One of my earliest memories is my mom standing in her mom's kitchen, gently hugging her and reminding her that we'd already eaten.

I was about 5 at the time. We'd flown up from California, where we lived then, to visit my grandma in Idaho. She'd just made us a delicious breakfast and as soon as the dishes were washed and everything was put away, she started the process over, gathering pans and eggs and other items on the counter.

Later, my mom hoped out loud that she would never wind down the way her mother did, with severe dementia.

She did and my siblings and I had painful front row seats to the slow destruction of a really vibrant, brilliant woman. As the youngest child, I was the first to drop out of her memory as Alzheimer's stripped away the details of her life. It was like watching someone peel the layers from an onion. Her world got smaller until it didn't look much like a world at all.

Like her, I hope out loud that I will never wind down the way my mother did, with severe dementia.

And like her, I tell my children not to worry too much. It may already be too late for me, if that's my future, I say. But medical science will figure it out before you're at risk. Then I mentally cross my fingers, a dual gesture that could mean I'm fibbing or that I'm wishing. Or both.

Finally, there's some momentum. Scientists, doctors, policymakers and even politicians have signed onto a goal to have effective treatments for the dreaded disease by 2025. They're developing plans for efficient testing of multiple potential treatments, some probably not even conceived of yet.

The goal is ambitious. I have written about medicine for many years, so I've seen how both fast and slow things can move in terms of a single disease. I've also tracked whatever the current thinking is on what happens with Alzheimer's, much of it later discarded as research progresses. It's enough to make one skeptical.

But this time, I share the hopefulness of Dr. Francis Collins, director of the National Institutes of Health. This week, he noted "we are at an exceptional moment" in terms of discoveries related to Alzheimer's, learning more in the last few months than in recent years.

No one is 100 percent sure what causes the disease. They suspect beta-amyloid causes the plaque on the brain, somewhat like pouring maple syrup on circuitry, gumming things up. They're also exploring how tangles of the protein tau make things worse. It's likely there is genetic and environmental interplay.

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As important as what's happening is figuring out at what point it is possible to step in and change the future for people who would otherwise develop the disease. Is there a window of opportunity, as Dr. Reisa Sperling of Harvard Medical School suggested this week to the Associated Press?

And it will all be trickier still because until you get the disease, for most it is impossible to say if you will get the disease. That makes testing of possible preventive treatments harder. It's like trying to measure what didn't happen — perhaps in some cases to people it might not have happened to anyway.

What I know for sure is that this should not just be of interest to people like me who wonder if the disease lurks in our own futures. It is an especially costly disease, both in the dollar costs to governments and individuals and in terms of human capital. That should matter to everyone.

Deseret News staff writer Lois M. Collins may be reached by email at lois@desnews.com.

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