Alzheimer's disease needs better preventive strategies and treatments

The Alzheimer’s Association sponsors a journal titled Alzheimer’s & Dementia. In the March 2010 issue, they provide a report on facts and figures related to Alzheimer’s disease (AD).

I’m a sucker for data so I spent some time going through the manuscript and here are some of the things that stood out to me:

Ninety (90) drugs are under investigation using human volunteers in the U.S. to slow or stop the progression of AD.

Individual U.S. state figures estimate the states likely to have the highest percentage change in number of individuals with AD by the year 2025:

Utah 127% increase
Alaska 126% increase
Colorado 124% increase
Wyoming 114% increase
Nevada 100% increase
Idaho 100% increase

As the percentage of deaths due to vascular disease, cancer and HIV have declined the percentage due to AD has increased. This trend is expected to increase over time. Between 2000 and 2006, in the U.S. the change in cause of death numbers were:

Alzheimer’s disease 46% increase
Breast cancer 2.6% decrease
Prostate cancer 8.7% decrease
Heart disease 11.1% decrease
HIV 16.3% decrease
Stroke 18.2 % decrease

Eleven million Americans provide unpaid care for a person with AD or other dementia–these family members and friends contribute 12.5 billion hours of care valued at $144 billion dollars per year.

The majority of unpaid caregivers (59%) are 50 years of age or older and are more likely to endorse high emotional stress related to caregiving (40% compared to 28% for caregiver of older people with Alzheimer’s disease.

The most common co-occurring medical disorders in those with AD are:

Coronary artery disease 26%
Diabetes 23%
Congestive heart failure 16%
Cancer 13%

Co-exisiting AD and other dementias increase the cost for care for most medical conditions in Medicare beneficiaries. This includes increased costs for hospital care, physician care, skilled nursing facility care and home health care.

AD and other dementias are increasingly the primary diagnosis for those entering hospice care (17% in 2008 compared to 7% in 2000).

The summary concludes with a review of the issue of race in AD. African-Americans are 2 times more likely and Hispanic Americans 1.5 times more likely to develop AD.

You have to die of something. The rates of AD increase with each decade of life. Reducing death rates for heart disease and cancer will increase longevity but increase the burden of AD to the population. I am hoping that by the time I have the first signs of Alzheimer’s that my left anterior descending coronary artery is 99% occluded.

The medical care system (and medical education system) will need to address the growing need for care for AD. Preventive strategies and better pharmacologic and non-pharmacologic treatments are urgently needed.