Barron's : The Coming Alzheimer’s Crisis—and What to Do About It

The Coming Alzheimer’s Crisis—and What to Do About It

When Covid-19 hit, Rosanne Corcoran went into lockdown mode, creating a cocoon around her family and dismissing the part-time paid caregiver who had helped her care for her mother, Rose, who has Alzheimer’s. But for months, Rose has stayed up all night, leaving the 53-year-old Rosanne so sleep-deprived that her cardiologist recently counseled her to look past her fears about the virus and bring in help.

Rose was first diagnosed with mild cognitive impairment a decade ago. When, in 2015, doctors said she could no longer live independently, Corcoran put her Realtor license in escrow and brought Rose to live with her family outside of Philadelphia. The mother of two young adults snuck in a couple hours of normalcy to run errands, go to the chiropractor, or take a walk, with the help of a regular paid caregiver—until Covid-19 hit. Doing without the additional help has taken its toll. “My mother has declined, and I’ve declined. It’s an awful choice to have to make, but I’m going to, because I want to survive this,” says Corcoran, who just rehired a caregiver for weekend help, despite the pandemic.

Families grappling with Alzheimer’s often face awful choices, but it has been taken to new heights over the past year. Roughly a third of the 450,000 Covid deaths in the U.S. have been at long-term care facilities like nursing homes, where about half of the residents are living with Alzheimer’s or some other form of dementia. Even those who have been safe from the virus have suffered; 70% of caregivers surveyed by UsAgainstAlzheimer’s this past fall reported a decline in their loved ones’ memory or behaviors. Residents in long-term care facilities have been isolated from relatives and friends who supplement their care, provide extra eyes that spot changes in health conditions, and tap into reservoirs of memories to keep them engaged, while unpaid caregivers like Rosanne have been cut off from support services.

The pandemic has cast a harsh light on the inadequacies of the U.S. caregiving system and the enormous emotional and economic burden on families—and ultimately the economy—bringing the fight against Alzheimer’s to an inflection point. It comes as the oldest baby boomers enter the age range where Alzheimer’s is often diagnosed, and against a backdrop where science could be on the cusp of sorely needed victories—including the possibility of the first new drug approval in 18 years, and progress in biomarkers to enable earlier detection.

Alzheimer’s is a progressive brain disease that is the most common cause of dementia. Of the top 10 causes of death globally, it’s the only one that can’t be cured, slowed down, or prevented, at least not yet. The disease manifests in different ways, with some patients living 20 years after diagnosis, though it’s often closer to four to eight years. Although 80% of those with the disease are 75 or over, Alzheimer’s typically emerges in midlife, 20 to 30 years before symptoms like memory loss or troubles with language appear.

With the world in the midst of an aging boom, the number of people living with Alzheimer’s or some form of dementia is expected to triple by 2050 to 152 million—a bit more than the population of Russia today. That is bringing recognition to the scale of the problem, with nonprofits, academics, businesses, and governments in January creating a global initiative, Davos Alzheimer’s Collaborative, aimed at speeding up the global response to the disease, in part by using the road map offered by the discovery of Covid-19 vaccines.

“Alzheimer’s is a disease of greater prevalence and greater lethality than Covid-19,” says George Vradenburg, who co-founded the advocacy and research group UsAgainstAlzheimer’s. “This is an ongoing pandemic. Its cost to America in terms of direct medical costs is significantly higher than cancer.”

Cost estimates vary, but a 2020 paper in American Journal of Managed Care put the total health-care cost of the disease at $305 billion—and projected it would hit $1 trillion by 2050. With few treatments available, most of the direct costs come from skilled nursing care, paid home health care, and hospice.

While some of this is covered by Medicaid for low-income Americans, most of it is not covered by Medicare, leaving families to foot the bill. The total lifetime cost of care for someone with dementia is estimated at $357,000 in 2019 dollars, according to the Alzheimer’s Association. The bulk of those costs are borne by family caregivers, often in the form of unpaid caregiving—not to mention the psychological and emotional toll.

For Stephanie Monroe, the uncertainty, confusion, and fear around her parents’ care during the past year have been the worst experiences of her life. Monroe, who retired from the federal government and now works on equity and access-related issues at UsAgainstAlzheimer’s, has agonized over whether to find alternative housing for her parents. The Baltimore-area long-term care facility they live in had spotty communications about Covid-19 outbreaks and protocols, and there were signs that her father, who has Alzheimer’s, was deteriorating as social activities like choir and mah-jongg were suspended. A move, though, would separate her parents from her aunt who lives in the community, as well as nearby church friends. “There’s no good decision,” Monroe says. “It’s all about weighing the consequences, costs, and benefits—and feeling guilty about any decision you make.”

The costs can ripple through generations, and not just due to lost wages or time out of the workforce for caregivers. Studies show that spousal caregivers who report strain face a 63% higher mortality risk in four years than noncaregivers who are the same age. Smaller studies also found that some caregivers have compromised immune systems and increased need for medications, and have seen their own health-care costs increase in the aggregate by an estimated $9.7 billion. “The financial costs are underestimated. The emotional, psychological, and even physical costs are underestimated,” says Amy Florian, CEO of Corgenius, which helps financial advisors navigate these issues with their clients. “It affects people in every respect.”

Alzheimer’s was recognized as the most common cause of dementia in 1976. In the 45 years since, progress in fighting the disease has been glacial, in part due to misperceptions about the disease that delayed funding and scientific research and created an inadequate care system in its early days.

“As a nation, we struggled to see the disease as a disease,” says Dr. Jason Karlawish, co-director of the Penn Memory Center. For decades, culturally, Alzheimer’s symptoms—memory loss, confusion, or forgetting to pay bills—were brushed aside as just the natural course of aging, and problems that could be handled by family, almost always wives and daughters, Karlawish says.

With limited funding in the first 20 years, research was restricted primarily to how a brain with Alzheimer’s changed, rather than to the multifaceted pathways that contribute to the disease, the factors that influence a person’s risk, and devising cutting-edge clinical trials. Research talent was lost to diseases attracting more investment, says Dr. Maria Carrillo, chief science officer at the Alzheimer’s Association. Even today, much of what is currently available is short-term palliative therapies that don’t address the underlying biology of the disease.

The complexity of the brain adds to the challenge. Because there isn’t yet a solid understanding of why memory changes, the clinical trials for Alzheimer’s take longer, often 18 to 24 months, because researchers need to see if the drugs move memory, rather than just look at underlying changes in the biology. Early trials were open to those who had a clinical Alzheimer’s diagnosis. But now, trials include people with biomarkers like the amyloid plaques and tau tangles (both are forms of problematic protein deposits in the brain) that are now seen as hallmarks of Alzheimer’s disease, and have been the target of many of the drugs in trial.

The past decade has brought change, partly due to the advocacy of organizations like the Alzheimer’s Association and UsAgainstAlzheimer’s. Funding for Alzheimer’s and dementia research at the National Institutes of Health has increased to roughly $3 billion, about half of what is spent on cancer, but far higher than the $448 million allocated in 2011.

Drug development is also looking more promising; there are now more than 100 ongoing trials. More recent clinical trials for Biogen’s much-anticipated aducanumab and Eli Lilly’s antibody donanemab incorporated biomarker tests that earlier trials lacked. The near-term attention is on Biogen’s monoclonal antibody aducanumab, which is awaiting a decision from the U.S. Food and Drug Administration, expected by June. It has been a bumpy road for the treatment, with an advisory panel of the FDA questioning the merits of aducanumab last fall.

If approved, even with conditions, experts on aging say it will serve as a signal and bring in a rush of investment. A lack of approval could have the opposite impact in the near term, but researchers note several other treatments on the horizon, including drugs from Roche’s Genentech and Japan’s Eisai. Even more encouraging is the diversification of treatments deeper in the pipelines that go beyond amyloid and tau tangles—important because scientists think Alzheimer’s will ultimately be treated much like heart disease, with a mix of therapies and interventions, or possibly a combination therapy.

There has also been progress around biomarkers and blood tests that could help with early detection—crucial since the disease can emerge decades before symptoms. “Ten years ago, we would have said it’s science fiction: There’s no way we can measure tiny proteins in the brain in blood,” Carrillo says. But C2N Diagnostics introduced a test last fall that has been tested on a small group, and Lilly and Roche Holdings also have tests, with trials possibly completed by summer and more information about whether they can be mass produced also forthcoming. “That would be game-changing,” Carrillo says.

With recent research suggesting that about 40% of dementia is modifiable, scientists are also testing how interventions around cognitive engagement, diet, sleep, and exercise could affect risk factors for Alzheimer’s. That’s another reason there’s a push for doctors to make cognition tests part of their standard protocol: Currently, less than half of primary-care physicians in a survey by the Alzheimer’s Association said it’s part of their standard practice. Technology could also facilitate earlier detection, with researchers looking to smartphones and artificial intelligence to pick up on subtle changes in keystrokes, typing speed, or writing patterns that could be early flags.

These scientific development are reason for hope, but even biotech executives say that a cure is a ways away. As a result, care will continue to be at the center of Alzheimer’s treatment, and fixing the U.S. caregiving system needs to be a top priority.

Unlike cancer or heart disease, much of the cost related to Alzheimer’s disease comes from caregiving. Medicare doesn’t cover most long-term care. Medicaid covers more, but requires near-impoverishment to qualify. The average annual Medicaid payment for those 65 and older with Alzheimer’s is 23 times as high as for those without Alzheimer’s—an annual average of $8,779 versus $374.

Caregiving typically is associated with helping older adults with feeding, bathing, grooming, or using a toilet, but those needs typically come in the last third of the disease. The first two-thirds are largely focused on helping Alzheimer’s patients with daily life, including monitoring medicines and finances, transportation, and keeping them engaged and safe.

An army of family and friends—often women in their prime earning years—shoulder roughly two-thirds of the care for those with Alzheimer’s. Many interrupt their careers, give up promotions, cut back on hours, or quit jobs. The average caregiver spends about five years on care for a dementia patient. That indirect cost can total roughly $500,000 per person, based on models that account for lost wages, promotions, and benefits, as well as the obstacles most people face when trying to re-enter the workforce in their 50s or 60s, says Norma Coe, associate professor of medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania.

The indirect costs are likely to be higher in the future, as a larger share of the next cohort of caregivers are primary breadwinners or single. The hit to their Social Security, for example, may be even greater than for some in the current cohort who may be able to claim spousal benefits on their higher-earning partner’s record, says Coe. Rising female labor-force participation played a big role in the last economic recovery, especially as male labor participation has fallen. The absence of these women could further hamper economic growth.

Plus, fear of future long-term care needs for parents also weigh on their children’s calculations about moving away and job choices, according to Coe. If parents have long-term care insurance to help cover such needs, adult children are more likely to move away and potentially take different jobs—suggesting that caregiving fears could also be restraining the type of mobility and productivity needed for a dynamic economy.

The financial costs can cascade through multiple generations as caregivers compromise their own finances and retirement security. At the local level, Medicaid budgets are crowding out investments in youth education. “We are seeing right before our eyes the intergenerational impact,” Vradenburg says. Millennials make up a sixth of those caring for people with Alzheimer’s.

The sheer number of baby boomers could outstrip available caregivers—including informal ones, since family sizes have been shrinking. With fewer daughters and sons able to care for aging parents, demand for long-term care facilities like memory care and assisted living will increase. Both are largely paid for out of pocket, raising questions of how families will digest those costs. The annual median cost of assisted living is about $51,600, according to Genworth’s Cost of Care survey. The median cost of assisted living facilities with memory care is even higher, at roughly $57,000 a year.

With costs rising, demand for home and community-based services that can keep people independent longer and out of nursing homes will only intensify. Yet many of these services—such as adult day care—have been especially hard hit during the pandemic, with many forced to shutter because of lockdowns. Many of those that stayed open, meanwhile, have suffered a severe financial hit, says Kirsten Jacobs, director of Dementia and Wellness Education for LeadingAge, an association of nonprofit providers of aging services.

At some point, in the later phases of dementia, when people may get more agitated or their safety may be compromised, many Alzheimer’s patients will need round-the-clock care in a facility. Here, Florian worries about Covid’s lasting impact: “I fear that stigma is going to increase and persist after Covid because of what happened during the pandemic with people in facilities.”

Long-term care facilities could also come out financially scarred: Two-thirds of nursing-home providers in a recent survey from the American Health Care Association and National Center for Assisted Living said they won’t make it another year, given Covid-related costs. The pandemic has also thrown into question the business model of nursing homes relying on the short-term rehab stays that Medicare covers for those just out of the hospital to subsidize the long-term care these facilities provide for those on Medicaid, as fewer people have elected to get surgeries and the rehab business has dried up during the pandemic.

“This is our opportunity to really be thinking about how and where we can care for people at the lowest cost and get the best outcomes—lowering Medicare and Medicaid costs but also the cost to the family,” says Coe.

That will require investing in long-term care infrastructure. Near the top of the list is focusing on supportive services that ultimately can save money by keeping people at home longer, says Nora Super, senior director of the Milken Institute Center for the Future of Aging.

President Joe Biden’s agenda includes money for increased access to home and community-based services, funding for states to innovate more-creative and cost-effective ways of providing care, as well as tax credits for informal caregivers and increased tax benefits to buy long-term care insurance with retirement savings. Experts on aging want to see more investment in resources such as adult day facilities, training nurse practitioners to become dementia-care specialists, and creating dedicated teams that can help families navigate the web of specialists, clinical trials, and services.

Technology will also play a big role, and not just with telemedicine. Technology can provide a range of monitoring that allows for independence but alerts caregivers when needed. Sensors in rooms could mitigate physical danger, while software that can help monitor bill-paying or bank accounts could help, since impaired money-management skills are among the first visible symptoms.

Also high on the priority list: rethinking the value of caregivers. Many paid caregivers at long-term care facilities hold multiple jobs and have long commutes to work—both of which have made the entire system vulnerable during Covid. It has also contributed to incredibly high turnover and shortages in an overstretched industry. “The pandemic made it clear that how we pay caregivers isn’t adequate,” Super says. “We need to make sure we are paying them living wages and offering a career ladder to make this an industry they want to be part of. That’s going to take government intervention.”

Considering ways to compensate the army of informal caregivers that provide the bulk of care for Alzheimer’s patients also needs attention; proposals like paid eldercare leave and Social Security credits for caregiving could slow the intergenerational ripples created by the disease. Also on the table: ways to save for, and possibly insure against, the long-term care risk. For example, the bipartisan Homecare for Seniors Act introduced in the House in 2019 could be revived, potentially allowing home care to be considered a qualified expense that could be paid for by health savings accounts.

“There are models out there. It’s about the will to put them in place and recognize this is a big challenge that could really bankrupt our system,” says Super. “What gives me hope is that the pandemic has raised awareness of how the system is broken.”

WSJ : Tightening Oil Supplies Inject New Momentum Into Price Rally

Tightening Oil Supplies Inject New Momentum Into Price Rally
Signs of strength under the surface of the energy market suggest further gains for crude prices, some investors and analysts say

A booming rally in oil markets has pushed crude prices to their highest levels since near the start of the coronavirus pandemic, powered by production curbs and recovering demand.

Brent-crude futures, the benchmark in energy markets, have risen more than 50% since the end of October and are approaching $60 a barrel for the first time since Covid-19 began to erode oil demand in early 2020. Futures for West Texas Intermediate—or WTI, the main grade of U.S. crude—last week surpassed $55 a barrel for the first time in over a year.


The speed of the recovery has surprised some investors and analysts, given that coronavirus continues to curtail demand. It has juiced shares of companies including Exxon Mobil Corp. and ConocoPhillips after a troubled 2020 for oil-and-gas producers, making energy stocks the best performers on the S&P 500 this year.

“The market definitely has some momentum,” said John Kilduff, partner at Again Capital LLC, a hedge fund that invests in energy derivatives. “WTI is going to be targeting $60, too.”

Oil is rising against a mixed economic backdrop, with data published Friday suggesting that the labor market faces a long road to recovery. But the stock market continues to power higher, in part because investors expect a new dose of fiscal stimulus and vaccines to goose growth.

Behind oil’s rally: Huge stockpiles that accumulated in the early stages of the pandemic have winnowed down faster than many people expected. Traders say that could pave the way for further price gains if demand, which has already recovered in China and India, picks up in developed economies.

The fall in inventories is largely down to efforts by the Organization of the Petroleum Exporting Countries and its allies, led by Russia, to restrain production. Since agreeing to the cuts at the peak of the crisis in energy markets in April, producers have held back a cumulative 2.1 billion barrels of oil, OPEC said last week.

U.S. companies have also helped to prevent production from swamping demand. Global appetite for oil remains below pre-pandemic levels despite a pickup in consumption of gasoline, naphtha and fuel oil, which is used to heat homes and power ships.

American producers are pumping 17% less crude than they did on the eve of the pandemic, according to the Energy Information Administration.

All this has pulled the amount of crude oil and petroleum products stored around the world down by about 5% since its peak in 2020, according to Morgan Stanley analyst Martijn Rats.

There is no shortage of oil, but one sign the market is tightening stems from the relationship between current and future prices. Spot prices have climbed to a premium over prices for crude to be delivered down the line, showing that traders are willing to pay more for immediate access to oil.

On Friday, WTI contracts for oil that will be delivered next month cost $5.16 more per barrel than contracts for crude that will change hands in March 2022. That is the biggest premium for front-month futures since the start of the pandemic and contrasts with a historically large discount last April, when a glut of oil pushed WTI prices below zero.


“It is a bullish indicator,” said Scott Shelton, an energy analyst and broker at United ICAP. “I don’t think there’s any question about that.”

Analysts say this dynamic—known as backwardation—has been exaggerated by a slowdown in purchases of long-dated energy contracts by airlines and other companies that buy them to hedge fuel prices.

Still, some investors say the condition shows the rally has further to run. It gives traders an incentive to take oil out of storage, because they earn more from selling it straight away. That in turn would bolster prices by whittling down supplies. Lower forward prices also make it harder for producers to lock in profits for barrels they will sell in the future, encouraging them to keep oil in the ground.

Backwardation could encourage more money managers to bet on crude, said Mark Hume, co-manager of BlackRock’s BGF World Energy fund. When spot barrels of oil fetch a premium, funds earn a profit when futures approach expiration and they flip their position forward into cheaper later-dated contracts.

The chance to capture this extra return has drawn investor money into commodity markets in recent months, adding to existing bullishness about raw materials, according to Ruhani Aggarwal, an analyst at JPMorgan Chase & Co.

Still, some analysts think investors are overly optimistic, saying the oil market faces hurdles including the potential for an increase in Iranian exports. Plus, new coronavirus variants could lead to further restrictions on movement.

“Just when we’re ready to say we’re over with the virus, the virus isn’t over with us,” said Helima Croft, global head of commodity strategy at RBC Capital Markets.

FT : For how long can Europe keep businesses from going under?

For how long can Europe keep businesses from going under?
Small and medium-sized companies call for more help as coronavirus curbs hit revenues

In the centre of Florence, near the Uffizi gallery and Cathedral of Santa Maria in Fiore, Pasquale Naccari has serious doubts about whether the seafood and pizza restaurant his family has run for more than 50 years can survive much longer.

“We are in a desperate situation,” said Mr Naccari. “My bank account balance is almost zero for the first time in years and my business is on the verge of collapse; state funding is inadequate, badly distributed and delayed.”

The plight of the Il Vecchio e il Mare restaurant epitomises the existential crisis facing thousands of Europe’s small and medium-sized companies that have had much of their income wiped out by the coronavirus pandemic and the curbs to contain it. 

The eurozone economy fell into a double-dip contraction in the final quarter of last year, shrinking 0.7 per cent from the previous three months, data published this week showed, resulting in a record postwar contraction of 6.8 per cent over the whole of 2020.

However, there is almost no trace of this painful situation in the latest data on the number of businesses filing for insolvency in the eurozone, which fell sharply after the pandemic hit the region last March and stayed lower for the rest of the year.

Experimental data published by Eurostat this week showed a one-fifth drop in businesses filing for insolvency in the eurozone in the third quarter of 2020 from a year earlier. That followed a 41 per cent year-on-year drop in corporate insolvencies in the second quarter. 

The main reason is that governments have spent huge sums to shield their economies from the pandemic.


The bloc’s four biggest economies, Germany, France, Italy and Spain, committed to spend an extra $3.1tn — a third of their combined gross domestic product — including vast loan guarantees, subsidies for millions of people’s wages and bailing out scores of companies, according to the IMF. 

But Mr Naccari said government aid, including subsidised wages for furloughed employees, had often been delayed and was nowhere near enough to offset a 60 per cent drop in his restaurant’s revenues. 

“We cannot cover fixed costs such as electricity, water and gas,” he added. “Some people lack the cash flow to pay the rents of their houses and do their shopping. Those who survive today do so only to fail tomorrow.” 

In response, some Italian restaurant and café owners have started disobeying an order to close at 6pm. In Hungary, restaurant owners promised a similar show of civil disobedience during protests in Budapest last weekend.

Even in Germany, where the government has spent more on its pandemic response as a share of GDP than most European countries, there are signs that the second lockdown in force since late last year is taking its toll. 

An Instagram video posted by Bianka Bergler, who was forced to close her hairdressing salon in Dortmund in December, has gone viral with 2.2m views of her appeal for the government to speed up its payments.

“Every day I look at the account with fear,” she said, explaining that she was overdrawn and could not pay her five staff. “No bridging aid has yet arrived.” 


Her video touched a nerve: German business groups have been complaining for weeks about delays and difficulties in applying for state aid. Helge Braun, chief of staff for German chancellor Angela Merkel, this week called Ms Bergler’s video “startling and impressive” and promised to “ensure that the aid is paid out quickly”.

Berlin recently extended until April a waiver exempting over-indebted companies from having to file for insolvency. But German corporate bankruptcies still broke a long run of monthly declines by rising in both November and December. Several hotels have gone bust in recent months, including Sofitel Berlin, Nordport Plaza in Hamburg and a chain of 10 Holiday Inn Express and Crowne Plaza hotels.

Dehoga, the German hotel and restaurant association, estimates turnover in these sectors fell 47 per cent last year and a recent survey found a quarter of its members were considering giving up. “Many companies are still waiting for the November aid promised on October 28,” said Ingrid Hartges, general manager of Dehoga. “These companies have their backs to the wall.”

Part of the problem is that companies are hitting EU limits on state aid. Ministers from Denmark, Austria and the Czech Republic called in the FT last week for the EU to raise its €800,000 cap on direct grants and €3m ceiling for uncovered fixed cost compensation.

Euler Hermes, the trade credit insurer, estimates eurozone business insolvencies will rise 29 per cent this year after falling 17 per cent last year, with the biggest increase of 73 per cent expected in Italy.

“One in four companies in Europe will be cash constrained this year,” said Maxime Lemerle, head of sector and insolvency research at Euler Hermes. “These zombified companies in hospitality, retail, transport, leisure and events could go bust very quickly even if the support measures are wound down quite slowly.”

In France, a third fewer businesses filed for bankruptcy in the year to November than in the previous year — helped by a temporary waiver on companies being declared insolvent that expired in August, according to the Banque de France.

But the French government still worries that some companies may collapse and last week finance minister Bruno Le Maire said Paris may convert some of its €130bn of loan guarantees into grants.

While most European governments have extended support programmes to this year, some business leaders and officials worry about what will happen when the aid dries up. 

In Greece, banks have granted moratoria to suspend payments on a fifth of their performing loan books.

Yannis Stournaras, governor of the Greek central bank, said: “You never know what is going to happen when this assistance ends — either the moratoria of the private sector banks or the public sector support — and that is the key test. Much will depend on how much growth we have.”

>>> Barron’s Weekend Summary: The pandemic underscores the growing burden on fam

Barron’s Weekend Summary: The pandemic underscores the growing burden on families—and on the economy—of Alzheimer’s disease

* Cover story: “The pandemic has cast a harsh light on the inadequacies of the US caregiving system and the enormous emotional and economic burden on families—and ultimately the economy—bringing the fight against Alzheimer’s to an inflection point. It comes as the oldest baby boomers enter the age range where Alzheimer’s is often diagnosed, and against a backdrop where science could be on the cusp of sorely needed victories—including the possibility of the first new drug approval in 18 years, and progress in biomarkers to enable earlier detection.”

* Tech Trader: Positive on AMZN: Shares of the e-commerce giant have appreciated every year since 2014, increasing more than tenfold over that span, and the company has spent years pressing its advantage in e-commerce—but the announcement that Andy Jassy would take over as CEO shows the real value driver has been the emergence of Amazon Web Services, a division that is synonymous with cloud computing.

* Trader: The yield curve—as the difference between short- and long-term bonds is known—has been steepening rapidly, rising above one percentage point last week in the two-year/10-year curve, which in the short term is simply a reflection of stronger growth expectations and more inflation, though it could eventually become a problem.

* Interview: 1) Dr. Jason Karlawish, who works at the Penn Memory Center, primarily focusing his research and writing on the study of Alzheimer's, talks about where the US took wrong turns in its approach to Alzheimer’s, reasons for optimism, and the changes needed as the number of Americans living with Alzheimer’s is expected to more than double to 13.8M by 2050; 2) Savita Subramanian, strategist at BAC, says outperformance could last for years, as it did after the tech bubble burst, and that finding promising investments is even more important today, especially if the market itself delivers lackluster returns, as she expects it to do.

* Profile: George Smith and Chris Pearson of Davenport Small Cap Focus seek small companies with executives who act as “owner-operators”—those with large insider ownership who behave more like the devoted founder of a business than a hired-gun executive who might cash in stock options and move on (top 10 holdings: CNNE, MCRI, AQUA, STC, BLDR, LAMR, CFX, JJSF, NEU, SWCH).

* Features: 1) Cautious on Robinhood: The online trading app’s last traditional round of private fundraising valued the company at $11.7B, and analysts think it could go public for considerably more than the $13B that MS paid to buy E*Trade last year, but to achieve that valuation it will have to prove its revenue stream is secure and consistent; 2) Positive on ANGPY, IMPUY, SBSW: Platinum is generating more interest because of its role in the green economy and its relative scarcity, and bulls argue that platinum could head back toward its old high in the next five years because of supply constraints, resilient automotive demand, new uses such as hydrogen fuel cells, and investment interest; 3) Positive on HLT: Despite problems in the hotel sector because of the pandemic, Hilton runs a so-called asset-light portfolio and relies heavily on recurring, long-term franchise fee agreements, making it less tethered to luxury brands, overseas locations, and big cities than its rivals—and favorably positioned to ride out the storm; 4) With Alzheimer’s disease a growing problem in the US, financial advisors play a key role—they are often the first to spot the signs of dementia, because they’re less likely to be in denial about the symptoms, and trouble with finances is often one of the first problems; 5) Positive on CASY: The retail chain, which owns and operates more than 2,200 stores in 16 states, outperformed the S&P 500 for years before than pandemic, thanks to double-digit earnings and revenue growth and an expanding footprint—but though it underperformed the index last year, growth is likely to accelerate as lockdowns end; 6) Last year, more than two dozen actively managed stock funds returned more than 100 percent, versus the Russell 3000’s 19 percent gain, a remarkable feat because during the past decade, no fund returned more than 100 percent in a calendar year—though it’s not a sign that active management is back; 7) Regulatory actions on the horizon under the Biden administration are likely to give shareholders access to new data to aid their decision-making about companies, including mandatory disclosures of climate risks and board diversity—and rule changes could also give them a louder voice in corporate-governance discussions.

* European Trader: Cautious on Danone: A letter to the company from activist investor Bluebell Capital Partners reinforces the belief that chief Emmanuel Faber has been too focused on sustainable development to the detriment of shareholder value—and some investors may prefer consuming its products but not buying its stock.

* Emerging Markets: The military coup in Myanmar—seen as a growth story among frontier markets in Asia—is bad news in the near term for investors, as supply-chain interruptions threaten everything from luggage manufacturing to energy projects.

* Commodities: “Frenzied trading in silver recently lifted prices to an eight-year high. But fundamentals already pointed to a break out in the metal before the latest rally, some analysts say, and prices remain undervalued.”

* Streetwise: Though the notion of buying shares of office landlords now, when prices remain depressed and their dividend yields are strong, might seem to be a good idea, says UBS analyst Brent Dilts, it may be better to favor what is already working in REITs—in particular, warehouse owners, whose dividends aren’t strong but who are riding an e-commerce boom that should send rents up.

WWD : Maison Alaïa Picks Pieter Mulier as Creative Director

Maison Alaïa Picks Pieter Mulier as Creative Director
The Belgian designer, who worked closely with Raf Simons, is to present his first collection for spring 2022.

More than three years after the death of fashion legend Azzedine Alaïa, the house that bears his name has hired Pieter Mulier as creative director.

Best known for his work as Raf Simons’ right hand at Jil Sander, Dior and Calvin Klein, Mulier starts immediately and is to present his first Maison Alaïa collection for the spring-summer 2022 season.

The Belgian designer will be based in Paris, and picks up the mantle of a couturier almost universally praised for his exacting methods and dedication to hyper-feminine, figure-flattering silhouettes.

Disclosing the hire exclusively to WWD, Maison Alaïa chief executive officer Myriam Serrano said it was an emotional day.

“His appointment marks the opening of an important new chapter for our maison as we jointly seek to carry the foundational values and distinctive style of Alaïa into the future,” Serrano said.

“Pieter stands out with remarkable technical talent and devotion to the craft, a sharp eye for construction and a sense of timeless beauty that is deeply ingrained in the creative approach of our maison,” she continued, also lauding his “keen intellect, true generosity and unwavering humanity.”

The high-profile hire is the latest sign of creative renewal at Compagnie Financiere Richemont, parent of Alaïa and Chloé, which late last year named Gabriela Hearst its new creative director. Hearst is expected to show her first collection in early March during Paris Fashion Week. Last month during couture week in Paris, AZ Factory, a joint venture between Richemont and designer Alber Elbaz, unveiled its first designs and put them for sale online.

In a statement, Mulier said it is “an absolute dream” to join Maison Alaïa.

“Always ahead of his time and open to all arts and cultures, Azzedine Alaïa’s powerful vision has served as an inspiration, as he always sought to give the necessary time to innovative and enduring creation,” he said. “It is with this tremendous sense of admiration and responsibility that I will seek to carry forward his legacy of celebrating femininity and placing women at the heart of creation.

“I look forward to meeting the valued Alaïa clients and friends as well as the Alaïa Foundation, and to jointly shaping the future of this legendary maison,” he added.

After studying design and architecture at the Institut Supérieur d’Architecture ‘Saint-Luc’ de Bruxelles, Mulier started his fashion career working at the Raf Simons men’s label in Antwerp, and expanded his design sphere into women’s wear and accessories alongside Simons when the latter took the creative helm of Jil Sander.

A discreet presence on the fashion scene who posts artworks, groovy buildings and photos of his adorable, digging-crazy dog John John on his Instagram feed, Mulier came to prominence during his Dior days, stealing many scenes in “Dior and I,” a 2014 documentary by Frédéric Tcheng that charted Simons’ emotionally charged first two months as artistic director of the French couture house.

When Simons moved to New York to become chief creative officer of Calvin Klein, Mulier was named creative director and was responsible for executing Simons’ creative and design vision for men’s and women’s ready-to-wear, and the bridge and better apparel lines and accessories. Simons brought out Mulier for his runway bows. Mulier also managed all men’s and women’s design teams within the Calvin Klein brand, under Simons’ leadership.

That impressive and varied resume, plus his background in architecture, won Mulier the plum post at Alaïa, where collections start with 3D shapes rather than flat sketches.

It is understood that Mulier will be devoted exclusively to Maison Alaïa, and he should bring a gust of innovation and fashion newness to the house.

The selection of a new creative leader at Alaïa was a delicate operation, given the towering legacy of the late Tunisian couturier and the fierce loyalty of the staffers he left behind. He died in November 2017 at age 77.

An iconic couturier of the modern era, Alaïa was known for his refusal to bow to industry timetables and marketing pressures, preferring to work at his own pace. He gained international fame in the Eighties because of the success of his evening dresses, snug knits and sculpted leathers, and was nicknamed “The King of Cling” because his clothes fit like a second skin.

Since his passing, the house has reinterpreted designs from his vast archives, and made limited expansion moves, in tune with his rigorous, at-his-own-pace ethos.

Serrano, who quietly joined Alaïa in 2019 from Chloé, where she had been its director of communications and accessories, last year introduced a wardrobe of Alaïa’s most emblematic designs called The Editions in a gesture to devotees — and in a bid to recruit future ones. The initial 30 looks, spanning from 1981 to 2017, were shown alongside Alaïa’s spring 2021 collection and made their debut at retail last November.

A second batch was presented alongside the fall 2021 collection last month.

Since Alaïa was purchased by Richemont in 2007, the conglomerate invested in staffing, a three-story flagship in an 18th-century mansion in Paris that opened in 2013, and a location on New Bond Street in London that opened in 2018.

Serrano broached the topic of creative renewal in an interview with WWD last year, disclosing that the house has recruited new talents in accessories and knitwear. She also allowed that the house was mulling a second step that could involve recruiting an artistic director.

WSJ : How Big Tech Got Even Bigger

How Big Tech Got Even Bigger
Technology giants such as Alphabet, Amazon and Apple are more dominant than a year ago thanks to a greater reliance on their services during the pandemic. The forces propelling them to new heights are expected to outlast Covid-19

The tech industry’s titans were already huge before Covid-19, the subject of soaring valuations and snowballing antitrust investigations. The pandemic has only made them bigger. A lot bigger.

In almost every facet of life—the tools we use to work, study, and play; how we shop and interact; the way companies operate and market their products—people and businesses have become more reliant on technology over the past year. Even amid one of the most punishing economic downturns on record, spending surged on computers, videogames, online retail, cloud-computing services and digital advertising.

The result was dizzying growth for some of the largest corporations in history—and for their stock prices. At a time when companies such as airlines and bricks-and-mortar retailers struggled to survive, combined revenue for the five biggest U.S. tech companies— Apple Inc., AAPL -0.31% Microsoft Corp. , Amazon.com Inc., AMZN 0.63% Google-parent Alphabet Inc., and Facebook Inc. FB 0.60% —grew by a fifth, to $1.1 trillion. Their aggregate profit rose an even faster 24%. And their combined market capitalization soared by half over the past year to a staggering $8 trillion.


Their economic sway expanded in other ways, too, including employment: Amazon alone added 500,000 new workers in a single year, roughly equivalent to the entire population of Atlanta.

Lawmakers and regulators may yet find ways to rein them in, but the economic and societal forces propelling Big Tech to even higher heights seem likely to outlast Covid-19. Microsoft Chief Executive Satya Nadella has said that he expects spending on technology to double to 10% of gross domestic product from its current level of 5%. This month he said he now expects that to happen even faster.

Here is a closer look at the rise of the big five: