UNTANGLING THE MYSTERIES OF THE BRAIN To address this anticipated crisis, ad-
vocates including Argentum successfully lobbied for the “Building Our Largest De- mentia Infrastructure for Alzheimer’s,” or BOLD Act. Congress passed it on a bipar- tisan basis, and the president signed it into law at the end of 2018. The law empowers the Centers for Disease
c S F O Conceptual Framework for the CDC's Healthy Brain Initiative Roadmap PRINT ONLY
in the brain might infl uence the nature and severity of the other disease manifesting itself in a sick brain. Another NIH-funded study of 1,000 se-
niors and their autopsied brains published in late 2017 found that more than 94 per- cent of those studied had at least one brain disease. Seventy-eight percent of those suf- fered from two or more, 58 percent suff ered from three or more, and 35 percent suff ered from four or more diseases. A research team from Chicago’s Rush Alzheimer’s Disease Center conducted the study. This suggests a need for the FDA to allow
trials of combined drugs, so that dementia suff erers could receive medicines that target the several problems simultaneously plagu- ing their brains, said Penn Institute on Ag- ing’s Director Dr. John Q. Trojanowski. “The fact of the matter is that multiple
pathologies are part of Alzheimer’s and Par- kinson’s, and we’ve known that for a long time,” he said. “So what I’m trying to do is to try and get everyone’s attention so we
can begin developing combination therapies sooner rather than later.”
The Coming Public Health Crisis The Alzheimer’s Association estimates that someone in the United States develops the disease every 65 seconds, and that by 2050 that’s going to increase to every 33 seconds. Currently, almost 6 million Americans have developed the symptoms of Alzheimer’s, and most are 65 years and older. As the total number of seniors grow both
in the United States and around the world, so too will the total number of people who will develop Alzheimer’s, forecast research- ers. They estimate that 7.1 million Ameri- cans may develop Alzheimer’s by 2025, and by 2050, that number could climb to 13.8 million if current trends continue and no new breakthrough treatment is found. The costs are profound, both in terms of the money for care (projected to balloon to more than $1.1 trillion a year by 2050,) and the personal tolls on family caregivers.
22 SENIOR LIVING EXECUTIVE JANUARY/FEBRUARY 2019 R
Control to encourage states to escalate their public health eff orts to educate citizens about brain health and dementia. The measure also authorizes the CDC to ask Congress for $100 million over the next fi ve years to fund state eff orts to help local communities cope logistically and emotionally with the antici- pated epidemic. Some of that eff ort will go to helping establish local “Alzheimer’s Disease and Related Dementias Public health Cen- ters of Excellence.” These centers could also train caregivers and implement the CDC’s Healthy Aging Public Health Road Map (
cdc.gov/aging). The CDC’s Healthy Brain Initiative en- courages doctors and state and local health authorities to educate the public about what it takes to maintain a healthy brain, and emphasizes the need for early diagnosis of cognitive decline, so that families can plan ahead. Various studies have found that up to half of those suff ering from dementia aren’t informed by their doctors about the diagnosis. Sometimes, it’s just easy to miss for those who care for seniors daily, said Ni- cole Fowler, a research scientist at Indiana University’s Center for Aging Research, the Regenstrief Institute. Fowler worked with families in senior living communities prior in her career as a research scientist. “How many families postpone talking
about moving, or care, or anything until there’s an actual crisis?” asked Fowler. “And all of a sudden, an older adult is in the hos- pital, and we suddenly have to talk about a nursing home, and where are they going to go, and rehab.” The concept is that if you’re able to pick up on the science of cognitive impairment earlier, it might help you avoid those crises. It’s still going to be hard. But we can avoid some of these crises and potentially custom- ize the care a bit better for that person. So providers need to talk about the aging brain, and to inform families of the reality. That’s one thing that’s really important for staff ers to talk about.”
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