Are our stroke associations warning of the same crisis for stroke and have they created a strategy to address it? FUCKING UNLIKELY.
From the ASA; By 2030, 3.88% of the US
population >18 years of age is projected to have had a stroke.
Between 2012 and 2030,
real (2010$) total direct annual
stroke-related medical costs are expected to increase from $71.55
billion to $183.13 billion. Not as bad as Alzheimers but still substantial.
Current quibbling over what Jeb Bush meant when
he said it’s time to phase out and replace Medicare — as opposed to
“attacking the seniors,” as one woman at a recent event bellowed out —
will soon seem quaint against the realities of our future.
Never
mind projections that the program will be able to finance only
86 percent of its obligations by 2030. Or that by 2050, the number
declines to 80 percent, according to a recently released
Social Security and Medicare Boards of Trustees report.
Kathleen Parker writes a twice-weekly column on politics and culture. She received the Pulitzer Prize for Commentary In 2010.
These are relatively comforting numbers compared with
new projections from the Alzheimer’s Association. By 2050,
the group says, 13.8 million Americans may have Alzheimer’s disease, at a cost of $1.1 trillion per year, mostly to Medicare and Medicaid.
Today, by comparison, 5.3 million have the disease.
“Basically,
it will bankrupt Medicare,” said Robert Egge, the Alzheimer’s
Association’s chief public policy officer. I met with Egge and chief
science officer Maria Carrillo during the association’s recent
international conference in Washington.
The 2015 cost
of care for Alzheimer’s and all other dementias is estimated at
$226 billion, with 68 percent being paid by Medicare and Medicaid, Egge
said.
This total includes only direct costs
for the care of Alzheimer’s sufferers — there currently is no treatment
— and doesn’t take into consideration unpaid care by families. Within
the next 10 years, 19 states will see at least a 40 percent increase in
the number of people affected.
Lest you feel overwhelmed by
numbers — and demoralized by the reduction of human suffering to
numerical values — suffice it to say that we are in a state of
emergency. Yet, even with this obvious urgency, relatively few resources
have been dedicated to research for prevention and treatment compared
with other chronic diseases. This, despite the fact that Alzheimer’s is
the sixth leading cause of death in the United States, according to the
Centers for Disease Control and Prevention.
Current federal
research funding is less than $600 million annually, while top
scientists say they’ll need $2 billion a year to meet the association’s
2025 goal of prevention and effective treatment. There’s cause for some
hope. Last month, bipartisan House and Senate subcommittees approved
increasing funding to the National Institutes of Health for Alzheimer’s
research by 50 percent and 60 percent, respectively.
If
this funding becomes law — and the association’s goals are met — costs
could be reduced by $220 billion over the first five years and
$367 billion in 2050 alone, according to an association report. Sixty
percent of those savings would accrue to Medicare and Medicaid.
Among
other scientific developments reported this week, researchers have
isolated a “common ancestor” among all forms of dementia, including
Alzheimer’s, Parkinson’s and Lewy body.
“All
are caused by misfolding proteins,” Carrillo explained to me. Two
different “misfolded” proteins — amyloid beta and tau — are toxic to
brain cells.
I am sad to report these proteins cannot
be corrected with daily doses of a sturdy zinfandel. There is, however,
a new drug that delivers a molecule scientists have created to
“chaperone” these proteins so that they fold correctly.
Carrillo
doesn’t want to overstate the value of this one-target-one-molecule
approach, though it is promising. She suggests that eventually we’ll
treat Alzheimer’s with a “cocktail” that will be created based on an
individual’s genetic makeup and other factors.
Other
hope-inspiring developments include six diagnostic tools that, in
combination, can be useful in predicting Alzheimer’s. They include
memory and thinking tests, as well as MRI scans that can measure the
thickness of the brain’s right entorhinal cortex and the volume of the
hippocampus, both of which are important to memory.
It
is reassuring that both policymakers and scientists are committed to
tackling these diseases. But women especially should be interested in
the progress of dementia research. For reasons unknown,
women suffer Alzheimer’s
at a higher rate — two-thirds of today’s sufferers are women. And
women’s function declines twice as fast as men’s. This fall, the
association will issue an international call for research on why this is
so.
In the meantime, Congress should waste no time in
correcting the travesty of too-little funding for a devastating disease
that demands our urgent attention. Otherwise, what to do about Medicare
will be rendered irrelevant.
