Alzheimer’s Disease—America’s Tsunami

us-senate-vote-ipoWASHINGTON, D.C.– Amidst a tempest of election season political turbulence, a wave of bipartisan unity is rising in support of biomedical research, according to two US Senators speaking on Tuesday at an Alzheimer’s disease forum in Washington D.C., organized by AtlanticLIVE. “Every one of us knows how vulnerable we are,” says Senator Dick Durbin, D-IL. The Democratic senator shared the stage with Republican Senator, Susan Collins, R-ME who warns that the nation is facing a “tsunami of cases.” As baby boomers enter old age and people are living longer, one out of two people who reach the age of 85 will develop Alzheimer’s disease. “Alzheimer’s disease is going to bankrupt Medicare and Medicaid,” she says. “We cannot afford not to make this investment [in research].”

Despite the prolonged budget battles in congress, funding for medical research seems to be emerging as a possible exception to the long string of miserly cuts in federal spending. “This is special,” Durbin says of funding research on disease. “I believe this issue covers the spectrum [of political opinion].” Senator Collins is seeing the same support building from her Republican allies. “Constituents resonate to Alzheimer’s disease [as a government priority],” she says. Even ardent critics of the contentious Affordable Care Act (Obama Care), including Sen. Lindsey Graham, R-SC, and former Florida Governor Jeb Bush, are united with liberal Democrats on this issue. Collins cites a recent concrete example, “Republicans are in control of the Senate,” she says, “and they just authorized a 60% increase in Alzheimer’s disease funding.”

Members of congress from both sides of the aisle are calling for a national strategy to defeat Alzheimer’s disease, modeled on the rapid response to the AIDS epidemic or the war on cancer started 40 years ago. Last week Senator Collins proposed new legislation to address the lack of long-term care, for example to provide the custodial in-home care that an Alzheimer patient must have. Senator Durbin has proposed a 5% increase in budget to the NIH per year for 10 years to make the necessary investment for breakthroughs in Alzheimer’s disease and other biomedical research.

From Senator Durbin’s perspective this issue goes beyond improving health and relieving human suffering; he sees biomedical research as a matter of national security. The number of research grants funded by the NIH has declined every year for the past 10 years. Between 1999 and 2009, Asia’s share of worldwide research and development expenditures grew from 24 percent to 32 percent. Meanwhile, American expenditures fell from 38 percent to 31 percent. “America’s place as the world’s innovation leader is at risk as we are falling behind in our investment in biomedical research,” he says.

Biomedical research is a powerful force for economic growth. Senator Durbin cites the Human Genome project as an example where the federal investment has been paid back many times over in technological development and economic gain. This is something that has not escaped notice of leaders in other countries, Senator Durbin observes. “Look at what China is doing. They want to be dominant [in biomedical research and in political leadership in the 21st century]. “We better wake up to this reality,” Durbin warns. “America needs to make a strong commitment to biomedical research in the 21st century,” he says.

But is a cure for Alzheimer’s disease realistic? With the exception of rare genetically-induced forms of early onset Alzheimer’s, no one believes that there will be a silver bullet cure for Alzheimer’s disease. This is because Alzheimer’s disease and dementia are a multifactorial problem, says Richard Mohs, Vice President for Neuroscience Clinical Development at Eli Lilly and Company, who also spoke at the forum. Looking to the future from his perspective in the pharmaceutical industry he predicts, “I don’t think we’ll see the disease disappear–at least not in my lifetime. But the risk will go down, just as it has with heart disease.”

This is far more than a glass-half-full view of the problem, because slowing the progress of the disease may be enough. “It [Alzheimer’s disease] is a slow underlying pathology. . . Slowing the disease is essentially a cure for many,” he says, “because of their advanced age.” Senator Collins adds, “If we can delay onset even five years, it pays for the cost of research,” because the cost of caring for someone with Alzheimer’s disease is so enormous. Mohs predicts that the solution to Alzheimer’s disease will involve a combination of life-style changes (including diet and exercise) and drug treatments, much the way diabetes is managed successfully today.

The key will be early diagnosis. PET (positron emission tomography) scanning is a brain imaging technique that can detect amyloid deposits in the brain 10 to 15 years ahead of the memory loss. These deposits eventually damage brain cells and cause dementia. Drugs that have been developed to attack these deposits of amyloid protein show promise, but they don’t cure the disease. In fact, in some cases these drugs have worsened the disease. The consensus of experts is that drug treatment must be started much earlier, before years of slowly advancing pathology reach a point of no return. This is why identifying risk factors and early signs of Alzheimer’s disease at the pre-symptomatic stage are so important. PET scanning can do this a decade before symptoms begin to appear, but the technique is specialized, expensive, and invasive. Unlike MRI brain imaging, radioactive substances must be injected into patients to reveal the amyloid deposits in the brain using a PET scan. New tests to detect proteins in body fluids, cerebral spinal fluid, and even saliva, hold great promise as early warning signs of the disease that could warrant further testing. If simple tests find evidence for Alzheimer’s disease, then early treatments could be started to knock the amyloid deposits out before the brain becomes severely damaged. “Recovery may be possible,” Mohr says, even in those who now have AD, if the progress of the disease could be slowed or therapies to promote cell regeneration and repair were used, because the brain will repair itself if it can.

Alzheimer’s disease affects not only the person afflicted, erasing their memories and leaving them isolated, lost, and dealing with multiple debilitating brain dysfunctions, but it also affects everyone in the family. Senator Collins knows this from “having seen this very close [in her family]. . . Alzheimer’s disease affects even a grandchild whose name is no longer remembered.”

Today there are 5 million Americans with Alzheimer’s disease. There are 43 million family caregivers dealing with the chronic debilitation in loved ones, $450 billion in uncompensated long-term care. Americans aged 85 and older are the fastest growing segment of the population. What we are seeing is only the start of what is certainly a health care tsunami about to roll over American. Making the investment in medical research now will better prepare us to meet that impending crisis.


Alzheimer’s: The Cost of Caring, The AtlanticLIVE

Durbin Introduces The American Cures Act, Press release March 12, 2014

Senator Collins Announces New Legislation in Support of Family Caregivers at National AARP Event. Press Release, July 8, 2015.

Adapted from, Fields, R.D. Burying Political Hatchets to Fight Alzheimer’s Disease. Scientific American Guest Blog, July 23, 2015