The Dollars and Sense of Alzheimer’s

June 19, 2015 by

June 19, 2015

By Medical Discovery News

As people age, they begin to worry about developing dementia and its most common cause, Alzheimer’s. Alzheimer’s is a neurodegenerative disease that can affect your cognitive abilities, the ability to function in daily life, and orientation. If that’s not devastating enough, those with Alzheimer’s only live four to eight years on average after diagnosis.

In America, Alzheimer’s is the 6th leading cause of death. Today 5.1 million of those 65 or older are living with this disease, a number that is only expected to grow as the population ages – by 2050 it is projected to affect 13.5 million of those 65 or older. The few drugs readily available only moderate the symptoms, as there is no way to cure, slow, or prevent Alzheimer’s.

Recently, the Alzheimer’s Association published a report called “Changing the Trajectory of Alzheimer’s Disease: How a Treatment by 2025 Saves Lives and Dollars.” It focuses on the costs associated with a theoretical treatment that could delay the onset of Alzheimer’s for five years. If such a thing were discovered, it could have a huge impact on people’s lives and their financial.

Since Alzheimer’s is a disease of older Americans, treatments for it are mostly funded by Medicaid and Medicare. Currently, Medicare covers 80 percent of the total costs of Alzheimer’s care in America, which equates to $153 billion. By 2050, the total costs of caring for those with Alzheimer’s is expected to rise to $1.1 trillion, with Medicare allocating one-third of all its expenses to treating it.

Within the Alzheimer’s population, a higher proportion will be in severe stages of the disease by 2050, as opposed to early or moderate stages. In the early stage of the disease, people can continue everyday functions and may appear symptom-free. They do have deficits in their abilities to think and learn, but the financial impact and burden on family members are low. In the moderate stage, memory lapses, inability to express thoughts, and confusion become apparent. Finally, in the severe stage, people have trouble taking care of themselves and require extensive daily care. In 2050, almost half of those affected will be in the severe stage.

The Alzheimer’s Assocation presents a case for funding biomedical research now, before the human and economic costs can be realized. For the sake of argument, they describe a hypothetical new treatment that would delay the onset of Alzheimer’s symptoms by five years. If such a thing were available by 2025, it would save $220 billion in its first five years. By 2050, 6 million fewer people would be affected by Alzheimer’s, saving families $90 billion in healthcare costs and the federal government $367 billion. Even if such research costs $2 billion a year starting today, a way to delay Alzheimer’s by just five years would pay for itself within three years.

Research from very basic studies on the brain to translational research leading to new therapeutics and early diagnostics are desperately needed. There are many promising studies that suggest a delay in the progression or even cure for Alzheimer’s are possible.

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A Top 10 List To Die For

September 13, 2013 by

Sept. 13, 2013

By Medical Discovery News

How are you going to die?

The Centers for Disease Control would answer that life expectancy depends greatly on where someone lives. Life expectancy in the United States ranks 40th in the world with 77.97 years.That addresses when someone might die but what about how? Most likely, it will be from one of these top 10 causes, based on how many Americans they kill each year.

10) Suicide – 38,285. Many factors are now known to influence suicide: mental illnesses, genetics, certain pharmaceuticals, traumatic brain injuries, drug and alcohol abuse, and chemical or hormonal imbalances. To decrease these rates, education about the signs preceding suicide and accessible treatment is necessary.

9) Kidney Disorders – 45,731. Although dialysis can help people survive a little longer without a kidney, it is no cure. Kidney damage can occur from infection, high blood pressure, or toxic reactions to drugs, leading to chronic kidney disease that affects more than 26 million Americans.

8) Influenza and Pneumonia – 53,667. Both these diseases mostly affect the very old, very young, or those with immune system problems. This figure could be lowered with vaccinations.

7) Diabetes – 73,282. The rate of diabetes is increasing, with one in 500 children being diagnosed, corresponding to trends in obesity, diet, exercise, and aging. Lifestyle changes could decrease diabetes rates.

6) Alzheimer’s – 84,691. This form of dementia affects older adults, mostly over 60, and is caused by the build-up of beta-amyloid protein plaques in the brain. There is currently no cure.

5) Accidents – 122,777. The leading cause of accidental deaths depends on age. For children and young adults it’s car accidents, adults over 35 are most likely to accidentally overdose on drugs, and for those over 65 it’s most likely to be related to a fall.

4) Stroke – 128,931. A stroke occurs when an area of the brain does not receive oxygen due to a ruptured or blocked blood vessel. Those with high blood pressure, diabetics, smokers, and alcoholics are at the highest risk. The good news is that deaths from strokes decreased by almost 45 percent in 10 years but still leads to more than 250,000 hospitalizations yearly.

3) Chronic Lower Respiratory Diseases – 143,382. These diseases of the lungs and airways include bronchitis and emphysema, although the latter kills 20 times more than the former. Smoking is the leading cause of this condition.

2) Cancer – 575,313. Lung, colon, breast, pancreatic, and prostate cancers have the most victims out of more than 200 different types affecting more than 60 different organs. Another piece of good news is that five-year survival rates have increased about 15 percent since the 1970s.

1) Heart Disease – 596,339. Advances in science have improved care, reducing these deaths by 18 percent in 10 years. However, as 25 percent of adults have high blood pressure, 67 percent are overweight, and 20 percent smoke, Americans have plenty of risk factors to improve on.

The United States has maintained its leadership role in biomedical science and needs to continue this in the future. Support biomedical research – your life may depend on that next scientific advance.

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Astronauts with Alzheimer’s

July 19, 2013 by

July 19,2013

By Medical Discovery News

“That’s one small step for a man, one giant leap for mankind.” Since Neil Armstrong uttered those iconic words as he stepped onto the moon for the first time in 1969, researchers have learned that the high levels of radiation an astronaut is exposed to while traveling in space can harm them long after they have returned to Earth. As scientists debate the likelihood of a manned mission to Mars, the issue of long-term exposure poses a significant obstacle, especially now that it has been linked with Alzheimer’s disease.

The radiation in space is more complex than that on Earth, because it includes galactic cosmic radiation and solar particles normally blocked by Earth’s atmosphere. In addition, the Earth’s magnetic field traps some of the radiation from the sun in belts, which space shuttles fly through on their way to outer space. The longer the trip, the greater the exposure, so within a 750-day roundtrip to Mars an astronaut would be exposed to four times the acceptable lifetime radiation limit for a human.

The average person is exposed to 3 millisieverts (mSv) of radiation each year, from radon that naturally exists in the air, small radioactive particles in water and soil, rays from the sun, and medical tests (a chest X-rays delivers about .02 mSv). But if a person were exposed to 50mSv, their blood would start to change. Exposure to 1,000 mSv causes hemorrhage, vomiting, hair loss, and even death within two weeks, such when an accident occurs at a nuclear energy facility like Chernobyl or Fukushima. Exposure to 20,000 mSv can cause death in minutes, as with a nuclear bomb. 

NASA believes that a 3 percent increase of chance of death due to radiation exposure during a space mission is an acceptable risk for astronauts. This increases the astronaut’s lifetime risk of death from cancer to 23 percent, almost a one in four chance. Now a study reveals an additional risk for astronauts exposed to radiation in space: Alzheimer’s disease.

Scientists at the University of Rochester and Harvard University exposed mice to doses of radioactive iron at levels comparable to those expected on a trip to Mars. Six months after the radiation exposure, the mice showed mental impairments including issues with memory. Furthermore, male mice had accumulated the beta-amyloid protein that is associated with the start of Alzheimer’s, suggesting a more rapid progression in male mice.

Obviously mice are different than humans and space explorers would be exposed to more than one type of radiation, so this model may not exactly mimic what would happen to humans traveling to Mars. However, in addition to the increased risk of cancer and death, space explorers must now consider the increased chance for and more rapid development of dementia. New technology to provide radiation shielding for astronauts could minimize the amount of radiation they are exposed to.  

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An Early Start to Alzheimer’s

April 12, 2013 by

April 12, 2013

By Medical Discovery News

More and more data suggest that treatment for Alzheimer’s disease may be more effective if started early, even before symptoms appear. In addition, recent clinical trials of treatments for mild to moderate Alzheimer’s have failed, suggesting that waiting to treat the disease until these stages may be too late, and once the degenerative process has started it cannot be stopped. But since Alzheimer’s has no identifiable markers in its early stages, how would doctors know when and whom to treat?

 

Alzheimer’s is a form of dementia that causes an irreversible loss in brain function and gradually gets worse over time, affecting memory, thinking, and behavior. Buildup of insoluble proteins in the brain causes amyloid plaques or neurofibrillary tangles, two hallmarks of the disease along with a loss in connections between electrically active nerve cells called neurons. There is no definite diagnosis, other than autopsy.

A recent study of an extended family of 5,000 people from Colombia who inherited a form of Alzheimer’s revealed that the disease begins much earlier, and the deterioration of the brain occurs in more ways than previously thought. Affected family members had mild problems thinking and remembering at an average age of 45 and dementia at 53. However, researchers also noticed changes in affected family members at younger ages, before the first signs of plaques in the brain.

The study compared twenty 18- to 26-year-old family members who carried a mutation called presenilin1 E280A and were very likely to develop early onset Alzheimer’s with 24 non-carriers. Both groups underwent a variety of tests including MRIs, memory tests, cognitive tests, blood tests, and cerebral spinal fluid sampling. The groups did not differ significantly in their dementia ratings or psychological scores. However, carriers had fewer neurons in several regions of the brain that are affected by Alzheimer’s. Carriers also had higher levels of the amyloid protein that causes plaques in their cerebral spinal fluid. 

Previous studies of Alzheimer’s patients showed they have lower levels of amyloid than normal, which had been attributed to amyloid accumulating in the brain. Based on this information, scientists thought Alzheimer’s was explained by the progressive buildup of amyloid in plaques that causes brain cells to die, leading to symptoms of Alzheimer’s. This new study suggests that there are early changes in the brain even before amyloid plaques. 

This challenges what we know about when and how Alzheimer’s develops. Inherited, early onset Alzheimer’s may be caused by the body producing too much amyloid, while late onset Alzheimer’s may be the result of the body’s inability to clear amyloid from the brain. Researchers are now focusing on family members ages seven to 17 to determine if they can detect any brain differences even earlier.

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Scanning for Alzheimer’s

September 21, 2012 by

By Medical Discovery News

Sept. 15, 2012

Alzheimer's affects 5.4 million Americans

At first it seems to be occasional forgetfulness, followed by jokes of Mom having another “senior” moment. Then her lapses start to get serious. A teapot left on the stove starts a fire. The family doctor suspects she has dementia, which a neurologist confirms, but when asked if it’s Alzheimer’s Disease, doctors can only guess. Today, the only method available to confirm someone had Alzheimer’s is through an autopsy.

Having the ability to diagnose Alzheimer’s while someone is alive can help rule out other possible conditions such as a drug’s side effects or depression, which can cause similar early symptoms.   Patients could then begin therapies to manage the disease and allow families to make necessary accommodations.

A test recently approved by the Food and Drug Administration combined with clinical symptoms can get doctors pretty close to a diagnosis. The test uses a weakly radioactive fluorescent dye called Amyvid that latches on to amyloid plaques in the brain. Amyloid plaques are protein fragments that normally break down, but in people with dementia they accumulate into hard insoluble plaques. It’s unclear whether amyloid plaques cause Alzheimer’s, but their presence is indicative of the disease. Once Amyvid binds to the plaque, a positron emission tomography or PET scan reveals the location and amount of protein clusters in the brain.

While a clear scan is a relief, patients with a positive scan don’t necessarily have Alzheimer’s. Twenty to 30 percent of people over 65 have some plaque and may never develop dementia. But the test is significant to Alzheimer’s research since it will allow scientists to identify and track people with dementia, expanding their knowledge about the causes of Alzheimer’s and its progression. Scientists can also monitor how the disease develops under experimental therapeutics.

Finding effective treatments for Alzheimer’s will become increasingly important as America’s population ages. It is the No. 1 cause of dementia, affecting 5.4 million people. That number is expected to double in the coming years. By 2050, the cost to treat people with Alzheimer’s is projected to soar to $1.1 trillion.

Currently, there is no cure for Alzheimer’s. Some drugs appear to slow its progression, but the benefit is disappointingly small. Most of what can be done is manage symptoms. While scientists don’t yet fully understand what causes Alzheimer’s, it’s clear the illness develops under a complex series of events in the brain over a long period of time. The causes likely include some mix of genetic, environmental, and lifestyle factors.

Typical symptoms of Alzheimer’s include difficulties performing routine tasks and learning new information, getting lost on familiar routes, language problems, and personality changes. Eventually the memory declines to the point where family members aren’t recognized, language is lost, and basic functions such as eating and dressing require help.

This is only one of many studies into understanding Alzheimer’s that could lead to promising diagnostics and treatments.

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