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Alzheimer’s Ahead

An epidemic of age-related dementia looms
October 24, 2012

Every 68 seconds, another American is diagnosed with Alzheimer’s disease. The coming wave of older people with dementia will place an unprecedented emotional and economic burden on society (see “The Dementia Plague”). We’re living longer thanks in part to advances in medical technology, but we’re not necessarily living better.

Approximately 80 million baby boomers are beginning to approach the years when symptoms of Alzheimer’s disease emerge.

The risk for those 65 and older is 10 percent, and it nears 50 percent by age 85. A report on the global economic impact of dementia by Alzheimer’s Disease International estimated the 2010 costs of care at $604 billion.

We are wholly unprepared for this crisis. Despite decades of research, we have no cure, nor even any drug that can reverse or stave off symptoms more than temporarily. Considerable effort has targeted the plaques of amyloid protein that form in the brains of Alzheimer’s patients, but none of the latest clinical trials have succeeded. Though we must continue to explore amyloid’s contribution, we also need to research more widely, because there is more to Alzheimer’s disease.

We are wholly unprepared for this crisis.

Efforts need to be made to investigate treatments that target other potential mechanisms, such as abnormal accumulation of brain tau protein and inflammation of neurons. Resources need to be found for work on drugs or vaccines that protect a healthy brain before it becomes damaged. Many research groups, including my own, have developed brain scans and other tests that can detect the disease years before dementia develops. 

We cannot afford to wait for new treatments, with their long development times. We should act now on compelling evidence that lifestyle choices such as diet and cardiovascular conditioning can forestall dementia symptoms. For example, two key Alzheimer’s prevention strategies, diet and exercise, are known to prevent type 2 diabetes, which doubles the probability of developing Alzheimer’s dementia. 

If society is to avoid being overwhelmed by the cost of the Alzheimer’s epidemic, the disease must become an international health priority. Yet we have not invested as much in fighting it as we have in combating other diseases. Recent findings from the U.K. support increasing Alzheimer’s research funding by a factor of 30 to reach parity with cancer research. Making such an investment to catch up will pay off by saving millions of lives and, eventually, trillions of dollars.

Gary Small is director of the University of California, Los Angeles, Longevity Center.

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