Cost of health care for Alzheimer's to surge

With baby boomers entering their 50s and 60s, society can expect to see an explosion in the number of people with Alzheimer's disease within the next 50 years unless prevention or a cure is found, said an executive of the Alzheimer's Association recently.

According to an Alzheimer's Association fact sheet, 11.3 million to 16 million people could be afflicted with the disease by 2050. Since people can live an average of eight years -- some as many as 20 years -- after symptoms appear, the national cost of long-term care will run into the billions.

"With the baby boomers approaching their 60s and the death rates declining -- it's not a maybe -- we're going to be in it," said William Fisher, CEO of the Alzheimer's Association of Northern California and Northern Nevada, which recently hosted a conference on the disease at Stanford.

Advocates such as Fisher say a cure can be found, and researchers are at the cusp of new information that might be the key to prevention.

"There's a growing body of data that relates cardiovascular health to Alzheimer's disease," Fisher said. "By improving cardiovascular health -- watching your cholesterol, weight, blood pressure, getting enough exercise and not smoking -- you minimize the overall risk of getting Alzheimer's."

In the future, people might be immunized to prevent AD, and molecular genetic studies are decoding the processes that lead to the disease. Equally compelling are the advancements in improving the quality of life for both the patient and the family members who care for them.

Four drug treatments have been approved by the Food and Drug Administration: Aricept, Exelon, Reminyl and Namenda. Although the drugs do not cure the disease or get people back to work, they do help to improve memory, attention and concentration. They also help to minimize delusions, anxiety, and mood swings, Fisher said.

Alzheimer's disease is not a normal part of aging, although people who have the disease tend to be older than 65. They often have other chronic diseases such as heart arrythmia, diabetes, osteoporosis, and asthma. Prescription drugs -- taken for 5 to 10 years -- are a major portion of their health care costs.

Advocates are calling for discount medications and changes in Medicare's re-imbursement policies that allow more units of time for office visits. It takes time for patients with Alzheimer's to describe pain, respond to cues and answer questions.

Also experts say family members, who are usually the primary caregivers, need improved insurance coverage for fatigue and stress-related illnesses that come from caring for someone 24/7.

Fisher said doctors are getting better at making referrals. There are a myriad of reasons why doctors are reluctant to manage patients with Alzheimer's for the long haul. They aren't always compliant in taking medications or following directions; nor do they show up consistently for follow-up.

"Old people are expensive to treat," said Fisher, whose grandmother died of Alzheimer's. "You need special re-imbursement from Medicare, and there's no cure."

Lou Sian
Staff Writer, San Mateo County Times

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