Alzheimer's Disease Prevalence, Economics, Risk & Current Research

Alzheimer’s Disease Prevalence, Economics, Risk and Current ResearchElizabeth Chapman, MDUniversity of Wisconsin Hospital and Clinics, Division of Geriatrics

Dementia: Definition (adapted from DSM-IV)• Decline in memory and in at least one of the

following cognitive abilities:• Ability to speak coherently or understand spoken or

written language.• Ability to recognize or identify objects, assuming intact

sensory function.• Ability to perform motor activities, assuming intact motor

abilities and sensory function and comprehension of the required task.• Ability to think abstractly, make sound judgments and

plan and carry out complex tasks.

• The decline in cognitive abilities must be severe enough to interfere with daily life.

http://www.alz.org/downloads/facts_figures_2013.pdf

Types of Dementia

65%

5%

15%

7%8%

Percentage

Alzheimer's Disease

Vascular Dementia

Mixed Dementia

Dementia with Lewy Bodies

Other

Adapted from: http://www.alz.org

There are many types of dementia, Alzheimer’s Disease

being one of them.

Alzheimer’s Disease (AD)• Most common type of dementia – 60-80% of all

cases• Progressive neurodegenerative disorder• Clinical diagnosis is based on symptoms:• Problems with memory AND one or more other cognitive

disturbance• Symptoms develop gradually

• Definite diagnosis is based on characteristic changes in brain pathology (plaques, tangles)


Changing US Demographics

http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/2012_Documents/Docs/EntireChartbook.pdf

72 million people~20% of US population

42 million people~13% of US population

BabyBoomers turn 65

Dementia Trends with Age


Increasing Prevalence of Alzheimer’s Disease


Baby Boomers turn 85

Costs of Dementia: Mortality

http://www.cdc.gov/nchs/data/databriefs/db115_fig4.pnghttp://www.cdc.gov/injury/wisqars/pdf/10LCID_All_Deaths_By_Age_Group_2010-a.pdf.

#6

#5

Costs of Dementia: Mortality


Costs of Dementia: Monetary

Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf

PLUS $9.1 billion in indirect costs related to caregiver health care use

resulting from the physical and emotional strains of caregiving

2050

$1.2 TNOW

$203 B


Estimated Cost of Unpaid Caregivers

2011 Walmart Sales

2011 Total Sales at McDonald's

$0 $50

$100 $150 $200 $250 $300 $350 $400 $450

$216

$419

$27

Cost (Billions)

(17.5 billion hours of unpaid care)Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf


Estimated Cost of Unpaid Caregivers

2011 Walmart Sales

2011 Total Sales at McDonald's

$0 $50

$100 $150 $200 $250 $300 $350 $400 $450

$216

$419

$27

Cost (Billions)


Costs of Dementia: Caregiver Stress


Costs of Dementia: Caregiver Stress


Costs of Dementia: Caregiver Stress• 53% of caregivers report “a good amount” to “a

great deal” of financial strain• Higher rates of depression in caregivers (39%)

than non-caregivers (17%)• Caregivers rate their personal physical health

more poorly than non-caregivers


Dementia Research• In 2012, the Obama Administration announced a

plan to commit $156 million to address Alzheimer’s Disease

• The US Department of Health and Human Services’ National Plan to Address Alzheimer’s Disease aims to:• Prevent and Effectively Treat Alzheimer’s Disease by 2025. • Enhance Care Quality and Efficiency. • Expand Supports for People with Alzheimer’s Disease and

Their Families. • Enhance Public Awareness and Engagement. • Track Progress and Drive Improvement.

http://aspe.hhs.gov/daltcp/napa/NatlPlan2013.pdf

Dementia Research

Research Goals:1.A. Identify Research Priorities and Milestones1.B. Expand Research Aimed at Preventing and Treating Alzheimer’s Disease1.C. Accelerate Efforts to Identify Early and Presymptomatic Stages of Alzheimer’s Disease1.D. Coordinate Research with International Public and Private Entities1.E. Facilitate Translation of Findings into Medical Practice and Public Health Programs

http://aspe.hhs.gov/daltcp/napa/NatlPlan2013.shtml

Tasks for Researchers

Understand the how

Alzheimer’s

Disease affects brain cells

Identify the

triggers for

Alzheimer’s

Disease

Find ways to

diagnose the

disease earlier

Discover better

ways to treat

Alzheimer’s

Disease

Uncover ways to prevent

Alzheimer’s

Disease

Understanding how AD affects brain cells

Courtesy of Dr. Neil Buckholtz; Lennart Mucke, Nature, Vol 461|15 October 2009

Identifying Triggers for AD• AD genes • Presenilin-1, Presenilin-2, and Amyloid

precursor protein (associated with early-onset disease)• Apolipoprotein E-e4 (increases risk of

late-onset AD)• Still trying to understand what these

genes do

• Cardiovascular risk factors• High blood pressure, high cholesterol,

diabetes

• Dietary risk factors• Relationship with exercise

Finding Ways to Diagnose AD Earlier

Courtesy of Dr. Neil Buckholtz

Amyloid imaging

FDG-PET

MRI hipp

CSF Aβ42

CSF tau

Cog

Function

Finding Ways to Diagnose AD Earlier

Courtesy of Dr. Neil Buckholtz; Klunk et al. Annals of Neurology 2004

Discovering Better AD Treatments• Treatment Targets• Drugs that reduce beta-amyloid levels in the body and

brain• Preventing tau protein from forming tangles• Reducing inflammation in the brain • Decrease insulin resistance, cholesterol build-up in blood

vessels

http://www.alz.org/research/science/alzheimers_treatment_horizon.asp

XX

XX

Preventing Alzheimer’s Disease

People with a risk of developing Alzheimer’s Disease

DEMENT IA

Medications, physical exercise, mental exercise, healthy diet,

vaccineshttp://www.alz.org/research/science/alzheimers_treatment_horizon.asp

AD ResourcesNIA Alzheimer’s Disease Education and Referral Center (ADEAR)

Toll-free information line, 1-800-438-4380Web site (English & Spanish) : www.nia.nih.gov/alzheimers

HHS Alzheimer’s.gov

http://www.alzheimers.gov/

Alzheimer’s Association

Web site: www.alz.org

Courtesy of Dr. Neil Buckholtz

http://www.nia.nih.gov/alzheimers

http://www.alz.org/

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Alzheimer's Disease Prevalence, Economics, Risk & Current Research