Alzheimer's Disease: Our Biggest Long-Term Health Challenge

As we grapple with reforming health care in America, the discussion often seems to gravitate to short-term issues while ignoring growing long-term threats. There is a health care tsunami approaching. It is Alzheimer's Disease. How we deal with this crisis will tell us a lot about how we are doing on health policies and actions for the long term -- and about how we are doing as a society.

My family and I have had first-hand experience: a loved one gradually became more and more disconnected -− more and more helpless. We felt the anguish of Alzheimer's, as have millions of other Americans.

Alzheimer's Disease is the number one long-term health challenge our country faces as the baby boomers enter retirement. This disease is poised to wreak devastation on as many as 16 million sufferers by 2050. It is just the beginning. Around half of us over the age of 80 will develop Alzheimer's. Alzheimer's already costs more than $110 billion in annual health care spending and is spiraling upward. And Alzheimer's inflicts cruelty on entire families. It can impoverish the caregivers who must abandon work to look after sufferers, while causing depression and despair in spouses, children and other loved ones.

Despite heroic calls for action -- such as the recent proposal for a National Alzheimer's Strategic plan by the Alzheimer's Study Group -- our health care debate appears to be bypassing this looming crisis. Or maybe we are in denial because Alzheimer's is so terrifying.

We must address this crisis. We must begin by putting Alzheimer's into the center of our national dialogue about reforming health care.

I hope we will see our leaders in Washington rise to this challenge. Meantime business leaders like me, and leaders in lots of other walks of life, need to stand up and join together in galvanizing action on Alzheimer's. And we have a moral imperative too: the sufferers of Alzheimer's often cannot speak up for themselves. We must be their voice and their champions.

What do we need to do?

One priority is to accelerate the work on medical innovations to prevent, to detect early, to treat, to halt and ultimately to cure Alzheimer's. There are exciting signs of early progress in labs in innovation-based biopharmaceutical and diagnostics companies and at the National Institutes of Health (NIH). We can take practical steps to fast-track the science. We can also accelerate the regulatory processes that develop information on groups at higher risk, that develop early warning diagnostics and that move molecules into new medicines for this disease.

For example, as we are now doing with some other chronic diseases, if we could identify people who are most at risk and who then suffer from Alzheimer's, and treat these patients early, we would have a huge win. Early detection, and early intervention, could generate enormous health rewards, while saving families from ruinous costs and heartache.

With existing clinical trial methods, this could take decades. But there is a tremendous opportunity for the NIH, the FDA and the biopharmaceutical and diagnostics companies to collaborate on creating new models of innovation and clinical trials. We need new approaches that allow us to test potential new Alzheimer therapies in people at risk or with early stages of the disease, see what has promise, and zero in on the best bets for prevention. In this way we could hope to move the horizon for breakthroughs from decades to years. And by succeeding with Alzheimer's we would have a new model for faster, more cost-effective work on other chronic and preventable diseases.

That's just one idea for accelerating the science. We need lots more. But no matter how fast we can advance science to stop Alzheimer's, we have millions of people in our country suffering from this disease today and millions more who will develop it before we have effective new treatments.

So our second priority must be to respond with courage and compassion to the human and societal crisis. There is an impulse to keep the sufferers out of sight and off our conscience. We must not let this happen. To echo Franklin D. Roosevelt, a great society is judged by how well it helps the most defenseless among its citizens.

Virtually everything we should be doing for the victims of Alzheimer's -- and their families -- has lessons for a better, more efficient health care system for all of us. Unlike today, routine checkups for people over 60 should include simple tests, including biomarkers from blood tests and metrics of mental functioning. Medicare should reimburse doctors for such primary prevention tests. Unlike today, we should intervene early with simple therapies for stimulation and social interaction to help delay and lessen the effects of the disease.

Unlike today, physicians need to have the quality time with the patients to monitor them and individualize their treatment. Unlike today, we should put in place cost-effective support mechanisms such as home care help and counseling for family members -- so that they can keep those affected with Alzheimer's in a home environment as long as possible while continuing to work themselves, and avoiding where possible the huge costs and impersonal environments of institutional care. This will involve training more people −- doctors, nurses, social workers, and other caregivers to deliver this level of care.

Does this sound a lot like what we know we need to do in other areas, to make health care better and more cost effective? Surely it does.

We must begin somewhere to turn health care reform from ideas into good policies and actions. Through a national crusade on Alzheimer's, we can rally as Americans around our biggest long-term health care challenge. What we learn from that can help us get other things right. And when we look in the mirror as a nation that wants to care for its weakest citizens, we will like what we see.

 

 

Comments

[zuppy]

Dr. Edward Tobinick, a qualified dermatologist based in Los Angeles he named Institute of Laser Medicine; which is also home of Institute for Neurological Research. Edward Tobinick from his dermatology practice has created this video which has the title "Rapid Relief for Orthopedic Surgeon with Severe Pain". This purports to demonstrate that an Orthopedic Surgeon with severe back pain wassuccessfully treated within minutes with off-label Etanercept (Enbrel) a Black Box Warning drug! I invite you to watch the video and form your own opinion!..­.........b­ut what about all the publications!!! Please speak out for the Alzheimer's disease patient and their familes.

http://www.youtube.com/user/nrimed

Rapid Relief for Orthopedic Surgeon with severe pain From: nrimed | 20 July 2009 | 562 views Orthopedic Surgeon responds within minutes to a single dose of perispinal etanercept for severe pain. Perispinal etanercept is a patented treatment developed and invented at the Institute for Neurological Research®, a private medical group, inc. in Los Angeles. This video was shot in July 2009. More complete information at http://www.painbreakthrough.com. See also Tobinick, E., Perispinal etanercept for neuroinflammatory disorders Drug Discovery Today 2009 Feb;14(3-4):168-77. ... (more info)

[zuppy]

Media Information: Today Thursday October 15, 2009 at 1.00pm

Edward L.Tobinick Presentation at GTCbio Thursday October 15, 2009

Venue: The US Grant San Diego
326 Broadway, San Diego, CA, 92101
Phone
619.232.3121

http://www.gtcbio.com/userAgenda.aspx?id=160

1.00PM TNF Antagonists for Neurological Disorders: From Concept to the Clinic
Edward Tobinick Director, Institute for Neurological Research® UCLA

Other Title: 1995 Edward Tobinick, Director Skin Cancer Institute
http://latimes.perfectmarket.com/1995-07-04/news/ls-19989_1_skin-cancer

Other Title: 2007 Edward Tobinick, Director, Institute of Laser Medicine
http://www.click2houston.com/mylife/11035359/detail.html

Other Title: 2003 Edward Tobinick, Director, Institute for Neurological Research
http://www.nrimed.com/

Other Title: 2008 Edward Tobinick, Department of Medicine, Institute for Neurological Research
http://www.ncbi.nlm.nih.gov/pubmed/18184433

I invite you to meet Dr. Edward Tobinick, Dermatologist at this public forum. This will accord you the opportunity to discuss extraordinary Medical breakthoughs as reported by Dr. Edward Tobinick over the last ten years. Here is a list of Selected publications by Edward Tobinick, Director, Institute for Neurological Research
http://www.tobinick.com/publications.htm

[zuppy]

GTCbio San Diego Thursday 15th October Edward Tobinick will be presenting. News reporters, your opportunity to meet Edward Tobinick in this public forum.
Tobinick Presentation http://www.gtcbio.com/userAgenda.aspx?id=160 TNF Antagonists for Neurological Disorders: From Concept to the Clinic Edward Tobinick, M.D. Director, Institute for Neurological Research, UCLA Distracted by the failure of lenercept for MS in the mid-90’s, the scientific community abandoned the development of biologic TNF antagonists for neurological disorders. An innovative drug delivery strategy, combined with the selection of a unique anti-TNF biologic for the appropriate indications, has proven remarkably successful and elucidated new mechanisms of disease pathogenesis in neuroinflammatory disorders, including Alzheimer’s disease and neuropathic pain. The architect of this new treatment paradigm and holder of mutliple issued U.S. and foreign patents will discuss how he conceived and implemented these series of innovative treatment approaches which yield rapid improvement, within minutes, of Alzheimer’s disease and sciatica. The basic science and clinical data, including a recently concluded randomized, double-blind, placebo-controlled study, will be reviewed, and the implications for drug discovery and development will be discussed. This presentation will include high definition videos documenting rapid clinical response to perispinal etanercept.

[Limbicdoc]

There is legislation in the form of the Alzheimer’s Breakthrough Act of 2009, in both the House H.R. 3286 and the Senate S. 1492. As of July both had been referred to committee. It is important to note that in the last four sessions of congress dating back to 2004 there have been similar bills and all died in committee.
Alzheimer’s knows no boundaries it affects all races and socioeconomic demographics. It was discovered 100 years ago and the way we diagnose it with 100% accuracy (brain tissue under a microscope) has not changed since it discovered by Dr. Alzheimer. Diagnostically we can get to 80-90% accuracy, without a brain biopsy (not done) or autopsy, but for a disease that is killing 48,000 Americans every year, we should be able to do a little better. The treatments remain extremely limited. Most interestingly of all the sound bites and media comments in the health care debate, not one congressman, senator or the president has mentioned the words ‘Alzheimer's disease’ in this full scale health care debate, at least in terms of what all the media outlets present. Fred's story is tragic and sad, like five million others. It takes a bit of courage to speak out about it. We need more high profile people like Fred to speak up and push this issue forward-for real.

Joseph J. Sivak MD
http://alzheimmers.blogspot.com

[Jim Joyce]

Spot on Fred, we should focus in on what are the causes of these devasting diseases like Alzheimers and reward our scientists within universities and pharmaceutical companies to identify medicines and treatments that can change peoples lives. Then compensate our primary care physicians to identify the signs and symptoms of these conditions and intervene early in the disease progression. Jim

[zuppy]

Dr Edward Tobinick dermatology practice Institute of Laser Medicine Los Angeles. Also address of Institute for Neurological Research. Tobinick, his employees have no research background in neurology. Last ten years Tobinick published claims in off-label use of etanercept (tradename Enbrel) from disc-related pain to later, Alzheimer's disease. in 1998, Etanercept came to market therapy for rheumatoid arthritis. In 1999, Tobinick took out patent with claims in off-label use of etanercept for disc-related pain. He called his disc-related treatment "DiskCure". In his authored disc-related pain studies, he invented anatomical changes, also in his Alzheimer's papers. There exists no patient data analysis in the public domain to support Tobinick's or that they ever existed. It's all a fraud. Etanercept is a large molecule, generally does not cross the blood brain barrier. This is no barrier for Tobinick: Invent something that you will not find in your Medical Anatomical textbook, the "Cerebrospinal Venous System (CSVS) a term I coined myelf, guotes Tobinick. This Tobinick claims, is a space of valveless bidirectional flow continous connection between spine and brain, where etanercept can get past the blood brain barrier into the brain. In 2003 Tobinick's disc-related study published in Swiss Med Weekly, he rewrote the Medical Anatomical textbook to claim a certain space close to the epidural / dura space, where through natural and physical causations it was plausable for the adminstration of etanercept perispinally that would find its way in to the spine.

[Sederer]

Mr. Hassan provides a strong call for making Alzheimer's Disease integral to health care reform since this illness highlights so many key aspects of what must be done from supporting innovation in diagnostics and therapeutics to early detection and treatment.

A complex disease like Alzheimer's is like a variety of other brain disorders that present as behavioral and cognitive problems such as schizophrenia, bipolar disorder and severe depression. They are all absent from the health care debate even though their prevalence, suffering, family and social burden, disability and cost are among the very highest of all medical conditions - looming in impact with heart and lung diseases, diabetes, cancer and arthritis.

Biomarkers and drug treatments are today's great hope for brain diseases. We should support the science of discovery while also recognizing that the path from new discovery to practice is measured typically in years, often more than 10 years for most treatments determined to be safe and effective. What that means is the greatest improvements in care in the immediate years ahead will be from improving the provision of care we know to work today.

Healthcare services can improve now by: screening for mental disorders in primary care and holding doctors and healthcare organizations to delivering evidence-based treatment and by measuring and monitoring them to determine if they are doing is what we know works. That's how we will reduce the science to practice gap now while we wait anxiously for new science to emerge.


Lloyd I Sederer, MD

[LaniN]

I disagree that Alzheimers is the biggest long term challenge. Our nation is ill from top to bottom with any number of big, long term health challenges. It would be more accurate to state that ending the rise in severe, life-long chronic illness is our biggest challenge.

In 2000. the CDC reported that 1 in 6 school age children had a neurological disorder, and that percentage has not dropped. Autism has rapidly changed from a rare disorder to 1 in 150 in more recent reports, with at least one state reporting 1 in 96. Of the children born in recent years, it is estimated is that 1 in 3 will develop diabetes. Other autoimmune disorders and cancer rates have also risen.

The current young generation is believed to be the first in this nation's history that will have a shorter life span than its parents.

Yes, universal health care is essential, but just as important (if not more so) is frank discussion of the crisis in the health of the US population. We need a no holds barred, dedicated scientific exploration of what is going so wrong. A strong commitment, like the race to moon once was, to diligently work, with no stone left unturned, to uncover the causes as well as the cures. And that includes a serious look, unfettered by corporate influence, at the environmental poisoning around us, in our air, our food, and our water.

[RMankovitz]

Actually, BigPharma may be indirectly providing a solution to the coming Alzheimer epidemic. Let's call it the "early death" solution, where few will live long enough to contract the illness.

Picture this: in the near future (perhaps even now), it becomes apparent that the medical community can no longer prevent, treat, or even contain catastrophic diseases that, for those infected, result in death in a matter of days. Neither antibiotics nor vaccines have any effect. Further, the very hospitals that people run to for treatment become deathtraps that foster the spread of these deadly diseases. The only hope is to strengthen your immune system to the point that it can deal with the pathogens, just as nature intended.

Science fiction? The book "Rising Plague" by Brad Spellberg, MD, an infectious disease expert, describes the pandemic in graphic terms, citing actual case histories that put sci-fi to shame. It is the opinion of many in his field that it has already arrived and the pharmaceutical companies, by ignoring new antibiotic development, are doing nothing to prevent it. There is mounting evidence that infectious diseases are now the third leading cause of death in the US, and that the "antibiotic era" is over.

For more background, here is a link to "Bad Bugs, No Drugs" from the Infectious Diseases Society of America:

http://www.idsociety.org/badbugsnodrugs.html

Information on nature-based illness prevention can be found in the book "The Wellness Project."

Roy Mankovitz, Director
http://www.MontecitoWellness.com

[mariancutler]

Listen closely to the health care reform debate raging from Capitol Hill and you'll hear time and again a call for focus on preventive medicine. According to advocates for HR3200 (and others, most likely), prevention is one of the cornerstones reform is built on and the engine to fuel funding for universal coverage.

With such conviction as the basis of all arguments to implement reform, it's time to get specific regarding these prevention programs and the savings they will provide. Echoing Mr. Hassan's comments, Alzheimer's prevention should be top of the list. To date, multiple studies have been conducted ... some by industry, many by NIH and other government agencies .. all showing promise that prevention and early intervention are the keys to staving off the deteriation and caregiving expenses associated with the disease.

Today, more than 5 million Americans suffer with Alzheimer's and another 8 million care for them at great personal and health expense. We have neither the time nor the financial and human resources to wait for the situation to get any more dire. The time to act is now.

[Nutcase]

I would never minimize the tragedy that is Alzheimer's but, by the same token, he is minimizing mental illness by calling Alzheimer's our biggest challenge. The number of people afflicted by mental illness is greater, it is more costly and it is far longer in duration for most people.

[ScribeLife]

Mr. Hassan raises points about which some of us are all too expert. Yet my urgency to see ways of treating, if not curing, Americans and their disabilities (not limited to Alzheimer’s disease) is no more intense than that for the uncounted young people who follow behind us, somewhere on the lonely Autism spectrum.
Count us somewhere in the middle of this sandwich. We cannot abandon our WWII era elders by the roadside nor can we are our pockets endlessly deep for alternative treatments for our grandchildren’s Autism. We need science all right, but science that also encompasses the best ways to open the developmental windows that Autism closed. Families are struggling to fill unthinkable gaps in health care coverage, pitting the young we began to love against the elderly we have loved so well.
The weakest citizens are those who cannot be protected from medical travesty. They cannot be said to be mostly, mainly, or primarily the aging victims of Alzheimer’s disease. They are the youngest among us, too, whose voices have not been heard as voters, on blog posts, or as communicators at all.
We must not pit the old against the young. Pope John Paul II said: “Tell me what you love, and I will tell you who you are. . . A nation, then, is first of all rich in its people. Rich in man. Rich in youth. Rich in every individual who watches in the name of truth. . .”
Who then, will we be?

[ckdogs]

Unless there is a drug cure that comes up soon - not likely - the cost of Alzheimer's care will be difficult to reduce. At a certain point, these people wind up in nursing homes - and full freight is $6000/mo. There are some facilities that charge less - but you wouldn't want a loved one there. Not sure what the answer is for this problem.

[elph]

When you set aside the politics, the healthcare debate in large measure comes down to Alzheimers as Mr. Hassan rightly states. We're in for a long road on this one so we should bring it down from outer space and call it what it is. Hopefully drug company chiefs like Mr. Hassan who have had personal experiences with Alzheimers and family members will be in a position to make sure good drug companies will find cures and treatments, not to mention develop a sane and practical health care policy.