By Peter Berger
Special to Alzheimer’s Weekly
Published Week of Aug. 12 - Aug. 18, 2007

Longer life spans pushed up the cost of caring for the 6 million-plus Americans with Alzheimer's disease and other forms of dementia to an estimated $76 billion in 2005.

"Alzheimer's Disease Facts and Figures clearly shows the tremendous impact this disease is having on the nation. And with the projected growth of the disease, the collective impact on individuals, families, Medicare, Medicaid, and businesses will be even greater," Harry Johns, president of the Alzheimer's Association, said in a prepared statement.

"However, there is hope," he added. "There are currently nine drugs in phase III clinical trials for Alzheimer's, several of which show great promise to slow or stop the progression of the disease.” Phase III is the final trial new medicines go through before the FDA considers them for approval. Harry Johns continued to add, “This, combined with advancements in diagnostic tools, has the potential to change the landscape of Alzheimer's."

In the recent CNN/YouTube Presidential Debate, Democratic presidential candidates were asked what they are “prepared to do to fight Alzheimer’s disease now?” Emphasizing that we have the resources belonging to “the richest nation on Earth,” everyone spoke strongly of increasing the care and treatment that reaches every American. You can watch the five-and-a-half-minute video right here:

Alzheimer’s is rising higher on government agendas everywhere. Worldwide, the cost of providing for 29.3 million people with dementia in 2005 was $315 billion, according to another estimate published in the journal Alzheimer's & Dementia: The Journal of the Alzheimer's Association. This figure is significantly higher than the 2003 worldwide estimate of $250 billion by the same researchers, revealing that costs have accelerated in just two years and underscoring the need for more research into the disease.

The $315.4 billion figure is higher than the total budget of all but eight of the world's countries -- the United States, Japan, Germany, France, Great Britain, Italy, China and Spain, the researchers said.

Lead author Dr. Anders Wimo of the Karolinska Institutet in Stockholm attributed the rise to the "graying of the world," together with the higher gross domestic product in developing countries that boosts the wages of medical personnel and caregivers. Wimo calculated the cost of dementia by combining estimates of its prevalence with medical and non-medical charges in each country. The worldwide total also included $105 billion for the cost of "informal care," the lost wages of caregivers -- many of whom are retired spouses -- responsible for providing "support in personal activities of daily life," such as bathing, dressing and grooming. The researchers calculated that 90 percent of dementia patients lived at home in developing countries and relied on 1.6 hours of informal care per day, the same amount for those in developed countries, of which 73 percent lived at home.

That is approximately one-sixth of what the U.S. government is expected to spend this year on Medicare, the federal insurance program that covers 44 million seniors and disabled people.

The study figures came as no surprise to Dr. Sam Gandy, chairman of the Alzheimer's Association's Medical and Scientific Advisory Council. "The study suggests very clearly that we will need to expand the Medicare budget, otherwise all funding will only cover dementia," he said.

Gandy decried the decline in research dollars by the National Institutes of Health, a trend that started in 2003 and has hit Alzheimer's harder than cancers and HIV, he said. Notwithstanding, new research projects are appearing the world over. "We hope to have an effective medication within the next five years. We're also hoping to have developed a blood or brain scan to identify people at risk, so we can start treatment before the disease develops," Gandy said.

Meanwhile, doctors treating patients with dementia believe the No.1 funding priority should be finding a cure. Dr. Charles DeCarli, director of the Alzheimer's Disease Center at the University of California, Davis, said that "hot on the heels of finding a cure" is a pressing need to develop a "social infrastructure" that provides more efficient care for patients and relieves some of the burden on family members.