Dr. Chartrand explores the tragic, yet little known
impact of Alzheimer's that is exacerbated by uncorrected
hearing loss upon society .Reader Inquiries may be
directed to "Contact Us" or faxed to 719-676-6882.
From Hearing Health Magazine 2000:
The (Economic) Toll of Alzheimer’s Disease
By Max Chartrand, M.A.,
DigiCare Hearing Research & Rehabiliation
Persons with Alzheimer’s disease (AD) cost Medicare
approximately 2.6 times more money than those who do not
have the diagnosis, according to a recently released
study sponsored by the AARP Andrus Foundation. The
annual tab for a person with AD was around $18,500 if
s/he was living in a community setting versus $33,500
when living in a nursing home.
Researchers at Duke University, under the direction of
Donald Taylor, Ph.D., tabulated these figures using
information from 18,000 respondents to the 1994 National
Long Term Care Survey, a nationally representative
sample of persons 65 and over.
The average paid by Medicare in 1994 was determined from
the actual fees incurred for inpatient, outpatient, home
health, skilled nursing facility, hospice and services
such as physician payments and items such as durable
medical equipment.
Medicare financed care, the study found, was influenced
by how long a person had been diagnosed with AD – the
longer diagnosed, the lower the costs. Once diagnosed,
costs decreased by 10 percent each additional year,
suggesting that fewer medical resources are invested in
persons with a formal diagnosis of AD as their life
expectancy drops, net of other variables.
Medicare costs represented only one-fourth of the total
cost of caring for a person with AD.
Finding the Keys ... and a Cure?
As prognosticators broadcast the potential for disaster
in a burgeoning population at greater risk for
Alzheimer’s, researchers are racing to solve its
mysteries. Leaders in the fields of neurology, genetics
and medicine are making important discoveries daily.
None is yet the definitive solution but each fills in a
piece of the puzzle. And the new knowledge has enabled
pharmaceutical companies to develop and test new
forumlas for treatment and prevention.
Whether any of these breakthroughs can be significant
enough and soon enough to avert an Alzheimer’s crisis is
unclear. There are reasons to be optimistic, however.
Among them is a growing collaboration between
researchers, practitioners and caregivers. The first
ever global summit was held in July 2000, World
Alzheimer Congress 2000 (WAC), drew thousands of experts
to Wash., D.C. By the time the July 9-18 conference was
over, several bold new approaches were on the table.
The most promising research is honing in on the cause,
perhaps ending a century-long debate. First identified
in 1906 by Dr. Alois Alzheimer, one of two markers in
brain tissue damaged by the disease has been considered
the culprit. But which is it? Plaque, made up of the
protein amyloid, which litters the space between brain
cells that control memory and behavior? Tangles of
another protein (tau) that aggregate within the cells?
Or is it a combination of both?!
The most recent evidence clearly points to plaque,
suggesting that it may be toxic to surrounding neurons,
and that the amount of amyloid buildup does indeed
correlate with the degree of dementia. Basing their work
on this research, neurobiologists from Elan
Pharmaceuticals reported at WAC that they have developed
a vaccine which, in mice, prevents buildup of the
protein and decreases existing plaque. Clinical
investigations of whether it has the ability to prevent
or cure the disease in humans could begin late this
year. Meanwhile, a newly developed oral drug has
demonstrated the ability to inhibit the buildup of
plaque in animals and will also enter human trials soon.
In the therapeutic arena, findings unveiled at the
conference offer hope for the first time of slowing the
progression of more advanced Alzheimer’s. Researchers
from the New York Univ. School of Medicine described the
effects of a six-month treatment with the drug memantine
on people with moderately severe and severe cases.
Overall, although the disease was not reversed by the
end of the study, those who received the drug performed
significantly better in cognition and in daily life
activities than those in a control group who had taken a
placebo.
Other promising avenues under investigation are:
Finding genetic variants that put people at greater risk
for Alzheimer’s.
Utilizing brain imaging technology to identify
structural or functional variations which precede
symptoms.
Investigating the relationship of cardiovascular risk
factors with the incidence of Alzheimer’s (e.g., whether
or not high-fat diets elevate risk or exercise, eating
vegetables high in antioxidants or other “heart-healthy”
actions decrease risk).
Furthermore, are the myriad studies pointing to a close
assocation in the older age-groups between degree of
Alzheimer's and unmitigated hearing loss. In fact, the
rate of uncorrected hearing loss has been reported to be
six times greater among those with Alzheimer's than
among the non-AD population, according to a recent study
by the University of Pittsburgh. Yet this startling
finding has not seemed to move the medical establishment
to-date.
Whatever the near future brings, Dr. Dennis Selkoe, a
leader in the battle against this elusive disease,
predicts that “sooner than one might have dared to hope,
Alzheimer’s will shed the veneer of invincibility that
makes it such a terrifying affliction.” He also believes
that practitioners will shortly have on hand not one but
several drugs capable of slowing and perhaps halting the
progress of the disease.
If Dr. Selkoe and others who share his optimism are
right, this is heartening news indeed.
--------------------------------------------------------------------------------
Dr. Max Chartrand, a staff writer for Hearing Health,
has studied Alzheimer’s for almost three decades. He is
the director of DigiCare Hearing Research &
Rehabilitation. digicarenet@aol.com |
|
|
|
