By Stephen Prescott, M.D
Copyright © 2017, The Oklahoma Publishing Co.
When the Centers for Disease Control came out with a new report about Alzheimer’s disease in the U.S. late this spring, the statistics were grim.
From 1999 to 2014, death rates from the memory-robbing illness had jumped by 55 percent. The big question is why?
The first part of the answer is that we have grown more sophisticated in our ability to identify Alzheimer’s. While there is still no single, simple test to diagnose the disease, recent years have seen the emergence of an increasing number of methods to determine whether a person suffers from Alzheimer’s: blood tests, brain imaging and a variety of cognitive assessments.
As a result, physicians are increasingly listing Alzheimer’s as the cause of death when they might previously have attributed it to an acute condition associated with the disease. The most prevalent of these conditions is pneumonia, which remains the most commonly identified cause of death among elderly people with Alzheimer’s and other dementias.
The second portion of the answer is one that, depending on how you look at things, is like a glass that’s either half-full or half-empty.
In the first decade of the 20th century, when Dr. Alois Alzheimer first identified the illness that would come to bear his name, the average American died before he or she turned 50. As a result, very few people lived long enough to develop Alzheimer’s.
In the ensuing 110 years, our life spans have stretched considerably; a child born in the U.S. today can expect to live to the age of 80 or so. This remarkable increase is due to a spate of health advances that include childhood vaccinations, antibiotics, control and prevention of communicable diseases like tuberculosis and influenza, and more effective prevention and treatment of chronic conditions like heart disease and some forms of cancer.
Still, with all these successes comes a downside. By living longer, we’ve opened the door to a disease whose primary risk factor is advanced age. As a result, Alzheimer’s cases have surged.
Today, more than 5 million Americans aged 65 and older have the disease. By 2050, health officials expect that number to rise to almost 14 million.
With these mushrooming numbers, we can expect death rates to continue to climb. According to the Alzheimer’s Association, an estimated 700,000 people in the U.S. had Alzheimer’s disease when they died in 2016. Although the disease significantly and directly contributed to almost all of those deaths, many of the death certificates listed other causes such as pneumonia. Nevertheless, a recent study found that Alzheimer’s was the second leading a contributor to deaths in the elderly, trailing only heart failure.
Unfortunately, while we have made significant strides in being able to identify and detect Alzheimer’s at earlier stages of the disease, we haven’t made corresponding advances in treatment. But it’s not for lack of trying.
Over the past two decades, just about every major pharmaceutical company has attempted and failed to develop an Alzheimer’s drug. They’ve tried different approaches and different drug delivery methods, but each clinical trial has been scuttled due to lack of efficacy or side effects. Indeed, this was the fate of the experimental treatment based on the work of the Oklahoma Medical Research Foundation’s Dr. Jordan Tang.
From each failure, researchers do their best to draw new lessons. Yet in the highly competitive world of drug development, pharmaceutical companies guard their data jealously, worried that any peek behind the curtain may give an edge to a competitor. Consequently, we must continue to rely on publicly funded, academic research to move the ball ahead in our understanding of Alzheimer’s.
The chief supporter of this work is the National Institutes of Health. All research that the NIH funds results in freely available publications in scientific journals. Other researchers — and drug and biotech companies — then build on these findings to develop a deeper understanding of and, ultimately, we hope, effective interventions against the disease.
As with all complicated diseases (think, especially, cancer), the search for new therapies has proved slower and more difficult than initially anticipated. But according to the Alzheimer’s Association, 1 in 3 seniors will die with the disease or another form of dementia, and Alzheimer’s will cost the country $259 billion in health and care costs this year.
In other words, we can’t afford not to continue this quest.
Rep. Tom Cole (R. Moore), who chairs the Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies, has served as a vocal advocate for the NIH and the medical research that it funds. Under his leadership, the NIH’s research budget has increased, fueling new initiatives to lay bare the roots of Alzheimer’s.
The current administration, though, has proposed a massive cut to the NIH’s budget. Were this reduction to take effect, there is no doubt that research on Alzheimer’s (and many other diseases) would suffer a major setback.
If we want to triumph over this wretched, memory-robbing disease, it will demand our every resource. Even so, the cost of this effort is dwarfed by the potential costs — both in dollars and human suffering — of turning back. And that’s a price we can ill afford to pay.
A physician and medical researcher, Prescott is president of the Oklahoma Medical Research Foundation and can be reached at [email protected].