Why We Must Blunt the Alzheimer's Epidemic

More than 35 million people worldwide have Alzheimer’s disease, as many as 5.4 million in the United States alone. By 2050, between 11 million and 16 million Americans are projected to have the disease. While the human toll of Alzheimer’s cannot be precisely measured, its financial costs can be tabulated. Payments for health care, long-term care and hospice for Americans with Alzheimer’s and other dementias are estimated to total $183 million in 2011. The cost is projected to increase to $1.1 trillion in 2050.  The total estimated worldwide costs of Alzheimer’s and other dementias are $604 billion annually according to Alzheimer’s Disease International. These prevalence and cost numbers reflect the current epidemic of Alzheimer’s disease and fuel projections of a growing epidemic with unfathomable financial costs worldwide. The cost of Alzheimer’s disease would be dramatically lower if disease-modifying treatments were available.  In the United States, about 70 percent of costs for Alzheimer’s are paid by government programs such as Medicaid and Medicare. Yet, other government programs, for example, the National Institutes of Health (NIH), have not responded to this epidemic with the funding required to find disease-modifying treatments that could decrease costs. A treatment that delays the onset of Alzheimer’s by five years – similar to the effect of anti-cholesterol drugs on preventing heart disease – would result in an immediate and long-lasting reduction in the number of Americans with Alzheimer’s  and the cost of their care. For example, a treatment that delays onset by five years and begins to show its effect in 2015 would decrease the total number of Americans age 65 and older with Alzheimer’s from 5.6 million to 4 million in 2020. Discovering treatments to slow disease progression – much as has been done with HIV/AIDS and several cancers – would result in far fewer people in the severe stages of the disease when care demands and costs are greatest. Assuming that treatment effects began in 2015, in 2020, the number of people age 65 and older with Alzheimer’s disease in the severe stages would drop from an estimated 2.4 million (no disease-modifying treatment) to 1.1 million. In 2050, the number of people in the severe stages would decline from an expected 6.5 million to 1.2 million. In the absence of disease-modifying treatments, the cumulative cost of care from 2010 to 2050 is projected to exceed $20 trillion in the United States. Yet, in 2011, NIH funding for Alzheimer’s disease ($450 million) was one-twelfth that for cancer, one-ninth that for heart disease, and one-sixth that for HIV/AIDS. Ultimately, solving the Alzheimer’s crisis will mean addressing the chronic underinvestment in research. This forecast of a dramatic rise in the number of Alzheimer cases in the coming years should catapult the government into action.