In the last several weeks I lost my phone (recovered), my iPod (gone) and even a piece of jewelry (I am pretty sure the cat is guilty). I was at the airport when I couldn’t remember where I parked my car for long enough to wonder if I actually did drive myself there. Don’t judge me; I know you do it too. I have a certain relative who would have 25% more free time if only he didn’t constantly forget where he left his pen.
All of us are prone to losing objects and forgetting appointments and struggling for that word on the tip of our tongue that we definitely should know. Sometimes we even forget the names of people who live in our house just for a second; admit it: how many times have you called your kid by the dog’s name? “Hey Fluffy—set the table!” Kids hate that, by the way.
Those momentary lapses of memory can be amusing or frustrating, but they usually don’t slow us down much. We laugh it off and say, “wow, I must be getting old” and move on to the next task. An op-ed I read recently in the NY Times, however, made me realize we don’t long have the luxury of humor when it comes to this issue.
Authored by Supreme Court justice Sandra Day O’Connor (ret.), Nobel Laureate neurologist Dr. Stanley Prusiner and Age Wave expert Ken Dychtwald, and entitled The Age of Alzheimer’s, the article pointed out these astonishing facts:
Starting on Jan. 1, our 79-million-strong baby boom generation will be turning 65 at the rate of one every eight seconds. That means more than 10,000 people per day, or more than four million per year, for the next 19 years facing an increased risk of Alzheimer’s. Although the symptoms of this disease and other forms of dementia seldom appear before middle age, the likelihood of their appearance doubles every five years after age 65. Among people over 85 (the fastest-growing segment of the American population), dementia afflicts one in two. It is estimated that 13.5 million Americans will be stricken with Alzheimer’s by 2050 – up from five million today.
Holy crap, is all I have to say to that. I better start labeling my possessions and family members now because we are all going to be walking around saying “who are you again?” sooner than we like to think.
13.5 million people with Alzheimer’s; that is 4.3% of the US population and a much larger number than those who, for example, have breast cancer or AIDS at any given time. Contrast that Alzheimer’s figure to the 11 million total cancer survivors alive today. It’s obviously a bigger number, but it is also a story that ends badly, as compared to the better news greeting cancer patients every day. Billions of dollars in research channeled into cancer treatment and cure has led to dramatically increased odds of survivorship, with many people living 20 years or more after receiving a cancer diagnosis. People with Alzheimer’s rarely live more than 4-5 years post-diagnosis.
Alzheimer’s has no known prevention or cure and its cause isn’t even known. Because of this the disease is progressing in prevalence and the odds of dying from it are marching forward as well. According to research performed by those in the know, the odds of dying from Alzheimer’s grew by 46% from 2000 to 2006 while the chance of dying from heart disease declined by 11% during that same time period.
The real point of the op-ed piece was to send a call to action to fund Alzheimer’s research on both prevention and treatment, which the authors point out as grossly underfunded. As an example, the National Institutes of Health spend about $3 billion a year on AIDS research, while Alzheimer’s, with five times as many victims, receives only $469 million. Unspoken in the article but clear to me is that there should also be a call to action for healthcare venture capitalists, who have a particularly large opportunity to capitalize upon if they can fund companies to address this monumental looming problem.
What I found particularly compelling about the op-ed’s call for Alzheimer’s research funding are the economic arguments made in support of it. The authors write:
As things stand today, for each penny the National Institutes of Health spends on Alzheimer’s research, we spend more than $3.50 on caring for people with the condition. This explains why the financial cost of not conducting adequate research is so high. The United States spends $172 billion a year to care for people with Alzheimer’s. By 2020 the cumulative price tag, in current dollars, will be $2 trillion, and by 2050, $20 trillion.
Considering that the current cost of running our ENTIRE healthcare system (all diseases, medical errors and inefficiencies included) is estimated at around $2.3 trillion, I am wondering what the heck our healthcare policy leaders are thinking when Alzheimer’s isn’t even usually mentioned among the key chronic diseases that need attention. Make sure to let this statistic really sink in: left to progress as it currently is, in 2050 Alzheimer’s will cost our nation 10 times what the entire healthcare system costs today. It is hard for me to even fathom that notion.
Peter Orszag, until recently the Director of the U.S. Congressional Budget Office, testified before Congress a few years ago about the factors contributing to rising healthcare costs and one of his comments was, “aging played only a minor role in the large increases in spending that occurred…the course of technological innovation will have a far greater effect on cost growth.” Um, seriously? I am not quite sure how Orzag’s math fits with the facts at hand. In fact, if you look at this article published in the Health Services Research Journal, and you look at this chart in the article:
you will see that the impact of age, historically estimated as contributing about 2% of the ongoing cost increase (as noted by Orszag), will, by 2050, drive 18% of the anticipated cost increase in our healthcare system. Some say people who ignore history are doomed to repeat it, but in this case ignoring the socio-economic impacts of the future may create a greater doomsday scenario. The primary known risk factor contributing to the rise in Alzheimer’s is aging. If Alzheimer’s can produce costs that are nearly 10 times the cost of our entire healthcare system within 40 years, we had better pray that we can’t remember what is happening around us. It won’t be pretty. Either that or we better get to work fixing the problem stat.
The New York Times op-ed notes that there is pending legislation before Congress that would raise the federal government’s annual commitment to Alzheimer’s research to $2 Billion and create a dedicated federal entity focused on this problem. Since we are spending a little more than $1.5 Billion per week (!) on the Afghanistan war, all we need is to end the war a week and a half earlier to cover that cost. Not to be flip but seriously, it is a zero-sum game and our political leaders seem to be hell-bent on ending up with zero. Since 46 of our current U.S. Senators and 110 of our current U.S. Congresspersons are over the age of 65, it seems one could make a compelling and very personally relevant argument to these elected officials to support the proposed Alzheimer’s legislation—they are the very individuals who should be afraid NOT to act.
I sincerely hope that our political leaders remember to do something about Alzheimer’s before they are too old and infirm to remember where they work. Former Defense Secretary and military strategist Paul Nitze once said, “One of the most dangerous forms of human error is forgetting what one is trying to achieve. “ If, by reforming our healthcare system, our political leadership is trying to achieve it’s long-term viability, they need to remember to deal with Alzheimer’s in an aggressive and thoughtful way. Failure to do so could make our national economic viability a lost memory.
An excerpt from this piece ran on November 10 on The Health Care Blog