TAMPA, Fla. (WFLA) – One of the most common forms of dementia in the world is Alzheimer’s disease, a brain disorder that leads to memory loss, confusion and behavioral changes. There are more than 6 million cases of Alzheimer’s disease reported in the United States, and over 9 percent are in Florida alone.
So, what is Alzheimer’s disease and what does it do to the brain?
Discovery of Alzheimer’s disease
The year was 1906. In the United States, the average life expectancy for men was nearly to 47, while women would typically live to about 51, according to data from the University of California, Berkeley.
That same year, a strange set of symptoms including memory loss and confusion led to a woman’s death.
According to the National Institutes of Health, the woman died of a strange mental illness, so a doctor decided to check her brain tissue. He found strange clumps in her brain that came to be called amyloid plaques, as well as tangled fibers, now called neurofibrillary tangles.
The doctor’s name? Alois Alzheimer.
The patient had suffered from “memory loss, language problems, and unpredictable behavior,” according to the NIH. His discovery of the plaques and tangles in his patient’s brain led to his discovery of what has been reported to be the most common cause of dementia in older adults: Alzheimer’s disease.
The Centers for Disease Control and Prevention reports that current life expectancies for men and women, as of June 2020 estimates, were about 75 years for men and 80 for women. The report says that the provisional life expectancies from their data were the lowest levels since 2006 for men and since 2007 for women.
As the number of adults with Alzheimer’s disease increases year by year, the long-term effects on health outcomes has changed, though the degenerative brain disorder is not the only cause of a lowered life expectancy in the U.S.
By the numbers
Globally, there are an estimated 50 million patients suffering from dementia, according to the World Health Organization. The WHO says Alzheimer’s disease contributes to 60-70% of those cases.
In the U.S., the CDC estimates that there are about 5.8 million people with Alzheimer’s disease. Roughly two-thirds, or 3.6 million in 2020, of all Alzheimer’s patients are women.
In 2020, the Alzheimer’s Association reported that an estimated 6.2 million had the disease, and of those with the disorder, there were 580,000 patients in Florida with Alzheimer’s, aged 65 and older.
Based on the two estimates, Florida residents account for between 9.35-10% of the country’s Alzheimer’s patients. The Alzheimer’s Association and the CDC both agree that this number is only going to grow.
According to the CDC, the number of people living with Alzheimer’s doubles every five years for those over 65 years-old.
Florida’s Department of Elder Affairs reports that:
- Florida has the second highest prevalence for Alzheimer’s disease in the U.S.
- Alzheimer’s disease is the 6th leading cause of death for Floridians 65 and older
- African Americans are twice as likely to get Alzheimer’s disease
- Hispanic Americans are 1.5 times more likely to get Alzheimer’s disease
- Estimates project that more than 720,000 Floridians will be living with Alzheimer’s by 2025
- 1.2 million Floridians provide unpaid Alzheimer’s care for their loved ones, two-thirds of whom are women and one-third are daughters, specifically
Understanding Alzheimer’s Disease
According to NIH, the plaques and tangles in the brain that Alzheimer had discovered lead to a loss of connections between the brain’s nerve cells, or neurons. The disease is complicated, and it gets progressively worse over time. There still isn’t a cure.
Symptoms and signs of Alzheimer’s are common among patients:
- Memory loss
- Poor judgment
- Loss of spontaneity
- Repeating questions
- Trouble handling money or paying bills
- Wandering or getting lost
- Losing things
- Mood and personality changes
- Increased anxiety or aggression
As the disease progresses, those suffering from Alzheimer’s have increased memory loss and confusion, and begin having difficulty with language, reading, writing, and working with numbers. The changes in their behavior reportedly become more noticeable as the symptoms become more severe.
By the time the disease has progressed to extremes, NIH says patients have trouble communicating and are completely dependent on others for their care, and may be bedridden. Weight loss, seizures, and loss of bowel control are common symptoms.
While the disease has been studied for years, scientists are still working to understand what causes the disease. NIH says a genetic mutation may be a cause of the disorder, but other illnesses can also increase the risk of developing Alzheimer’s Disease, as well as “health, environmental, and lifestyle factors.”
Costs of care
At this time, there is no cure or permanent solution for treating Alzheimer’s Disease. In 2018, the CDC reported that direct costs for treatment in the U.S. was about $277 billion, as of 2018.
The Alzheimer’s Association reports that by 2021, the cost of Alzheimer’s treatments and other dementias could cost the U.S. $355 billion, including $429 billion from Medicare and Medicaid payments.
That cost is expected to rise to $1.1 trillion.
In Florida, the Alzheimer’s Disease Initiative from the Department of Elder Affairs provides some respite care to caregivers of adults 18 or older who have been diagnosed as “having probable Alzheimer’s disease or other related memory disorders” that affect or interfere with everyday living.
In the last 10 years, the budget for ADI has only grown, according to state reports:
| State Fiscal Year | State Funding | Clients Served |
|---|---|---|
| 2010-2011 | $8,362,200 | 2,300 |
| 2011-2012 | $9,404,262 | 3,348 |
| 2012-2013 | $9,554,262 | 1,808 |
| 2013-2014 | $10,412,201 | 1,832 |
| 2014-2015 | $16,093,452 | 2,657 |
| 2015-2016 | $16,471,449 | 2,673 |
| 2016-2017 | $18,031,499 | 3,567 |
| 2017-2018 | $21,309,195 | 5,228 |
| 2018-2019 | $22,976,477 | 8,480 |
| 2019-2020 | $22,976,477 | 9,143 |
“The current total 2020-2021 SFY State General Revenue Budget for ADI is $32,381,826 in accordance with Section 430.501 – 503 F.S,” according to Florida’s Alzheimer’s disease state plan in 2020.
The Department requested an additional $6.7 million for the ADI program in June 2021.
The Dept. of Elder Affairs says in 2020, the cost of care for Alzheimer’s and dementia was about $66 billion in out-of-pocket spending. Medicare and Medicaid accounted for 67% of total health care and long-term care payments for Alzheimer’s disease and related dementia (ADRD).
The increase in care needs by America’s aging population has led to calls for heavy investment in elderly care facilities and workers by President Joe Biden in part of his American Jobs Plan.
If the plan is approved, $400 billion would go toward making home and community-based care more affordable and more accessible for America’s seniors and the disabled, including expanding access to long-term care services under Medicaid.
Search for a cure, Aduhelm approved by FDA
Research into potential treatments and cures for Alzheimer’s disease and other neurodegenerative illnesses recently led to a newly FDA-approved drug from Biogen. It is reportedly the first new Alzheimer’s treatment in almost 20 years.
The treatment is somewhat controversial, as its success rate is questionable and prohibitively expensive due to a yearly treatment cost of $56,000 according to early estimates. Still, the treatment would be covered by Medicare Part B benefits, according to a non-partisan study and report produced by the Kaiser Family Foundation.
The drug, called Aduhelm, is an “intravenous infused medication” that has shown mixed results in two studies done to test its efficacy with patients.
According to reporting by the Associated Press, Biogen’s drug does not reverse mental decline, but slowed it in one study. The FDA is requiring Biogen to do a follow-up study to confirm Aduhelm’s benefits, even though the drug has already been approved.
The AP reported that Biogen had stopped two previous studies in 2019 after results were “disappointing” and did “not meet its goal of slowing mental and functional decline in Alzheimer’s patients.”
In a 2019 release, Biogen announced that the failure in the two studies was a result of a weaker dosage. Analysis of their Phase 3 study showed that stronger doses had more of an effect during treatment, according to Biogen. The new analysis is what prompted their application for FDA approval in 2020.