Where Do We Stand With Alzheimer's?

Where do we stand with respect to this fatal neurodegenerative disease? How much is it costing our society monetarily? How close are we to putting the brakes on to slow its destructive march? These are a few of the questions I have regarding what’s going on with Alzheimer’s Disease.

The very latest investigative report on what AD is costing our society globally is now out.

The Worldwide Cost
The World Alzheimer’s Report 2010, published by Alzheimer’s Disease International, and just released on September 21st 2010, reveals the gargantuan size and scope of this disease to all of us. Listed in the Conclusions and Recommendations section of this report are some sobering statistics.

1. If dementia care were a country, it would be the world’s 18th largest economy, ranking between Turkey and Indonesia.

2. If it were a company, it would be the world’s largest by annual revenue exceeding Wal Mart (US $414 billion) and Exxon Mobil (US $311 billion).

3. According to the World Alzheimer’s Repot 2009, 35.6 million older people worldwide (around 1/2% of the world’s total population) live with dementia. By the year 2030, this number will increase to 65.7 million.

4. Alzheimer’s Disease International calls on governments to make dementia a health care priority and develop national plans to deal with the disease.

A Discovery Made Created An Opportunity That Was Lost
It has now been 103 years since German psychiatrist and neuropathologist, Alois Alzheimer, was credited for the diagnosis of what he called pre senile dementia in a middle-aged patient. The patient, Auguste Deter, had been housed in the Frankfurt Asylum for lunatics and epileptics when Alzheimer met her in 1901. From 1901 until 1906, Alzheimer was obsessed with the behavior that she exhibited and studied her until her death in 1906. In November of 1906, he gave a speech in which he presented his findings of pre senile dementia after concluding an autopsy study of the patients’ brain.

In spite of Doctor Alzheimer’s landmark discovery and work, the field of medical science and neurology basically squandered the next 50 years and did virtually nothing to further explore and extrapolate upon Alzheimer’s findings. Our collective ignorance as a society regarding the brain and the difference between a healthy one and a diseased one advanced little during this time period. When some people aged into their 50’s and 60’s, senility was presumed to have set in causing, what was referred to as, “becoming feeble-minded”. Senility, as it came to be viewed, was part and parcel of becoming old for some senior citizens.

As a child and adolescent, I can recall some older people and a few relatives being referred to as “addle-brained”, an old “shut-in”, or one that “lives in his own private world”. Older folks, suffering from as-yet-to-be-defined variations of dementia, were basically just closeted away at home, or packed off to a nursing home and written off.

It really wasn’t until the early 1970’s that Alzheimer’s Disease research developed the equivalent of a vehicle transmission and began to gain traction up to perhaps a walking pace.

Another 20 more years would then pass before AD research, clinical trials, and both government and private sector grant money would all start to pick up the pace.

Gaining Momentum
Between 1990 and the present we have begun to see noteworthy involvement of medical science, a substantial increase in clinical trials, governmental and private sector research funding and greater public awareness. The death of a popular former president, Ronald Reagan, movie actors Charlton Heston and Rita Hayworth, and other public figures have helped raise societal interest and involvement to a higher level of participation.

As of October 2010, we have only 5 FDA approved medications available for the treatment of Alzheimer’s. Those medications are: Aricept, Razadyne, Namenda, Excelon, and Cognex. The newest of the group, Namenda was approved in 2003. The oldest drug, Aricept, was approved 17 years ago in 1993. NONE of these current medications will substantially slow down the progression of this fatal disease. There are NO preventative NOR any curative medications available at this time to fight and counter AD.

On the other hand, there are over 100 clinical trials underway at present with 4 promising medications that have made it to a Phase III clinical trial. Those medications that successfully survive a Phase III trial and the followup study stand a 90% or better chance of making it to market. The 4 drugs are: bapineuzumab (AAB-001), gammagard, resveratrol, and , solanezumab (LY2062430).

Early detection and screening measures have shown promising results with PET scans, blood and cerebrospinal fluid biomarker tests, and retina scans. The biomarker tests and retina scans in particular have generated excitement for their ability to disclose the presence of what scientists call a “pre-Alzheimer’s condition” 10 to 15 years before the AD symptoms start to be noticed.

A substantial amount of research has been done with more on the way at investigating dietary risk factors. Researchers have found compelling evidence of how certain metals such as iron, copper and aluminum and fertilizer derivatives such as nitrates and nitrites may be major environmental contributors in the progression of Alzheimer’s.

Ignorance and Misinformation
Yet ignorance, myths and misinformation remain entrenched worldwide about AD. The same World Alzheimer’s Report 2010 found that several common misunderstandings about Alzheimer’s Disease and dementia still exist globally that include these beliefs:

1. It is not a very common problem.
2. AD is a normal part of aging.
3. Nothing can be done, families will provide care - it is not an issue for health care systems or for governments.

These misguided notions are reminiscent of the beliefs that existed between 1905 and the early 1970’s. Where education is absent and ignorance prevails, either no action or the wrong actions will be taken towards combating AD. Clearly, education about AD needs to be ramped up immediately.

Driving Change
The Alzheimer’s Association has been a primary driving force in lobbying congress and the the National Institute of Health for increased research funding. It works with the private sector and the general public in an effort to keep donations coming for additional research project grants.

On October 15th 2010, Maria Shriver is joining with the Alzheimer’s Association to release the Shriver Report, A Woman’s Nation Takes On Alzheimer’s. This report will be the first multidisciplinary approach at the impact of AD, the costs, the burden upon family and cargivers, and current medical research and breakthroughs. The Shriver Report will also feature a wide variety of professional entertainers, political leaders, and news correspondents. The Shriver Report is intended to ignite a national dialogue on the epidemic disease of AD.

An Action Plan From Out Of The Past
A multidisciplinary, mission driven approach to the challenge was the kind of force employed in the phenomenal World War II “Manhattan Project” which led to the creation and detonation of the world’s first atomic bomb. This remarkable achievement was executed on a timeline between 1942 and 1946 with an approximate budget of 2 billion dollars (22 billion dollars at present day rate).

The World Alzheimer’s Report 2010 has brought to light the severity of the costs and growth of this disease. A new case of AD is diagnosed every 70 seconds. The time for a dramatic increase in public and global education, funding for public and private research, and caregiving relief with insurance reform and change is now.

Perhaps now is the right moment to shake off the dust of time and revisit the top down organizational methods of the “Manhattan Project.” Utilize the how-it-was-done template as a present day vehicle for first bringing AD to a screeching halt, then a follow up knockout punch of finding a cure.


Jeff Dodson
October 12th 2010