A Dozen Things You Didn't Know About Alzheimer's

In the latest on the U.S. Budget Battle front, the Obama Administration recently published its long term projections for the 2015 Budget. One good bet is that whatever projections exist for long term healthcare costs, unless we get on top of the Alzheimer's crisis, those projections are likely to be way understated. Due to the near perfect correlation between aging and Alzheimer's, the longevity miracle of the 20th century is yielding a health crisis for the 21st. The analysts at OMB might factor in twelve things about Alzheimer's, which neither they nor few others of us know, but would be part of a serious analysis of what is to come:

1. Alzheimer's is a fiscal nightmare. It consumes an incredible 1% of Global GDP per year, roughly $604 billion. That figure is greater than the total GDP of all nations except the 20 richest. The costs are so extraordinary in large part because of the intensive caregiving that is required. By midcentury, the total number of people requiring care will triple. Private sector innovation in caregiving may help stem this tide.
2. Rates will quadruple. In the next 35 years, cases of Alzheimer's are going to quadruple, reaching 135 million by mid-century. If you're over 65, you stand a one-in-eight chance of getting the disease. Once you pass 85, your odds jump (or fall) to nearly one-in-two. And, prevalence in today's developing/poor countries will skyrocket at even more rapid paces than in the developed world, including the U.S.
3. Alzheimer's is the third deadliest disease in the U.S. Each year, Alzheimer's takes nearly a half-million American lives. But, as Alzheimer's is nearly perfectly correlated with age, it is today's developing/poor countries that as we approach mid-century will see the greatest impact.
4. Alzheimer's is endlessly destructive. Most people think that Alzheimer's destroys people's ability to remember. But it's far worse than that. The dementia struggles of legendary UNC basketball coach Dean Smith, which have recently gone public, illustrate the point. This long ESPN article discusses the icon's jaw-dropping deterioration. Incredibly, he no longer enjoys watching basketball; the games are too confusing and move too fast. Not long ago, upon his retirement, Coach Smith had won more games than all but three coaches in the history of the game. Its impact on society is even greater, albeit at different levels.
5. There may be many kinds of Alzheimer's. We might be thinking about Alzheimer's all wrong. When John Wayne had cancer, it was called "the cancer." Now there are dozens of kinds of cancer. Some very smart people think that's exactly the situation today with Alzheimer's. We think it's one degenerative disease, but there may be countless different forms -- which will require different treatments, preventions, and care methods.
6. You can be a "dementia friend." The UK has started a program that trains citizens in retail, banking, and other customer-facing jobs to be "dementia friends." There are too many ugly stigmas around Alzheimer's that cause people to act poorly when dealing with someone with dementia. These mistakes are easily corrected.
7. High-tech solutions are coming. Technologies may re-write the possibilities of life with dementia. Houses are becoming dementia friendly with the help of digital technologies -- like fall sensors, "smart" reminders, etc. These technologies will drastically extend a person's capability of living a life of independence -- or even semi-independence. One of the greatest advocates, George Vradenburg, has begun to talk about how Google Glass can be a prosthetic for Alzheimer's.
8. There is even progress on Diagnosis. The only definitive diagnosis for Alzheimer's disease is a brain biopsy. But there are new tools that are improving rapidly: The use of blood tests, enhanced cognitive screenings and imaging capabilities. But with serious, applied commitment and incentives there is no reason we cannot apply our growing technological capabilities to this challenge. Indeed, let's start demanding the innovative combination of low tech softer monitoring in care settings, especially home environments with caregiver and family attention, with "big data" analytics to advance our knowledge base around early detection and diagnosis.
9. "Big data" may uncover solutions and help solve some of these issues. We hear the rallying cries around big data with everything from unsynchronized stoplights to the war on terror. Leading organizations are bringing "big data" to help unlock the mysteries of Alzheimer's. The prospects are promising. Consider what we might learn if we use big data to analyze some of our most serious data sets like the Framingham Heart Study or several of those Dutch, UK or German studies increasingly collecting data for pricing and insurance schemes. Or, even more creative would be the use of big data to bring innovative pharmaceutical clinical trials into the 21st century by ongoing monitoring and analysis of results in real-life settings.
10. New Care Models for the 21st Century. As private sector models of home care such as Home Instead Senior Care extend their Alzheimer's Care Training, we are learning more about Alzheimer's than often had been achieved in more traditional 20th century analytical constructs. The applications here are not only for more effective and better Care. But, equally interesting might be the ability to marry technology with this private, targeted and personal home care to mine data for greater and deeper knowledge about this disease that conventional analytical and clinical approaches are not yielding.
11. Prevention Before Cure. New studies are teaching us more about prevention of Alzheimer's even before we learn how to cure or adequately treat the dreaded disease. Amazing, but let's celebrate this one!
12. An unexpected advocacy push: Quite recently, irreverent Hollywood comedian Seth Rogen delivered an impassioned plea for greater action against Alzheimer's disease before a U.S. Senate committee. And in London, Alzheimer's Disease International has begun a global petition to put Alzheimer's on the G20 agenda. After getting significant recognition by the G8 under David Cameron's leadership, Alzheimer's advocates are rightly setting their sights on the G20 meeting in Australia. But even as the star of 40 Year Old Virgin and Knocked-Up works toward the same goals as Alzheimer's Disease International, it remains curious how little of the disease - and its consequences - that we actually know about the world's most difficult, tragic, and costly diseases.

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