The Current State of Alzheimer’s Disease · 2015-07-23 · 3 What is Alzheimer’s Disease? •...
Transcript of The Current State of Alzheimer’s Disease · 2015-07-23 · 3 What is Alzheimer’s Disease? •...
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The Current State of Alzheimer’s Disease
Beth Kallmyer, M.S.W.
Vice President, Constituent Services Governor’s Conference, 2012
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Outline • Brief overview of Alzheimer’s disease • Impact of Alzheimer’s disease • National Alzheimer’s Plan • Pharmacological interventions • Non-pharmacological interventions • Alzheimer’s Association programs &
services
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What is Alzheimer’s Disease? • Alzheimer's is a type of dementia that
causes problems with memory, thinking and behavior. – Alzheimer's is the most common form of
dementia – Alzheimer’s is not a normal part of aging. – Alzheimer's worsens over time. – Alzheimer's has no current cure, but treatments
for symptoms are available and research continues.
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The challenge began 100 years ago… • November 1906: Alois Alzheimer
presented first case in Germany • 51-year-old Auguste D. had
profound memory loss, confusion, language difficulty, unfounded suspicions about husband and hospital staff
• Her young age made Alzheimer think Auguste had a rare disease associated with middle age
tangles
plaques
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What is happening in the brain?
cortex shrivels, especially near hippocampus
ventricles enlarge
AD brain = smaller overall
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Causes of Alzheimer’s • Age: The greatest known risk factor
• Likelihood doubles about every five years after age 65, after age 85 the risk reaches nearly 50 percent
• Family History • A parent, brother or sister or child with
Alzheimer’s = you are more likely to develop Alzheimer’s disease
• Risk and deterministic genes
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Causes of Alzheimer’s • Heart-head connection:
• Each heartbeat pumps about 20-25 percent of blood to head
• Brain cells use at least 20 percent of the food and oxygen your blood carries
• Increased risk suspected if high blood pressure, heart disease, stroke, diabetes and high cholesterol
• Head injury: • Strong link between serious head injury and future
risk of Alzheimer’s disease
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Alzheimer’s Disease is the 21st Century Healthcare Epidemic
2050
1 in 8 age 65+ 1 in 2 age 85+
16 AS MANY AS
5 MORE THAN
2012
million million
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Alzheimer’s is no longer an emerging crisis – it is here. • An estimated 5.4 million people are living with Alzheimer’s disease today – 5.2 million people age 65 and older and 200,000 under the age of 65 with younger-onset. • Among those 65 and older, 1 in 8 has Alzheimer’s and nearly half of individuals age 85 and older have the disease. • Every 68 seconds, someone develops Alzheimer’s and by 2050 someone will develop the disease every 33 seconds.
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Alzheimer’s and Mortality
• 6th leading cause of death across all ages
• 5th leading cause of death for those aged 65 and older
• Only cause of death among the top 10 in America without a way to prevent, cure or even slow its progression.
• Change in the Number of Deaths: 66%
• Between 2000 and 2008
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Caring for people with Alzheimer’s or other dementias will cost the United States $200 billion in 2012, including $140 billion paid by Medicare and Medicaid.
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Why is Alzheimer’s such a cost driver?
Most people with Alzheimer’s have 1 or more spends o other serious chronic conditions, and dementia complicates the management of other conditions.
A senior with diabetes and Alzheimer’s costs Medica Medicare 81% more than one with diabetes and no Alzh Alzheimer’s and an older person with Alzheimer’s and c cancer costs Medicare 53% more than one with cancer but no Alzheimer’s.
Nearly 30% of people with Alzheimer’s or B another dementia are on both Medicare and Medicaid.
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The costs for caring for people with Alzheimer’s and other dementias will soar from $200 billion this year to a projected $1.1 trillion per year by 2050.
This dramatic rise includes a 500% increase in combined Medicare and Medicaid spending and a 400% increase in out-of-pocket spending for families.
Costs are growing because the number of people with the disease is growing – and fast
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Alzheimer’s doesn’t just happen to individuals – it happens to families.
The economic value of the unpaid care provided to serious those with Alzheimer’s and other dementias totaled $210 billion.
Caregivers take on a tremendous physical and emotion emotional burden to care for a loved one with Alzheim Alzheimer’s. As a result, Alzheimer’s and dementia Alz car caregivers had nearly $9 billion in health care costs of their own.
In 2011, 15.2 million family members and friends provided 17.4 billon hours of unpaid care to those with Alzheimer’s and other dementias.
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The National Alzheimer’s Project Act (NAPA) Public Law 111-375
• Passed unanimously by both houses of Congress on a bipartisan basis requires:
– The creation of an Alzheimer’s Advisory Council.
– National Plan with annual updates.
– Annual recommendations for priority actions.
– Evaluation of all federally funded efforts in Alzheimer’s research, care and services – along with their outcomes.
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Pharmacological • Rigorous Phase I – IV
clinical trials process • Effective for subset of
individuals • Costly
Non-Pharmacological
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Current Alzheimer drugs boost signaling among dwindling neurons
Cholinesterase Inhibitors tacrine (Cognex) donepezil (Aricept) rivastigmine (Exelon) galantamine (Razadyne)
Glutamate Moderators Memantine (Namenda)
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• A broad range of drugs are in clinical trials • These drugs impact biological processes
associated with AD • More than 100 clinical trials on-going
across the US today
Therapeutic Pipeline for Alzheimer’s
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A first-of-its-kind, free, confidential, online and phone-based tool that provides comprehensive clinical trial information and an individualized
trial matching service for people with Alzheimer’s and related dementias.
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Advances in Early Detection of Alzheimer’s
Functional and Molecular Imaging
Structural Neuroimaging
Genetics
Proteomics
Protein production & clearance rates
Targeted biochemical
Neuropsychometric tests
Epidemiology
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Non-Pharmacological Interventions
-Interventions for individuals with Alzheimer’s disease
-Interventions for care-partners of a person with Alzheimer’s disease
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Pharmacological • Rigorous Phase I – IV
clinical trials process • Effective for subset of
individuals • Costly
Non-Pharmacological • Moving towards more
rigorous testing model (like pharmaceuticals)
• Effective for subset of individuals
• Relatively low cost
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• Improved quality of life for individual with Alzheimer’s and their caregiver
• Potential improved cognition, mood, behavior, etc. for individual with Alzheimer’s
• Potential improved quality of life, psychological well-being and mood for care-provider
• Low cost and relatively easy to implement
Benefits of Non-Pharmacological Interventions
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• Target outcomes for interventions: – Improve cognition – Improve Activities of Daily Living (ADL) – Improve Behavior – Improve Mood – Improve Quality of Life – Delay institutionalization
Interventions for Individuals with Alzheimer’s disease
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• Interventions tested to help with cognition: – Cognitive training – group sessions or individual
sessions; teaching of strategies to improve verbal learning; timing varies
– Cognitive stimulation – group sessions; themed activities to orientate and stimulate cognition through association and categorization, etc; 30-60 min, 2-5/week, 4-20 weeks
– Multi-component intervention – enriched group cognitive stimulation and the following: reminiscence, physical exercise, ADL training, support, etc.
Examples of Interventions for Individuals with Alzheimer’s
Olazaran et al. Dementia & Geriatric Cognition Disorders. 2010;30(2):161-78.
** Multi-component intervention found most beneficial
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• Target outcomes for interventions for caregiver: – Improve Psychological Well Being – Improve Mood – Improve Quality of Life
Interventions for Individuals Caring for Someone with Alzheimer’s
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• Interventions tested to help with care provider’s psychological well being: – Cognitive stimulation – group sessions; themed
activities to orientate and stimulate cognition through association and categorization, etc; 30-45 min, 2-3/week, 8-10 weeks
– Multi-component interventions – long-term programs based on caregiver education and support; other components uses depending on individual needs; individual sessions with family caregiver and other family members; 90 min, 1/1-3 weeks, 6-8 mos.
Examples of Interventions for Individuals caring for person with Alzheimer’s
Olazaran et al. Dementia & Geriatric Cognition Disorders. 2010;30(2):161-78.
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• Combination interventions – for individual with Alzheimer’s and their caregiver
• Lifestyle intervention – Diet – Exercise – Diet & exercise – Increasing social engagement – Controlling vascular risk factors (high blood pressure, smoking, etc)
Other Avenues Being Explored…
Olazaran et al. Dementia & Geriatric Cognition Disorders. 2010;30(2):161-78.
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Our vision is a world without Alzheimer’s disease
Our mission: • Advance research • Provide care
and support • Increase Concern &
Awareness • Public Policy &
Advocacy Efforts
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Largest Private Funder of Alzheimer's Research in the World
• Over $300 million to more than 2,100 scientific investigations since 1982
• Fund scientists at all stages of their career; open calls and targeted research funding (RFAs)
• Fund all types of research • 2012: 922 applications; over 70 research awards to
12 countries, ~$12.2M
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Nationwide chapter network • Information and referral • Care consultation • Support groups • Education • Safety services
24/7 Nationwide Helpline
• Information and referral in 140 languages
Alzheimer’s Association
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Alzheimer’s Association International Conference
• July 13-18, 2013 in Boston • Nearly 5000 attendees • All types of research highlighted • Social, Behavioral & Care Research Track
• Dementia Care @ AAIC
– Wednesday, July 17 – Submission now open for oral & poster sessions – www.alz.org/aaic
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Get day-to-day help
Get support
Plan for the future
• Daily care • Stages & behaviors • Support • Safety • Care Options • Legal & financial planning
www.alz.org/care
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Online Tools
• Alzheimer's Navigator • ALZConnected • Care Team Calendar • Comfort Zone® • Community Resource Finder
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Alzheimer’s Navigator • Map out a plan to approach Alzheimer's
– Step-by-step guidance-short surveys – Tips and tools – Local programs and services
• Move at your own pace – Review at your convenience – Prioritize an action plan – Invite others
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ALZConnected
• Connect with others – Message boards – Community solutions – Create and join private groups – Inbox
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Care Team Calendar
A free, personalized online tool to organize family and friends who want to help.
• Powered by Lotsa Helping Hands • Post items for which assistance is needed. • Helpers can sign up for specific tasks. • Friends and family can access AlzConnected message
boards, post announcements and photos, and share information.
• Add new helpers when ask to help.
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Comfort Zone®
• A comprehensive web-based location management service.
• Families can remotely monitor a person with Alzheimer’s by receiving automated alerts when a person has travelled beyond a preset zone.
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Community Resource Finder
• A comprehensive database of resources • All in one location, easy to search
– Medical care – Residential care – Community services – Alzheimer’s Association