Tikkun Magazine, July/August 2009
Stop the Alzheimer's Tsunami!
by George and Trish Vradenburg
Someone is diagnosed with Alzheimer's every seventy-one seconds. One in two Americans in their eighties has this disease, and one in ten over sixty-five. After cancer, it is the disease most feared by adult Americans. Five million Americans suffer with Alzheimer's today, and with the aging of America, ten million Baby Boomers will die of this disease. Even as death rates for cancer and heart disease are declining, Alzheimer's death rates are up 47 percent since 2000. Alzheimer's is now the nation's sixth leading cause of death.
There is no drug that will slow or stop Alzheimer's; there is no Alzheimer's vaccine; there is no cure. While lifestyle choices may help defer Alzheimer's, as with every disease, we cannot avoid the 50-50 chance of having this disease in our eighties. Alzheimer's drugs on the market are of limited help in masking Alzheimer's symptoms. Nothing yet on the market or in advanced trials will slow or stop this progressive neurological predator. There is no defense.
Alzheimer's is an unforgiving, vicious disease. It is not a sentimental long goodbye or slow path into the night but a terrifying descent into loss of identity and soul. Alzheimer's begins its work on our brain ten to twenty years before symptoms appear. Early-stage symptoms include an erosion of memory and free-floating anxiety. The middle stages of the disease produce paranoia and a growing inability to perform the activities of daily living. And the later stages result in complete dependence and immobility. Finally, the body "forgets" how to swallow and to breathe. Pneumonia is typically the identified "cause" of death, but it is Alzheimer's that is the true killer. The average time from the first symptoms to death is ten years.
Alzheimer's, like smoking, has second-hand victims -- the family and other caregivers whose resources, time, and emotions are drained as they try to support the immediate victim. The son who must leave a career to care 24/7 for an Alzheimer's-stricken mother. The wife whose golden age becomes a living hell because of the need to dress, toilet, shower, lift, and bed a husband. Caregivers of Alzheimer's victims report increased stress, illness, and physical ailments as a result of their efforts. Even as they abandon their jobs and thus lose resources, they are faced with increased medical expenses for the victim and themselves.
Medicare reports that a beneficiary with Alzheimer's costs three times as much as other beneficiaries. Why? Because an Alzheimer's victim forgets to take medicine for his or her other conditions, such as diabetes; because the victim suffers injuries associated with the loss of physical control; because this disease, on average, lasts a decade.
What's being done?
First, a great deal of basic research is exploring the mechanisms of the disease and potential intervention strategies. Potential drug treatments are in the testing pipeline. Several recent promising drug candidates demonstrated disappointing results in major clinical trials, but the Lipitor-sized markets for a successful Alzheimer's intervention are a powerful incentive for continued investment.
Second, a high-powered panel called the Alzheimer's Study Group (including prominent figures such as Sandra Day O'Connor, former National Institutes of Health director Harold Varmus, former Medicare director Mark McClellan, former surgeon general Richard Satcher, former House speaker Newt Gingrich, and former senator Bob Kerrey) recommended a National Strategic Plan for Alzheimer's that included significantly increased and strategically directed research investments and care support to address this disease. Congressional leaders are now reviewing those recommendations.
It is estimated that Alzheimer's will cost Medicare and Medicaid $20 trillion over the next four decades. What should we as a nation invest in order to avoid a $20 trillion liability? Certainly more than the $400 million a year now being invested by the National Institutes of Health, a level of investment relative to other diseases that was set in the 1990s when little was known about Alzheimer's or its fiscal and social impact.
The authors of this article, together with the Alzheimer's Association, are asking Congress to raise the level of public investment in Alzheimer's research by $2 billion in the next fiscal year, rising over a period of eight years to $5 billion a year. An investment of $30 billion over eight years would, in the estimation of the research community, permit us to stop Alzheimer's by 2020. That looks like a smart investment to avoid a $20 trillion liability. Research investments work. Early investments in HIV/AIDS research turned that terrible disease from fatal to manageable.
Look at the person next to you. One of you will get Alzheimer's and the other one will be the caregiver. Not good odds. It is time for this nation to focus like a laser on stopping the Alzheimer's tsunami.
George and Trish Vradenburg are the publishers of Tikkun. This editorial, generally written by George, is called The Contrarian because he often disagrees with our editorial opinions. In this case, by contrast, we asked the Vradenburgs to describe their work to massively increase funding for Alzheimer's research because we all agree on its vital importance.
