Tomorrow is World Alzheimer's Action Day. It'll be a rather low-key affair. No noisemakers, no parades or fireworks — though I might have a scoop of chocolate ice cream in honor of my grandfather, who loved chocolate ice cream. He died of complications from Alzheimer's more than 30 years ago — not that those two facts are in any way related.
The emphasis tomorrow will be on raising awareness of the disease and finding effective ways to diagnose and treat it. The need is stark.
An estimated 5.4 million Americans have Alzheimer's today; that number is expected to climb fourfold by 2050. Although 82,000 deaths were attributed to the disease in 2008, some researchers contend the annual toll is closer to 500,000 if Alzheimer's were correctly identified as the main comorbidity. The Alzheimer's Association says the total cost of care by private and public payers was $172 billion in 2010, and will soar to $1 trillion by 2050. Providers — from hospitals to post-acute care — are bracing for a deluge of patients with extremely complex needs, who require close supervision. We don't have enough geriatricians or nurses educated in dementia and Alzheimer's care, and we certainly don't have enough well-trained, professionally certified home care workers.
Still, there are hopeful developments. As I noted earlier this year, the Obama administration has committed hundreds of millions of dollars to spur research that will lead to effective treatments by 2025. Health & Human Services' national strategy on Alzheimer's will emphasize training for health care workers, registries to help patients get into clinical trials, and better coordination of funding and research.
In Oregon, a coalition of advocates in August announced a plan to manage the disease there. According to The Lund Report, the group proposes creating a website with links to information and resources, ensuring Oregon has a dementia-capable licensed health care workforce, requiring training for court-appointed guardians on legal issues related to dementia, and improving access to quality care. That could become a model for other states.
There's hopeful news from the pharmaceutical sector, too: At the congress of the European Federation of Neurological Societies earlier this month, Pfizer and GE Healthcare announced research with promising results. As the business intelligence company GlobalData reported:
"There are two major unmet needs that currently plague the field of Alzheimer's: the lack of therapies that actually target and impact disease progression, and a dearth of early diagnostic biomarkers and imaging tools." In its presentation, Pfizer showed that anti-amyloid therapies are effective in reducing amyloid, a protein often deposited in the brains of people with Alzheimer's. Pfizer's research also suggests that earlier intervention may yield better clinical outcomes, as others have speculated. GE Healthcare described a novel and effective amyloid imaging agent, highlighting how the biotech industry is "responding to the need for accurate early diagnostic tools for Alzheimer's."
In an earlier report, GlobalData described how scientists are deepening our understanding of the disease. Especially interesting is the belief by certain researchers that Alzheimer's is related to diabetes, with some "even going so far as to propose the name 'type 3 diabetes.' " Diabetes patients are two to three times more likely to develop Alzheimer's, GlobalData reports, and "there are also associations between AD and obesity, as well as AD and metabolic syndrome." Figuring out those relationships could lead to significant progress in treating Alzheimer's.
In the meantime, hospitals, as part of the continuum of care in their communities, will be called upon to support people with Alzheimer's and their families, whether the patients are in the hospital, at home or in a long-term care facility. "This is a community-wide program, and government can't deal with it alone, " Oregon State Sen. Laurie Monnes Anderson told The Lund Report. "While there are no cures, there are ways we can provide care more effectively."