modifiable risk factors, including greater use of hearing aids and reduced air pollution, that could still lead to greater declines.
Yet the reverse could also happen. If earlier and more widespread testing increases the number of dementia diagnoses, or if the definition of dementia broadens, rates will increase, Dr. Doraiswamy noted. Increasing life expectancy would have the same effect.
Obesity and diabetes, more common in recent decades, could lead to more dementia, but much-touted new drugs that reduce them could blunt that trend — if people can get them.
“None of this is inevitable,” said Dr. Gill Livingston, a psychiatrist at University College London who leads the Lancet Commission. “It depends on what we do.”
Public health policy makes a major difference, she noted, and, “The U.S. is in a time where policy is changing enormously.”
Dementia rates might rise, for example, “if people have less access to health care, so they are less likely to get their blood pressure treated and their high cholesterol treated,” Dr. Livingston said.
Slashed Medicaid coverage could lead to that result. So could a rollback of environmental policies, “if air pollution increases because of fossil fuels,” she added.
Already, dementia afflicts some American populations far more than others, researchers point out. Older women and Black people face greater risk, along with those who carry the APOE4 gene associated with Alzheimer’s disease.
Health disparities could mean that “affluent people will see lower rates of dementia” because of the new diabetes and obesity drugs, Dr. Doraiswamy said. “People who can’t afford them and whose conditions are not well-managed will see rates go up.”
The debate about how many older adults will develop dementia in coming decades, and about how individuals, families, government and the health care system should respond, will likely continue.
So will Ms. Presky’s fears.
For now, she enrolls in lifelong learning classes, takes walks and yoga classes despite orthopedic problems, listens to podcasts and reads a lot of history and fiction. She and her husband take in theater in New York and Phish concerts on the West Coast and will soon be heading to London and Paris.
Still, her advance directive contains many provisions about dementia. “I remain pessimistic,” she said, noting that her mother was diagnosed at 77. “I have seven more years before I meet her fate.”
Science
Owners of fire-destroyed Palisades mobile home park seek to displace residents for development deal
For months, former residents of the Pacific Palisades Bowl Mobile Estates have feared the uncommunicative owners of the property would seek to displace them in favor of a more lucrative development deal after the Palisades fire destroyed the rent-controlled, roughly 170-unit mobile home park.
A confidential memorandum listing the Bowl for sale indicates the owners intend to do exactly that.
The memorandum, quietly posted on a website associated with the global commercial real estate company CBRE, says that the Palisades fire created a “blank canvas for redevelopment” at a site “ideally positioned for a transformative residential or mixed-use project.”
“I just thought, oh my god, this is so much propaganda and false advertising,” said Lisa Ross, a 33-year resident of the Bowl and a Realtor. “How can they even get away with printing this?”
Neither the current owners of the Bowl nor the real estate companies listed on the memorandum responded to requests for comment.
The memorandum describes the current single-family residential zoning as “favorable” for developers; however, the city and mobile housing law experts have painted a different picture.
Fire debris at Pacific Palisades Bowl in January 2026.
(Myung J. Chun / Los Angeles Times)
“Multifamily and mixed-use development on this site is not allowed by existing zoning and land use regulations,” Mayor Karen Bass’s office said in a statement Wednesday, adding only low density single-family housing or reconstructing the mobile home park are currently allowed. “Mayor Bass will continue taking action and [work] with residents to restore the Palisades community.”
City Councilmember Traci Park also reiterated her focus on getting the mobile home park rebuilt and allowing residents to return, with a spokesperson noting she is not entertaining the potential for any rezoning efforts from a developer.
Zoning changes typically require a city council vote and are subject to the mayor’s approval or veto.
Beyond the zoning laws, the site is also currently governed by a state law requiring cities to preserve affordable housing along the coast and a city ordinance protecting mobile home residents against sudden displacement.
Spencer Pratt, a resident of the Palisades and an outspoken supporter of the neighborhood’s mobile home community, criticized the mayor and the owners in a statement to The Times. “It’s unfortunate that Karen Bass has not advocated for mobile home residents impacted by the fire,” he said, “and that the current owner of the Bowl is ignoring good faith offers from residents to buy the property.”
The mayor’s office disputed this, noting Bass recently led a delegation of Palisadians, including mobile home owners, to Sacramento to advocate for recovery. “Mayor Bass’ priority is getting every Palisadian home — single-family homeowners, town home owners, renters, mobile home owners.”
Los Angeles Mayor Karen Bass speaks during a private ceremony outside City Hall with faith leaders, LAPD officers and city officials to commemorate the one-year anniversary of the Eaton and Palisades fires on Jan. 7, 2026.
(Allen J. Schaben / Los Angeles Times)
Bass also advocated for the federal government to include the Bowl in its debris cleanup efforts; however, the Federal Emergency Management Agency ultimately refused to include it, unlike other mobile home parks impacted by the Palisades fire. Its reasoning: It could not trust the owners to rebuild the park as affordable housing.
Court rulings over the years found the owners routinely failed to maintain the infrastructure and worked to replace the park with an “upscale resort community.” Residents also accused the owners of attempting to circumvent rent control regulations.
After the fire, it ultimately took more than 13 months to begin cleaning up the debris.
Ross said she approached the owners with independent mobile home park developers who were interested in buying the fire-destroyed lot and letting residents rebuild within months. She also approached the owners with a proposition that the former residents band together to buy the park. She heard nothing back.
“They don’t communicate,” Ross said. “It’s a feuding family. That’s also why we had so many problems with maintenance and with upgrades in the park.”
Pratt, who is running for mayor against Bass, also called on private developers like Rick Caruso to step in and save the Bowl. (Caruso’s team noted his rebuilding nonprofit is looking into how to help residents of the Bowl.)
Ross is a fan of Pratt’s proposition. “We need those kinds of people — we need Rick Caruso. That would be great,” Ross said. To sweeten the deal: “I’ll cook for him. I would make him all his favorite dishes.”
Science
A virus without a vaccine or treatment is hitting California. What you need to know
A respiratory virus that doesn’t have a vaccine or a specific treatment regimen is spreading in some parts of California — but there’s no need to sound the alarm just yet, public health officials say.
A majority of Northern California communities have seen high concentrations of human metapneumovirus, or HMPV, detected in their wastewater, according to data from the WastewaterScan Dashboard, a public database that monitors sewage to track the presence of infectious diseases.
A Los Angeles Times data analysis found the communities of Merced in the San Joaquin Valley, and Novato and Sunnyvale in the San Francisco Bay Area have seen increases in HMPV levels in their wastewater between mid-December and the end of February.
HMPV has also been detected in L.A. County, though at levels considered low to moderate at this point, data show.
While HMPV may not necessarily ring a bell, it isn’t a new virus. Its typical pattern of seasonal spread was upended by the COVID-19 pandemic, and its resurgence could signal a return to a more typical pre-coronavirus respiratory disease landscape.
Here’s what you need to know.
What is HMPV?
HMPV was first detected in 2001, according to the U.S. Centers for Disease Control and Prevention. It’s transmitted by close contact with someone who is infected or by touching a contaminated surface, said Dr. Neha Nanda, chief of infectious diseases and hospital epidemiologist for Keck Medicine of USC.
Like other respiratory illnesses, such as influenza, HMPV spreads and is more durable in colder temperatures, infectious-disease experts say.
Human metapneumovirus cases commonly start showing up in January before peaking in March or April and then tailing off in June, said Dr. Jessica August, chief of infectious diseases at Kaiser Permanente Santa Rosa.
However, as was the case with many respiratory viruses, COVID disrupted that seasonal trend.
Why are we talking about HMPV now?
Before the pandemic hit in 2020, Americans were regularly exposed to seasonal viruses like HMPV and developed a degree of natural immunity, August said.
That protection waned during the pandemic, as people stayed home or kept their distance from others. So when people resumed normal activities, they were more vulnerable to the virus. Unlike other viruses, there isn’t a vaccine for human metapneumovirus.
“That’s why after the pandemic we saw record-breaking childhood viral illnesses because we lacked the usual immunity that we had, just from lack of exposure,” August said. “All of that also led to longer viral seasons, more severe illness. But all of these things have settled down in many respects.”
In 2024, the national test positivity for HMPV peaked at 11.7% at the end of March, according to the National Respiratory and Enteric Virus Surveillance System. The following year’s peak was 7.15% in late April.
So far this year, the highest test positivity rate documented was 6.1%, reported on Feb. 21 — the most recent date for which complete data are available.
While the seasonal spread of viruses like HMPV is nothing new, people became more aware of infectious diseases and how to prevent them during the pandemic, and they’ve remained part of the public consciousness in the years since, August and Nanda said.
What are the symptoms of HMPV?
Most people won’t go to the doctor if they have HMPV because it typically causes mild, cold-like symptoms that include cough, fever, nasal congestion and sore throat.
HMPV infection can progress to:
- An asthma attack and reactive airway disease (wheezing and difficulty breathing)
- Middle ear infections behind the ear drum
- Croup, also known as “barking” cough — an infection of the vocal cords, windpipe and sometimes the larger airways in the lungs
- Bronchitis
- Fever
Anyone can contract human metapneumovirus, but those who are immunocompromised or have other underlying medical conditions are at particular risk of developing severe disease — including pneumonia. Young children and older adults are also considered higher-risk groups, Nanda said.
What is the treatment for HMPV?
There is no specified treatment protocol or antiviral medication for HMPV. However, it’s common for an infection to clear up on its own and treatment is mostly geared toward soothing symptoms, according to the American Lung Assn.
A doctor will likely send you home and tell you to rest and drink plenty of fluids, Nanda said.
If symptoms worsen, experts say you should contact your healthcare provider.
How to avoid contracting HMPV
Infectious-disease experts said the best way to avoid contracting HMPV is similar to preventing other respiratory illnesses.
The American Lung Assn.’s recommendations include:
- Wash your hands often with soap and water. If that’s not available, clean your hands with an alcohol-based hand sanitizer.
- Clean frequently touched surfaces.
- Crack open a window to improve air flow in crowded spaces.
- Avoid being around sick people if you can.
- Avoid touching your eyes, nose and mouth.
Assistant data and graphics editor Vanessa Martínez contributed to this report.
Science
After rash of overdose deaths, L.A. banned sales of kratom. Some say they lost lifeline for pain and opioid withdrawal
Nearly four months ago, Los Angeles County banned the sale of kratom, as well as 7-OH, the synthetic version of the alkaloid that is its active ingredient. The idea was to put an end to what at the time seemed like a rash of overdose deaths related to the drug.
It’s too soon to tell whether kratom-related deaths have dissipated as a result — or, really, whether there was ever actually an epidemic to begin with. But many L.A. residents had become reliant on kratom as something of a panacea for debilitating pain and opioid withdrawal symptoms, and the new rules have made it harder for them to find what they say has been a lifesaving drug.
Robert Wallace started using kratom a few years ago for his knees. For decades he had been in pain, which he says stems from his days as a physical education teacher for the Glendale Unified School District between 1989 and 1998, when he and his students primarily exercised on asphalt.
In 2004, he had arthroscopic surgery on his right knee, followed by varicose vein surgery on both legs. Over the next couple of decades, he saw pain-management specialists regularly. But the primary outcome was a growing dependence on opioid-based painkillers. “I found myself seeking doctors who would prescribe it,” he said.
He leaned on opioids when he could get them and alcohol when he couldn’t, resulting in a strain on his marriage.
When Wallace was scheduled for his first knee replacement in 2021 (he had his other knee replaced a few years later), his brother recommended he take kratom for the post-surgery pain.
It seemed to work: Wallace said he takes a quarter of a teaspoon of powdered kratom twice a day, and it lets him take charge of managing his pain without prescription painkillers and eases harsh opiate-withdrawal symptoms.
He’s one of many Angelenos frustrated by recent efforts by the county health department to limit access to the drug. “Kratom has impacted my life in only positive ways,” Wallace told The Times.
For now, Wallace is still able to get his kratom powder, called Red Bali, by ordering from a company in Florida.
However, advocates say that the county crackdown on kratom could significantly affect the ability of many Angelenos to access what they say is an affordable, safer alternative to prescription painkillers.
Kratom comes from the leaves of a tree native to Southeast Asia called Mitragyna speciosa. It has been used for hundreds of years to treat chronic pain, coughing and diarrhea as well as to boost energy — in low doses, kratom appears to act as a stimulant, though in higher doses, it can have effects more like opioids.
Though advocates note that kratom has been used in the U.S. for more than 50 years for all sorts of health applications, there is limited research that suggests kratom could have therapeutic value, and there is no scientific consensus.
Then there’s 7-OH, or 7-Hydroxymitragynine, a synthetic alkaloid derived from kratom that has similar effects and has been on the U.S. market for only about three years. However, because of its ability to bind to opioid receptors in the body, it has a higher potential for abuse than kratom.
Public health officials and advocates are divided on kratom. Some say it should be heavily regulated — and 7-OH banned altogether — while others say both should be accessible, as long as there are age limitations and proper labeling, such as with alcohol or cannabis.
In the U.S., kratom and 7-OH can be found in all sorts of forms, including powder, capsules and liquids — though it depends on exactly where you are in the country. Though the Food and Drug Administration has recommended that 7-OH be included as a Schedule 1 controlled substance under the Controlled Substances Act, that hasn’t been made official. And the plant itself remains unscheduled on the federal level.
That has left states, counties and cities to decide how to regulate the substances.
California failed to approve an Assembly bill in 2024 that would have required kratom products to be registered with the state, have labeling and warnings, and be prohibited from being sold to anyone younger than 21.
It would also have banned products containing synthetic versions of kratom alkaloids. The state Legislature is now considering another bill that basically does the same without banning 7-OH — while also limiting the amount of synthetic alkaloids in kratom and 7-OH products sold in the state.
“Until kratom and its pharmacologically active key ingredients mitragynine and 7-OH are approved for use, they will remain classified as adulterants in drugs, dietary supplements and foods,” a California Department of Public Health spokesperson previously told The Times.
On Tuesday, California Gov. Gavin Newsom announced that the state’s efforts to crack down on kratom products has resulted in the removal of more than 3,300 kratom and 7-OH products from retail stores. According to a news release from the governor’s office, there has been a 95% compliance rate from businesses in removing the products.
(Los Angeles Times photo illustration; source photos by Getty Images)
Newsom has equated these actions to the state’s efforts in 2024 to quash the sale of hemp products containing cannabinoids such as THC. Under emergency state regulations two years ago, California banned these specific hemp products and agents with the state Department of Alcoholic Beverage Control seized thousands of products statewide.
Since the beginning of 2026, there have been no reported violations of the ban on sales of such products.
“We’ve shown with illegal hemp products that when the state sets clear expectations and partners with businesses, compliance follows,” Newsom said in a statement. “This effort builds on that model — education first, enforcement where necessary — to protect Californians.”
Despite the state’s actions, the Los Angeles County Board of Supervisors is still considering whether to regulate kratom, or ban it altogether.
The county Public Health Department’s decision to ban the sale of kratom didn’t come out of nowhere. As Maral Farsi, deputy director of the California Department of Public Health, noted during a Feb. 18 state Senate hearing, the agency “identified 362 kratom-related overdose deaths in California between 2019 and 2023, with a steady increase from 38 in 2019 up to 92 in 2023.”
However, some experts say those numbers aren’t as clear-cut as they seem.
For example, a Los Angeles Times investigation found that in a number of recent L.A. County deaths that were initially thought to be caused by kratom or 7-OH, there wasn’t enough evidence to say those drugs alone caused the deaths; it might be the case that the danger is in mixing them with other substances.
Meanwhile, the actual application of this new policy seems to be piecemeal at best.
The county Public Health Department told The Times it conducted 2,696 kratom-related inspections between Nov. 10 and Jan. 27, and found 352 locations selling kratom products. The health department said the majority stopped selling kratom after those inspections; there were nine locations that ignored the warnings, and in those cases, inspectors impounded their kratom products.
But the reality is that people who need kratom will buy it on the black market, drive far enough so they get to where it’s sold legally or, like Wallace, order it online from a different state.
For now, retailers who sell kratom products are simply carrying on until they’re investigated by county health inspectors.
Ari Agalopol, a decorated pianist and piano teacher, saw her performances and classes abruptly come to a halt in 2012 after a car accident resulted in severe spinal and knee injuries.
“I tried my best to do traditional acupuncture, physical therapy and hydrocortisone shots in my spine and everything,” she said. “Finally, after nothing was working, I relegated myself to being a pain-management patient.”
She was prescribed oxycodone, and while on the medication, battled depression, anhedonia and suicidal ideation. She felt as though she were in a fog when taking oxycodone, and when it ran out, ”the pain would rear its ugly head.” Agalopol struggled to get out of bed daily and could manage teaching only five students a week.
Then, looking for alternatives to opioids, she found a Reddit thread in which people were talking up the benefits of kratom.
“I was kind of hesitant at first because there’re so many horror stories about 7-OH, but then I researched and I realized that the natural plant is not the same as 7-OH,” she said.
She went to a local shop, Authentic Kratom in Woodland Hills, and spoke to a sales associate who helped her decide which of the 47 strains of kratom it sold would best suit her needs.
Agalopol currently takes a 75-milligram dose of mitragynine, the primary alkaloid in kratom, when necessary. It has enabled her to get back to where she was before her injury: teaching 40 students a week and performing every weekend.
Agalopol believes the county hasn’t done its homework on kratom. “They’re just taking these actions because of public pressure, and public pressure is happening because of ignorance,” she said.
During the course of reporting this story, Authentic Kratom has shut down its three locations; it’s unclear if the closures are temporary. The owner of the business declined to comment on the matter.
When she heard the news of the recent closures, Agalopol was seething. She told The Times she has enough capsules of kratom for now, but when she runs out, her option will have to be Tylenol and ibuprofen, “which will slowly kill my liver.”
“Prohibition is not a public health strategy,” said Jackie Subeck, executive director of 7-Hope Alliance, a nonprofit that promotes safe and responsible access to 7-OH for consumers, at the Feb. 18 Senate hearing. “[It’s] only going to make things worse, likely resulting in an entirely new health crisis for Californians.”
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