Medications To Treat The Underlying Alzheimer’s Disease Process
Aducanumab is the first disease-modifying therapy approved by the FDA to treat Alzheimers disease. The medication helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical outcomes such as progression of cognitive decline or dementia. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.
Aducanumab was approved through the FDAs Accelerated Approval Program. This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.
Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimers as potential treatments.
Who Gets Alzheimers Disease
- 2-in-3 people with Alzheimers are women.
- African and Hispanic Americans are more likely to develop Alzheimers than Caucasian Americans.
- Mississippi has a higher rate of Alzheimers mortality than any other state at 45.8%.
- Alzheimers mortality is lowest in New York at 13.1%.
- 30% of people with Alzheimers also have heart disease, and 29% also have diabetes.
What Happens To The Brain In Alzheimer’s Disease
Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimers disease. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems become evident. During this preclinical stage of Alzheimers disease, people seem to be symptom-free, but toxic changes are taking place in the brain. Abnormal deposits of proteins form amyloid plaques and tau tangles throughout the brain, and once-healthy neurons stop functioning, lose connections with other neurons, and die.
The damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories. As more neurons die, additional parts of the brain are affected. By the final stage of Alzheimers, damage is widespread, and brain tissue has shrunk significantly. Read more about what happens to the brain in Alzheimer’s »
This 4-minute captioned video shows the intricate mechanisms involved in the progression of Alzheimer’s disease in the brain.
What Are The Signs And Symptoms Of Dementia
Because dementia is a general term, its symptoms can vary widely from person to person. People with dementia have problems with:
- Reasoning, judgment, and problem solving
- Visual perception beyond typical age-related changes in vision
Signs that may point to dementia include:
- Getting lost in a familiar neighborhood
- Using unusual words to refer to familiar objects
- Forgetting the name of a close family member or friend
- Forgetting old memories
- Not being able to complete tasks independently
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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Disparities Still Impacting Health And Health Care
Reducing or eliminating disparity has been part of the national conversation as a key goal of the U.S. Department of Health and Human Services Healthy People initiative for more than 20 years., Yet disparity is still evident in health and health care.
While health disparities and health care disparities are often used interchangeably, there are important distinctions between the two terms. A health disparity exists when there is a higher burden of illness, injury, disability, or mortality in one group relative to another, whereas a health care disparity is used to describe differences between groups in health insurance coverage, access to and use of health care, and quality of health care. For both these disparities, the differences are not explained by variations in health needs, patient preferences, or treatment recommendations and are closely linked with social, economic, and/or environmental disadvantage.
The existence and adverse effects of health disparities are well documented. For example, Blacks and Native Americans are more likely than Whites to report a range of health conditions, including asthma and diabetes. Native Americans also have higher rates of heart disease compared with Whites.
Health care system factors that contribute to disparity should also be acknowledged. These include implicit bias on the part of health care providers, as well as cultural and language barriers that impede patient-provider relationships.
The Most Expensive Disease In The Nation
A 2017 report from UsAgainstAlzheimers shows that the U.S. has vastly underestimated the public costs and consequences of the Alzheimers epidemic, and major social trends have direct and adverse implications for our capacity to cope with the Alzheimers epidemic in the years ahead.
- Total annual out-of-pocket payments in the U.S. for healthcare, long-term care, and hospice care for people with Alzheimers and other dementias are projected to reach $1.1 trillion by 2050, if we dont develop a treatment or cure.
- Medicare and Medicaid only cover $175 billion, or approximately 68% of the out-of-pocket healthcare costs.
- Medicaid payments are on average 23 times higher for those with Alzheimers compared to those without, and Medicare payments are three times greater on average. By 2050, Alzheimers is expected to increase Medicare and Medicaid costs by over 330%.
- More than $250 billion is spent annually in out-of-pocket healthcare for Alzheimers, which is more than 179 times the amount spent on finding a cure.
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How Many Americans Have Alzheimers Disease
Estimates vary, but experts suggest that more than 6 million Americans age 65 and older may have Alzheimers. Many more under age 65 also have the disease. Unless Alzheimer’s can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. This is because increasing age is the most important known risk factor for Alzheimers disease.
Alzheimer’s In The United States
lzheimers in the United States is becoming more prevalent than ever.
The number of men and women with Alzheimers disease is expected to double in the next 30 years, according to a new analysis of U.S. Census data.
It is estimated that 6 million Americans aged 65 and older have Alzheimers today, or about one new case every 65 seconds. This number is expected to rise to 13 million.
High Costs And Effects Of Caregiving
- The estimated number of caregivers for people with Alzheimers and other dementias in 2020 is 11.2 million.
- Caregivers provided 15.3 billion hours of unpaid care in 2020, valued at almost $257 billion, to people living with Alzheimers and other dementias.
- Two-thirds of dementia caregivers are women.
- The prevalence of depression is higher among dementia caregivers than other caregivers, such as those who provide help to individuals with schizophrenia or stroke .
Duration Of Illness From Diagnosis To Death
Studies indicate that people age 65 and older survive an average of four to eight years after a diagnosis of Alzheimer’s dementia, yet some live as long as 20 years with Alzheimer’s dementia., – This reflects the slow, insidious and uncertain progression of Alzheimer’s. A person who lives from age 70 to age 80 with Alzheimer’s dementia will spend an average of 40% of this time in the severe stage. Much of this time will be spent in a nursing home. At age 80, approximately 75% of people with Alzheimer’s dementia live in a nursing home compared with only 4% of the general population age 80. In all, an estimated two-thirds of those who die of dementia do so in nursing homes, compared with 20% of people with cancer and 28% of people dying from all other conditions.
Managing Alzheimer’s Disease Behavior
Common behavioral symptoms of Alzheimers include sleeplessness, wandering, agitation, anxiety, and aggression. Scientists are learning why these symptoms occur and are studying new treatments drug and nondrug to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimers more comfortable and makes things easier for caregivers.
At A Glance: Alzheimer’s Disease
Promoting Health and Independence for an Aging Population
Alzheimers disease, a type of dementia, is an irreversible, progressive brain disease that affects an estimated 5.7 million Americans. It is the sixth leading cause of death among all adults and the fifth leading cause for those aged 65 or older.
The causes of Alzheimers disease and other dementias are not completely understood, but researchers believe they include a combination of genetic, environmental, and lifestyle factors. In more than 90% of people with Alzheimers, symptoms do not appear until after age 60. The incidence of the disease increases with age and doubles every 5 years beyond age 65.
The Centers for Disease Control and Prevention leads our nations public health efforts to help older adults with dementia to remain active, independent, and involved in their community by:
- Helping to promote awareness of Alzheimers disease and other dementias, including the importance of early diagnosis.
- Studying the societal and economic burden of dementias in states and communities.
- Supporting data collection on cognitive decline and caregiving.
- Working to ensure that caregivers have the resources to provide quality care to people with dementia.
What Is Known About Reducing Your Risk Of Alzheimers Disease
The science on risk reduction is quickly evolving, and major breakthroughs are within reach. For example, there is growing evidence that people who adopt healthy lifestyle habits like regular exercise and blood pressure management can lower their risk of dementia. There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. To learn more about the current state of evidence on dementia risk factors and the implications for public health, please read the following summaries on Cardiovascular Health, Exercise, Diabetes and Obesity, Traumatic Brain Injury , Tobacco and Alcohol, Diet and Nutrition, Sleep, Sensory Impairment, and Social Engagement or the Compiled Report .
Racial And Ethnic Disparities Exist In Alzheimer’s And Dementia Care
Racial and ethnic disparities in health and health care, such as those observed during the pandemic, extend to dementia care. Stigma, cultural differences, awareness and understanding, and the ability to obtain a diagnosis, manage the disease, and access care and support services for dementia vary widely depending on race, ethnicity and socioeconomic status. These disparities reach beyond clinical care to include uneven representation of Black, Hispanic, Asian, and Native Americans in Alzheimer’s research in clinical trials.
As discussed in the Prevalence section, health and socioeconomic disparities and systemic racism contribute to increased Alzheimer’s and dementia risk in communities of color., , , , -, , Older Black and Hispanic Americans are also disproportionately more likely to have Alzheimer’s and other dementias, as well as more likely to have missed diagnoses, than older White Americans.-, –
Caregiving for individuals with Alzheimer’s or other dementias differs between racial and ethnic groups too. These differences include the time spent on caregiving, cultural perceptions of the burden of caregiving, whether social networks provide support, and the psychological well-being of the caregiver.-,
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Concerned About Having Alzheimers
If youre concerned about your thinking or memory, or want to establish a baseline from which to monitor your cognition, BrainTest® is the application for you. BrainTest is the same kind of screening test at doctors offices, but one thats uniquely designed to screen for early changes in cognition associated with Alzheimers Disease, Dementia, and Mild Cognitive Impairment. BrainTest can be taken in the privacy of your own home, anonymously scored at our centralized scoring core-lab, and result videos delivered inside the application feature an explanation of your score from a Board Certified Physician. When youre ready, these results can be shared with your doctor to help start the conversation if youre concerned.
Alz. . Latest Facts and Figures Report. Alzheimers Association. Retrieved from
Alzheimers Statistics Amongst Americans
This year, 5.3 million Americans will live with Alzheimers in the United States, with an approximate 5.1 million people being 65 years and older. In terms of gender, 3.2 million are females and 1.9 million are male. Ethnicity also plays a role, as older African-American and Hispanic individuals are more likely to suffer from Alzheimers in comparison to older white individuals.
In terms of mortality rates, an estimated 700,000 people will die this year alone from Alzheimers. It is true that deaths from other major causes have decreased, however, deaths from Alzheimers have significantly increased. Between the years of 2000 and 2013, mortality rates increased by 71 percent.
Last, its important to focus on those who are caregivers and friends and family members provided an approximate 17.9 billion hours of unpaid care last year. This is emotionally taxing, as nearly 60 percent of Alzheimers caregivers report very high emotional stress.
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A Costly And Growing National Crisis
- In 2021, the total national cost of caring for people living with Alzheimers and other dementias is projected to reach $355 billion. This number does not include the estimated $257 billion price of unpaid caregiving.
- Medicare and Medicaid are expected to cover $239 billion, or 67%, of the total health care and long-term care payments for people with Alzheimers or other dementias. Out-of-pocket spending is expected to be $76 billion, or 22% of total payments.
Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . Dementia may also develop after a stroke or in the context of certain infections such as HIV, harmful use of alcohol, repetitivephysical injuries to the brain or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
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What Are The Stages Of Alzheimers
Alzheimers disease slowly gets worse over time. People with this disease progress at different rates and in several stages. Symptoms may get worse and then improve, but until an effective treatment for the disease itself is found, the persons ability will continue to decline over the course of the disease.
Early-stage Alzheimers is when a person begins to experience memory loss and other cognitive difficulties, though the symptoms appear gradual to the person and their family. Alzheimers disease is often diagnosed at this stage.
During middle-stage Alzheimers, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. People at this stage may have more confusion and trouble recognizing family and friends.
In late-stage Alzheimers, a person cannot communicate, is completely dependent on others for care, and may be in bed most or all the time as the body shuts down.
How long a person can live with Alzheimers disease varies. A person may live as few as three or four years if he or she is older than 80 when diagnosed, to as long as 10 or more years if the person is younger. Older adults with Alzheimers disease need to know their end-of-life care options and express their wishes to caregivers as early as possible after a diagnosis, before their thinking and speaking abilities fail.
Clinical Trials And Research
- Important clinical trials that focus on potential prevention and treatment for Alzheimers are under way, but we must continue to urge that these trials be sped up and that participants reflect the diversity of all those with Alzheimers. See our clinical trial page for more information.
- It is important that our government officials make fighting Alzheimers a national priority and dedicate adequate resources to research. Go to our action centerfor concrete ways that you can help.
- UsAgainstAlzheimers Chairman and Co-Founder George Vradenburg serves on the World Dementia Council to tackle this problem globally. Find out more about their work here.
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