Misplacing your keys, forgetting someone’s name at a party, or coming home from the market without the most important item – these are just some more →
Nearly 80 million baby boomers are starting to reach the age when they begin noticing and joking about memory challenges. For those with a family history of Alzheimer’s disease, their middle-aged pauses are no joke but a cause for concern that they too may succumb to this disease that afflicts 5.4 million Americans, 480,000 Californians, and 150,000 Angelinos. This illness robs people of their minds as tiny protein fibers — amyloid plaques and tau tangles — accumulate in brain areas controlling memory, language, judgment, thinking and behavior, and eventually leading to dementia.
We can’t afford to ignore this disease — the Alzheimer’s Association reported the staggering estimate that Americans are paying $200 billion a year for the care of these patients, whose Medicare payments are nearly three times those of older adults without dementia. By definition, patients with Alzheimer’s dementia can’t care for themselves, yet one out of every seven of them lives alone. If current trends continue, the costs of Alzheimer’s disease in 2050 are estimated to total $1.1 trillion, and the costs to Medicare and Medicaid will increase nearly 500 percent.
Today’s increased life expectancy accounts for the current Alzheimer’s epidemic and its financial burden, since age is the single greatest risk factor for developing the disease. People who were born in 1900 would have been lucky to have survived to age 50; those born today have a good chance of reaching age 80. So we’re living longer but not necessarily better — every 68 seconds, another American is diagnosed with Alzheimer’s disease.
Alzheimer’s advocates got some good news from Washington earlier this year when President Obama responded to the crisis by signing the National Alzheimer’s Project Act (NAPA) to accelerate research, education and caregiving efforts. Congress unanimously approved this bipartisan project, and a panel of experts has already begun to develop the plan’s details to help fight the disease more effectively, but the details will not be implemented without continued congressional support. For fiscal year 2013, the president proposes an additional $100 million for Alzheimer’s research, care, and support, which depends on congressional appropriation. Most of the funds — 80 percent — are targeted for much needed research. Currently, only about $500 million goes to Alzheimer’s disease research, compared with the $5.5 billion the National Institutes of Health (NIH) spend on cancer and the $4 billion spent on heart disease each year.
I have spent 30 years caring for patients and families suffering from the disease. As a faculty member at UCLA’s Semel Institute for Neuroscience and Human Behavior and through support from the Alzheimer’s Association and the NIH, I have studied new ways to evaluate and treat the illness. Despite modest funding, our group, along with many other physicians and scientists, has made progress over the years. Doctors can now diagnose the disease earlier and differentiate it from other causes of mental impairment, such as drug toxicity, depression or medical illness, as well as common memory slips people begin experiencing as early as age 45. There are drugs that temporarily improve cognitive and behavioral symptoms of dementia, but no cure yet exists. Early detection methods allow for testing of novel treatments, even when symptoms are mild.
The goal of many studies, including my own, is to develop brain scans and other biomarkers that can detect the disease years before dementia develops, so people at risk could then be treated with preventive drugs or vaccines that would protect a healthy brain rather than attempt to repair damaged brain cells. But like many others, I am becoming impatient, not only as a clinician and scientist, but as a family member who has seen the disease devastate relatives. I am not alone — more than 15 million Americans provide care for loved ones with dementia, and nearly 1.5 million of them are Californians.
The president and Congress took the first step by enacting the NAPA. But that first step will do nothing without the necessary funds to make the plan a reality. Along with my colleagues at the Alzheimer’s Association, I appeal to Representative Lucille Roybal Allard and other leaders of the House Appropriations Committee to make sure that we invest in research, education and care to fight this crippling disease. This is an investment that will pay off by saving millions of lives and, eventually, trillions of dollars.
Gary Small, M.D., is a member of the Medical and Scientific Advisory Board of the Alzheimer’s Association, California Southland, a professor of psychiatry and aging at UCLA, and director of UCLA’s Longevity Center.