By Mark A. Sager
June 15, 2013
Alzheimer’s is one of the most feared of all diseases of aging. It is one of the top 10 causes of death in the U.S. There is no cure, and there are no effective treatments. No one has ever survived. The fiscal and human costs of Alzheimer’s are intergenerational and will change our society if we ignore them.
The Alzheimer’s Association estimates that 5 million Americans have Alzheimer’s and that the number of persons and families affected by this disease will increase by more than 50% over the next 20 years. The baby boom generation, which makes up almost one-third of our society, is now turning 65 and at risk of developing the disease. Estimates are that one of eight baby boomers will develop Alzheimer’s, and even that if they do not, they will be caregivers for someone who has the disease.
In a recent RAND study, the total monetary cost of dementia was conservatively estimated at $157 billion in 2010. These annual costs are expected to increase to $379 billion by 2040, making Alzheimer’s more expensive than heart disease and cancer. Most of the costs directly attributed to Alzheimer’s are for nursing home and home care not covered by insurance. If we do not act quickly, Alzheimer’s will steal the life savings of a generation and encumber our tax dollars for decades to come.
In December 2010, in a rare sign of bipartisanship, Congress unanimously passed the National Alzheimer’s Project Act (NAPA) which committed this country to preventing and effectively treating Alzheimer’s by 2025. NAPA was passed in response to the recommendations of the Alzheimer’s Study Group, chaired by former Rep. Newt Gingrich and former Sen. Bob Kerrey, which described Alzheimer’s as a serious and growing challenge to our nation.
NAPA was signed into law in January 2011 and called for substantial investments to improve Alzheimer’s research and care. Unfortunately, the resources that would give us some hope of preventing or effectively treating Alzheimer’s by 2025 have been woefully inadequate.
The federal government, through the National Institutes of Health, currently spends only a half-billion dollars a year on Alzheimer’s research. This is significantly less than what is spent on research on other diseases including cancer ($5.4 billion), heart disease ($4 billion) and HIV/AIDS ($3 billion). We have made great progress in understanding and treating these diseases because of substantial commitments to build the research infrastructure necessary for developing new treatments.
Similar commitments have not been made in Alzheimer’s disease research. Because of the budget deal known as sequestration, Alzheimer’s disease research funding has actually dropped 4%, further threatening our country’s ability to avoid the fiscal and social devastation that awaits us.
Unless we as a nation are willing to put aside our political differences and make Alzheimer’s disease research a priority, we are at risk of losing a generation of young Alzheimer’s researchers who will turn elsewhere to make a living. Scientists, like new discoveries, take time to develop, and we are running out of time. Can we afford to ignore this very real phenomenon?
NAPA called for the creation of an Alzheimer’s Advisory Council on Alzheimer’s Research, Care and Services to advise the secretary of Health and Human Services on the development of the national plan. In April 2012, the Advisory Council described an urgent need to fund a strategic Alzheimer’s research plan to achieve the breakthroughs “essential to the saving of millions of lives and trillions of dollars.”
The Advisory Council recommended rapidly increasing Alzheimer’s research funding to a minimum of $2 billion annually. Although the Obama administration recently announced an additional $100 million in Alzheimer’s research funding, this amount falls far short of what is needed to avert the public health crisis that looms in our future.
The significant financial costs of Alzheimer’s and other dementias pale in comparison to the tremendous human toll on individuals and families who become caregivers. Depression, anxiety and myriad physical health issues are common among caregivers, resulting in missed work and increased use of health care. There is also the ongoing worry associated with the knowledge that Alzheimer’s often runs in families. Finding a means to prevent the disease is critical to current as well as future generations.
Research is telling us that the seeds of Alzheimer’s are present decades before the development of symptoms and disability. This is good news because if we can understand the biology of the disease before someone becomes symptomatic, then we should be able to develop treatments that delay the onset or slow the progression of the disease, and yes, maybe even prevent it altogether. However, none of this will ever come about without a commitment and sense of urgency. Placing a man on the moon required an eight-year national commitment. A similar commitment must be made to Alzheimer’s disease research and care. The costs of inaction for families and our society have never been clearer.
Mark A. Sager, MD, is director of the Wisconsin Alzheimer’s Institute at the University of Wisconsin School of Medicine and Public Health
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