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.

Anti-aging therapies and doctor assisted dying

These anti-aging therapies include bio-identical hormonal replacement, management of oxidative stress with anti- oxidants, reduction of chronic inflammation a forerunner of atherosclerosis and heart disease, genetic-restoring telomere length, stem cell therapy to replace senescent cells, etc.

In one of my keynote presentations, I discuss 7 ways to slow the aging process. Hopefully by slowing and/or reversing the aging process, these individuals can also change their biological clock to a period when they did not have these chronic diseases!

Should these breakthroughs materialize, we may even witness the time when people in nursing homes may actually be discharged and return to their homes, much like we now do with patients who are sent home from hospital after recovering from a medical illness or surgical treatment.

Maybe the health status of those individuals requesting “assisted dying” could be enhanced or their delayed if their biological life clock was reversed to an earlier period when they did not have those debilitating symptoms.

The late Dr.Roy Walford. in his book Maximum Life Span relates the history of the government’s approach to the polio epidemic of the 1940’s and 50’s His comment: “… if the government had invested in perfecting better iron lungs we would now have the best designed most comfortable iron lungs imaginable inhabited by thousands of polio victims…” Instead, by investing in basic research and developing a vaccine, epidemics like polio and smallpox have now theoretically been eradicated from our planet.

Regarding nursing homes, Walford comments “…the vast social support structures continuously accumulating to care for the helpless elderly are the iron lungs of Gerontology…”

It should be noted that in the 19th century when Dr. Edward Jenner developed his crude smallpox vaccine, he and the world did not know that smallpox was also caused by a virus. In my view the current knowledge of the causes of the aging process is probably at the same stage when Jenner was experimenting with a smallpox vaccine which he tested on his own son.

We do not really know what causes the aging process that leads to the development of the chronic symptoms and diseases of the elderly, what I like to call the 5 “D’s-disability, depression, discomfort, dementia, chronic diseases, and death. Why do the levels of hormones like DHEA begin to drop after age 30?