Tuesday, October 19, 2010

Alzheimer's: Care, Costs and a Cure

by Lora Gann

Last year my mother passed away after a relatively short battle with Alzheimer's disease. I say that it was relatively short, because in the grand scheme of things from diagnosis to death it was four years. The first two years we dealt with the slowing down of her mind and body, but she still remained the person whom we knew. There were many moments of frustration and fear, but for the most part we were able to deal with living with her new "normal" and enjoy each other.

Then, it got to the point when there was no more hiding. The family was in a constant state of high alert and crisis. We were helping to manage her care and trying to keep her in the house for as long as possible. A big concern was making sure that my father remained healthy, too. A new vocabulary replaced our old one: care givers, elder-care lawyers, shower seats, chair-lifts, ramps, long term care insurance, in-home visits, day care, companions, cognitive assessments, rehab, physical therapy, drug therapy, and more.

This disease is tragic and robs you of your dignity. My mother was a very proud woman who never wanted to live in an incapacitated way. She never wanted to burden her family and she wanted the end of her life to be as she lived - full of spirit, generosity, love and laughter. Unfortunately, that was not to be the case. It was a very sad end to her very vibrant life.

Ours was a very private battle. But, today, this disease affects 35 million people around the world and by the year 2050 it is predicted that 115 million people will have Alzheimer's, making this disease an enormous, world-wide public crisis. According to the World Alzheimer Report 2010* that was just published in September, the costs of caring for people affected by dementia have risen at an alarming rate and have impacted every health and social system in the world. This has dramatically affected the global economy; the total estimated worldwide costs of dementia are $604 billion in 2010 - 1% of world's gross domestic product.

Here are a few findings from this report and other recent research:

The likelihood of developing Alzheimer's doubles about every 5 years after age 65.
About 1 out of every 2 people over the age of 85 has Alzheimer's.
About 70% of the costs occur in Western Europe and North America.
In North America it is estimated that the annual cost of care per person is $48,605. And, in places in Latin America costs are estimated to be around $5,500 per person and in South Asia it is $903.
As population ages and life expectancy increases, we can expect these costs to rise sharply.

Costs include:

1. care giving by family and friends -- time family spend caring and helping with eating, dressing, bathing, toileting and grooming and shopping, preparing food, transporting and managing the household including finances

2. support provided by community care professionals - formal services provided outside the medical care system, including community services such as home care, food supply and transport and residential or nursing care

3. medical care - hospital care, medication and clinical care
Low and middle income countries are expected to have the sharpest increases. By 2050 2/3 of the people who have Alzheimer's will be from low and middle income countries.

In some high income countries between 1/3 and 1/2 of all people with dementia live in residential or nursing care facilities.

The report urges the international community to coordinate research and cost-effective approaches in order to manage these escalating costs, the societal burden and medical advances.

The risk factors of developing Alzheimer's disease are detailed as follows:

Advancing age.

Family history. People who have a parent or sibling that have developed Alzheimer's are 2-3 times more likely to develop Alzheimer's. Risk factor increases if more than one close relative has been affected.

Tobacco usage, poor diet, lack of exercise, alcohol consumption and social isolation all contribute.

High blood pressure, heart disease, stroke, diabetes and high cholesterol.


Research shows that there is a connection between heart health and brain health. Jean Carper's new book, "100 Simple Things You Can Do To Prevent Alzheimer's" offers the reader a comprehensive "to-do" list backed by medical studies. It is written with a tone that is both helpful and optimistic. She is an active 78 year old writer who, being at higher risk for Alzheimer's because she carries the gene,
ApoE4, decided to teach us all that the cure for Alzheimer's is prevention.

Much of what she reports is common sense and advice we have heard over and over again by our medical practitioners: Don't eat processed foods, cut back on saturated fats, exercise, eat brightly colored fruits and vegetables, watch your sugar in-take, and eat fish a couple of times a week.

But some of what she tells us may be surprising. Among them are: Being lonely can escalate Alzheimer's. Eating a lot of red meat can cause inflammation which can cause Alzheimer's. Lifting weights and strength training can limit loss of muscle mass which can in turn increase cognitive functions. A compound found in olive oil which contains antioxidants can help prevent the destruction of brain cells. Limit your usage of pesticides. Caffeine may actually help reverse some of the damage done by Alzheimer's. Cutting down your calorie intake can reduce factors that promote the disease. By keeping your brain busy your whole life, neuroscientists say your brain can actually ignore the symptoms of Alzheimer's, even though the pathology shows you should have the disease.

She sites research studies and doctors for each item on her list. It is a very interesting and easy read. Incorporating much of what she advises will not only help our mental health, but it will help us fight numerous other diseases as well.

Since some people live up to 15 years after diagnosis with this disease, we can see how families can become financially and emotionally devastated. So, what should we do? We know we can't hide from the threat of this disease, it is all around us. But, we can try to strengthen our heart health and mind health. We can make sure that our resources are protected by having a sound financial plan and long term care insurance. And, we should have very candid and open discussions with our loved ones about our wishes.

Though medical advances are being discovered all the time, it is time to take matters in our own hands and act on the idea that prevention can be a cure.

* World Alzheimer Report 2010, The Global impact of Dementia. Published by Alzheimer's Disease International, September 2010

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