Choices for Alzheimer’s management: more nursing home beds or medical research?

Before discussing these 2 choices, here are some interesting facts regarding Alzheimer’s that I have come across in my research.

Alzheimer’s ranks as the 6th leading cause of death in the US, surpassing  breast and  prostate cancer deaths combined; currently, someone develops Alzheimer’s every minute (thats 60 new cases every hour, 1440 for each day (24×60) and  525,600  for each year (1440×365). Predictions are that by 2050, this rate will double to a new case of Alzheimer’s developing every 30 seconds doubling the number to over 1 million new cases annually.

The medicare costs today to treat Alzheimer’s in the USA is $236 billion annually, excluding the $5000 that caregivers also spend annually. Based on the increase in the number of people over age 85, it is predicted that these costs will rise to over one trillion dollars annually by 2050.

Canadian picture -just as gloomy: according to Canadian vital statistics for  2013 , Alzheimer’s ranked as the 5th major cause of death behind, cancer, heart disease, stroke, and chronic respiratory disease; because the elderly are currently the fastest growing segment of our population  there are now more people over age 65 than those under age 17 with the prediction that by 2050 half of the elderly will be over age 85.

Since incidence of Alzheimer’s increases with age, only 8% of the Canadian population have some degree of Alzheimer’s at age 65, but by age 85 this incidence increases to 35%.  By the year 2050, with half of the the Canadian population over the age of 85, 35% of them could have Alzheimer’s, an alarming prognosis. It could also become the number one cause of death. The current annual health care costs for Alzheimer’s is around $30 billion,  which could increase to over $300 billion by 2050. It alone could bankrupt our healthcare system in Canada.

We desparetly need a solution now. In the title of this post I suggested there were 2 routes available: more nursing home beds or basic research to find the cause and cure  of Alzheimer’s. As with other pandemics in the past we also had similar 2 choices. For example, in the 1940’s and 50s with the polio epidemic, governments were facing a similar policy decision – should they   invest their resources to build more and better iron lungs and hospitals for the patients who need them? Or should they invest in basic medical research to find a cure for polio? The National Foundation for Infantile Paralysis as it was called in those days chose the latter – a wise decision.

Regarding Alzheimers we have the same 2 choices-more nursing home beds or medical research.  I especially like the comments by Dr. Roy Walford in his book  Maximum Life Span. (pages 17-18):

“… My point is that old age homes and all the vast social support structures continuously accumulating to care for the helpless aged are the iron lungs of gerontology. Improvements in the social, economic and medical support system for the elderly will merely provide symptomatic relief for an expanding problem. …” .

By giving top priority to constructing 1200 more nursing home beds, the province of Manitoba would seem to have made their decision. Of note in  Saskatchewan, the government claims that everyday there are 10 new cases of Alzheimer’s. That’s over 3600 cases each year. If eventually, 25% of these cases require nursing home beds, then the province would need to build over 900 beds annually. In the 19th century, tuberculosis – known also as the white plague – was the leading cause of death, claiming over 35% of the population. Sanatoria like the one in Ninette, Manitoba were quickly constructed and filled. With the discovery of antibiotics which specifically killed the tuberculosis bacterium, patients no longer needed to go to sanatoria to be cured and these buildings soon became museums.

I have become quite fascinated with the advances made in Alzheimer’s research, and will discuss the topics of the role of Vitamin D and the 7 common ways we have to slow the aging process in my future posts.

Nursing homes as research labs for dementia

The opening statement of the Report entitled “Nutritional Strategies to Combat Alzheimer’s” in the March 2013 issue of Life Extension Magazine, reads as follows:

“Someone in America develops Alzheimer’s every 68 seconds. This rate is projected to more than double by 2053, to one every 33 seconds.”

Since we in Canada have roughly 1/10th of the US population, the corresponding rate for Canada should be roughly one tenth that of USA.

In a recent radio and TV announcement, Canadian health officials outlined the costs of treating Alzheimer’s from the current 30 billion annually to over 300 billion within a couple of decades.

After reading this article, and with my recent attendance at a nursing home meeting where the CEO of that nursing home outlined plans for bed expansion, it occurred to me that nursing homes with their unique resident profile (compared to patients in hospitals or medical offices), might be excellent ‘labs’ to conduct clinical research on Alzheimer’s disease.

When I reviewed my blog, I found a post where I gave some statistics on incidence of dementia, and also my plans for to develop a podcast.

I have experience in the field of genetics and gerontology. I set up 3 private medical research Labs, including the Winnipeg Clinic Research Institute, the Kildonan Institute of Gerontology, and a private Cytogenetic diagnostic Lab. During my research career, I published over 40 scientific papers. Since the mid-1990’s as a medical educator, I have used the information gathered from various sources to develop various tools such as presentations, websites and blogs and videos to share to share my knowledge and interest in research and life extension. Sources I have leveraged include the Life Extension Foundation, Wellness magazine, A4M, etc., as well as my personal library of over 500 volumes, my clinical practice of over 30 years, and more than 20 years of experience treating elderly patients at the Holy Family Nursing Home in Winnipeg, Canada.

Realizing the importance of medical research in 2000, I set up the Semeon Hrushovetz Endowed Fund at the University of Manitoba which purchases books in the area of gerontology and complementary and/or alternative medicine for the Neil John Maclean Health Sciences Library.

Many current investigators, especially those engaged in life extension research, discovered the important role of nutrition in aging (e.g. Vitamin D and Alzheimer’s).

Another area is the field of searching for biological markers for aging and use them to test if anti-aging therapies are valid. Many of these studies, especially those related to biological markers of aging, could very easily be conducted at a nursing home.

I feel the Holy Family Nursing Home with its expansion program provides an excellent opportunity to establish such a unique research centre. I would be interested in an opportunity to discuss this idea with the nursing home’s board or building committee.

Can slowing the aging process reduce the incidence of Alzheimer’s

See my previous blog posts for statistics about the incidence of Alzheimer’s in Canada and Nursing homes as possible research labs for dementia.

Briefly here are the relevant statistics:
– by age 65, 8% of the population have some degree of dementia
– this increases to 35 % for those over age 85

My question:

If we can slow the aging process so that those at the chronological age of 85 could have the biological markers of a person age 65, would the incidence of Alzheimer’s also be slowed or dropped to 8% from 35%?

It seems to me that it would not be difficult to design such an experiment, especially since at present we do not have a specific medical treatment for dementia.

Gerontologists could see some positive results within a decade.

Just think if one could slow the aging process significantly, the elderly would die of other chronic diseases which are the major contributors to death, such as heart attacks, strokes, cancer and diabetes. It could certainly reduce the number of Alzheimer’s residents in our nursing homes if positive results are obtained.