Alzheimer's disease is the sixth leading cause of death in the United States. There is currently no cure, and the only available drug treatments, while masking the initial symptoms — memory loss, difficulties with problem solving and temporal and spatial relationships among them —do not delay the eventual atrophy of the brain. There is also no known way to prevent the disease, though a heart-healthy diet and strenuous regular exercise are both recommended to help stall its onset.
Late onset Alzheimer's, pegged to those 65 and older, is generally accepted as a disease of aging. The longer people live, the more likely they are to develop the disease. However, in the early onset, or familial, version of Alzheimer's that accounts for about 4 percent of cases, or 200,000 nationally, it is caused by an inherited genetic mutation, and typically strikes before age 50.
Overall, Alzheimer's is the most common form of dementia and affects 35,000 people in Southeastern Virginia alone, with numbers expected to increase with the aging of the population. Nationwide, 5.4 million have the disease and those numbers are projected to grow to 13.2 million by 2050. Currently, the direct and indirect costs of the disease are estimated at more than $200 billion annually, according to Lorenzo Refolo of the National Institute of Aging.
Though there hasn't been a successful clinical trial in nearly a decade, there have been two areas of progress recently regarding Alzheimer's: improved, earlier diagnosis; and passage of the National Alzheimer's Project Act (www.alz.org/plan) by Congress this year. The latter calls for funding to establish effective prevention and treatment of the disease by 2025. The Alzheimer's Association has said it will take $2 billion to fund the necessary research for a breakthrough — Congress awarded almost $500 million for 2012 and $528 million for 2013.
By contrast, cancer research, heart disease and AIDS receive around $6 billion, $4 billion and $3 billion respectively, according to Virginia Beach Alzheimer's advocate Dave Stephens, who is walking to Washington D.C. to lobby for more funds.
Mathew Baumgart, senior director of public policy for the Alzheimer's Association, says investment in research will not only pay off for patients but for society, as patient care is currently costing 280 times the amount spent on research. The immediate goal, he says, is to find a treatment that will delay the onset for five years, the equivalent of what Lipitor does for heart disease.
Until recently, Alzheimer's disease could only be ascertained by examining the brain after death; now a PET scan can pick up tell-tale plaques in the brain, and cerebro-spinal fluid can reveal bio-markers indicating a "high probability" of the disease. These may be evident as much as 20 years before any symptoms appear.
Increasingly, researchers are suggesting that early intervention with drugs is the best hope of stemming the disease. This, however, raises potential discrimination issues regarding insurance, and the ethical dilemma of whether to inform someone of a disease for which there is currently no cure.
At risk for Alzheimer's?
The highest risk factor is aging, followed by carrying the ApoE4 gene, which is present in 35 percent of those with Alzheimer's and carried by 20 percent of the general population. Other risk factors include smoking, head trauma, depression, obesity, and Type 2 diabetes. In early onset, genetics are the determining factor.