Alzheimer's Disease: Our Biggest Long-Term Health Challenge

We must address this crisis. We must begin by putting Alzheimer's into the center of our national dialogue about reforming health care.
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As we grapple with reforming health care in America, the discussion often seems to gravitate to short-term issues while ignoring growing long-term threats. There is a health care tsunami approaching. It is Alzheimer's Disease. How we deal with this crisis will tell us a lot about how we are doing on health policies and actions for the long term -- and about how we are doing as a society.

My family and I have had first-hand experience: a loved one gradually became more and more disconnected -− more and more helpless. We felt the anguish of Alzheimer's, as have millions of other Americans.

Alzheimer's Disease is the number one long-term health challenge our country faces as the baby boomers enter retirement. This disease is poised to wreak devastation on as many as 16 million sufferers by 2050. It is just the beginning. Around half of us over the age of 80 will develop Alzheimer's. Alzheimer's already costs more than $110 billion in annual health care spending and is spiraling upward. And Alzheimer's inflicts cruelty on entire families. It can impoverish the caregivers who must abandon work to look after sufferers, while causing depression and despair in spouses, children and other loved ones.

Despite heroic calls for action -- such as the recent proposal for a National Alzheimer's Strategic plan by the Alzheimer's Study Group -- our health care debate appears to be bypassing this looming crisis. Or maybe we are in denial because Alzheimer's is so terrifying.

We must address this crisis. We must begin by putting Alzheimer's into the center of our national dialogue about reforming health care.

I hope we will see our leaders in Washington rise to this challenge. Meantime business leaders like me, and leaders in lots of other walks of life, need to stand up and join together in galvanizing action on Alzheimer's. And we have a moral imperative too: the sufferers of Alzheimer's often cannot speak up for themselves. We must be their voice and their champions.

What do we need to do?

One priority is to accelerate the work on medical innovations to prevent, to detect early, to treat, to halt and ultimately to cure Alzheimer's. There are exciting signs of early progress in labs in innovation-based biopharmaceutical and diagnostics companies and at the National Institutes of Health (NIH). We can take practical steps to fast-track the science. We can also accelerate the regulatory processes that develop information on groups at higher risk, that develop early warning diagnostics and that move molecules into new medicines for this disease.

For example, as we are now doing with some other chronic diseases, if we could identify people who are most at risk and who then suffer from Alzheimer's, and treat these patients early, we would have a huge win. Early detection, and early intervention, could generate enormous health rewards, while saving families from ruinous costs and heartache.

With existing clinical trial methods, this could take decades. But there is a tremendous opportunity for the NIH, the FDA and the biopharmaceutical and diagnostics companies to collaborate on creating new models of innovation and clinical trials. We need new approaches that allow us to test potential new Alzheimer therapies in people at risk or with early stages of the disease, see what has promise, and zero in on the best bets for prevention. In this way we could hope to move the horizon for breakthroughs from decades to years. And by succeeding with Alzheimer's we would have a new model for faster, more cost-effective work on other chronic and preventable diseases.

That's just one idea for accelerating the science. We need lots more. But no matter how fast we can advance science to stop Alzheimer's, we have millions of people in our country suffering from this disease today and millions more who will develop it before we have effective new treatments.

So our second priority must be to respond with courage and compassion to the human and societal crisis. There is an impulse to keep the sufferers out of sight and off our conscience. We must not let this happen. To echo Franklin D. Roosevelt, a great society is judged by how well it helps the most defenseless among its citizens.

Virtually everything we should be doing for the victims of Alzheimer's -- and their families -- has lessons for a better, more efficient health care system for all of us. Unlike today, routine checkups for people over 60 should include simple tests, including biomarkers from blood tests and metrics of mental functioning. Medicare should reimburse doctors for such primary prevention tests. Unlike today, we should intervene early with simple therapies for stimulation and social interaction to help delay and lessen the effects of the disease.

Unlike today, physicians need to have the quality time with the patients to monitor them and individualize their treatment. Unlike today, we should put in place cost-effective support mechanisms such as home care help and counseling for family members -- so that they can keep those affected with Alzheimer's in a home environment as long as possible while continuing to work themselves, and avoiding where possible the huge costs and impersonal environments of institutional care. This will involve training more people −- doctors, nurses, social workers, and other caregivers to deliver this level of care.

Does this sound a lot like what we know we need to do in other areas, to make health care better and more cost effective? Surely it does.

We must begin somewhere to turn health care reform from ideas into good policies and actions. Through a national crusade on Alzheimer's, we can rally as Americans around our biggest long-term health care challenge. What we learn from that can help us get other things right. And when we look in the mirror as a nation that wants to care for its weakest citizens, we will like what we see.

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