Published on February 17, 2014
Elizabeth Chapman, MD University of Wisconsin Hospital and Clinics, Division of Geriatrics
• 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
Percentage Alzheimer's Disease 8% 7% Vascular Dementia 15% Mixed Dementia 65% 5% Dementia with Lewy Bodies Other There are many types of dementia, Alzheimer’s Disease being one of them. Adapted from: http://www.alz.org
• 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) http://www.alz.org/downloads/facts_figures_2013.pdf
72 million people ~20% of US population Baby Boomers turn 65 42 million people ~13% of US population http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/2012_Documents/Docs/EntireChartbook.pdf
Baby Boomers turn 85 http://www.alz.org/downloads/facts_figures_2013.pdf
#5 #6 http://www.cdc.gov/nchs/data/databriefs/db115_fig4.png http://www.cdc.gov/injury/wisqars/pdf/10LCID_All_Deaths_By_Age_Group_2010-a.pdf.
PLUS $9.1 billion in indirect costs related to caregiver health care use resulting from the physical and emotional strains of caregiving $1.2 T $203 B NOW Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf 2050
Cost (Billions) $450 $400 $350 $300 $250 $200 $150 $100 $50 $0 $419 $216 $27 Estimated Cost of Unpaid Caregivers 2011 Walmart Sales (17.5 billion hours of unpaid care) Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf 2011 Total Sales at McDonald's
Cost (Billions) $450 $400 $350 $300 $250 $200 $150 $100 $50 $0 $419 $216 $27 Estimated Cost of Unpaid Caregivers 2011 Walmart Sales Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf 2011 Total Sales at McDonald's
Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf
Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf
• 53% of caregivers report “a good amount” to “a great deal” of financial strain • Higher rates of depression in caregivers (39%) than noncaregivers (17%) • Caregivers rate their personal physical health more poorly than non-caregivers Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf
• 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
Research Goals: 1.A. Identify Research Priorities and Milestones 1.B. Expand Research Aimed at Preventing and Treating Alzheimer’s Disease 1.C. Accelerate Efforts to Identify Early and Presymptomatic Stages of Alzheimer’s Disease 1.D. Coordinate Research with International Public and Private Entities 1.E. Facilitate Translation of Findings into Medical Practice and Public Health Programs http://aspe.hhs.gov/daltcp/napa/NatlPlan2013.shtml
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
Courtesy of Dr. Neil Buckholtz; Lennart Mucke, Nature, Vol 461|15 October 2009
• AD genes • Presenilin-1, Presenilin-2, and Amyloid precursor protein (associated with earlyonset disease) • Apolipoprotein E-e4 (increases risk of lateonset AD) • Still trying to understand what these genes do • Cardiovascular risk factors • High blood pressure, high cholesterol, diabetes • Dietary risk factors • Relationship with exercise
FDG-PET CSF Aβ42 Cog CSF tau Amyloid imaging Function Courtesy of Dr. Neil Buckholtz MRI hipp
Courtesy of Dr. Neil Buckholtz; Klunk et al. Annals of Neurology 2004
• 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 X X X X http://www.alz.org/research/science/alzheimers_treatment_horizon.asp
D E M E N T I A People with a risk of developing Alzheimer’s Disease Medications, physical exercise, mental exercise, healthy http://www.alz.org/research/science/alzheimers_treatment_horizon.asp diet, vaccines
NIA Alzheimer’s Disease Education and Referral Center (ADEAR) Toll-free information line, 1-800-438-4380 Web 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
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