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New Alzheimer projections add urgency to search for prevention, cure

Posted on: 7/19/2009 ()

Investment in research critical to heading off collapse of health care system

Chicago/Washington, DC – An expected Alzheimer's epidemic will be far worse than previously thought, according to a new study published in the current issue of Archives of Neurology. The study, "Alzheimer's Disease in the U.S. Population," predicts the prevalence of Alzheimer's disease will increase 27% by 2020, an astonishing 70% by 2030, and nearly 300% by 2050, unless science finds a way to slow the progression of the disease or prevent it.

According to the study's authors, current and future estimates of Alzheimer's disease are essential for public health planning. But because Alzheimer's can progress slowly and is often not diagnosed, and because there is no requirement that the disease be reported, it has been difficult to gauge the scope of the problem.

According to Sheldon Goldberg, president and CEO of the Alzheimer's Association, "If left unchecked, it is no exaggeration to say that Alzheimer's disease will destroy the health care system and bankrupt Medicare and Medicaid."

Funded by the Alzheimer's Association and the National Institute on Aging, and conducted by researchers from the Rush Institute on Healthy Aging, the Rush Alzheimer's Disease Center, Rush-Presbyterian-St. Luke's Medical Center, and the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, the study evaluated the incidence of Alzheimer's in a biracial urban community, and applied the findings to U.S. Census data and National Center for Health Statistics mortality data to estimate prevalence in the U.S. population.

The researchers, led by Denis Evans, M.D., estimate that currently some 4.5 million Americans have Alzheimer's. Using low, middle and high U.S. Census projections, the researchers calculate Alzheimer's prevalence over the next five decades. The study predicts that by mid-century, between 11.2 and 16 million Americans will have Alzheimer's, with the medium number of cases expected to reach 13.2 million. The new numbers represent a significant increase over a 1990 study by the same researchers that estimated 7.5 to 14.3 million cases, with a medium range of 10.2 million, by 2050.

"Our choice is clearer than ever," said Goldberg. "Either increase funding for research to fend off this looming public health disaster, or sit back and wait for it to overwhelm the health care system."

The study suggests the increases in the prevalence of Alzheimer's disease are a result of the rapid growth of the oldest age group – 85 years and over – and of a decline in the death rate among persons over age 65 to about half the current rate by 2050. According to the study, by 2030 nearly half the individuals with Alzheimer's will be 85 years and older.

"Age is the single greatest risk for the disease," said Goldberg. "This study represents a significant step forward in confirming what we're up against. If we don't find answers soon, it will be devastating on multiple fronts."

Numerous economic studies have shown that Alzheimer's disease costs American business $61 billion annually, and by 2010, Medicare spending on Alzheimer's will rise to $49.3 billion (a 54% increase over costs for 2000) and Medicaid costs will rise to $33 billion (an 80% increase).

According to Goldberg, the solution to Alzheimer's lies in finding a way to prevent the disease or delay its onset so that millions of people now at risk never suffer its disabling effects. "The only way to do that is through investment in highly focused basic science research and clinical trials that will bring scientific discoveries out of the laboratory and into the hands of the people who will benefit from them," Goldberg said.

The Alzheimer's Association has been working with Congressional leaders to increase federal funding for Alzheimer research – from the estimated $640 million the National Institutes of Health will spend in 2003, to $1 billion annually. However, in the current budget climate, these requests have not seen significant movement. The Senate Appropriations Committee has proposed a 3.7% increase next year over current funding. Next month when the Senate returns, Senator Arlen Specter (R-Pa) and Senator Tom Harkin (D-IA), plan to offer an amendment that would provide a 9.2% increase. According to scientists, without these additional funds, the pace of Alzheimer research will slow dramatically.

After the NIA, the Alzheimer's Association is the leading source of Alzheimer research funding in the U.S.

The study concludes, "The large public health challenge is to make these projections obsolete and irrelevant by discovering routes to the prevention of the illness through better understanding of its underlying biology and by discovery of modifiable risk factors."

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