by Frederick W. Schaerf, M.D. | Neuropyschiatric Associates
Over the past several years, the awareness and realization that Alzheimer’s disease has reached epidemic proportions, with the potential to bankrupt our nation and rob us of a meaningful and productive life , has received increasing media exposure.
Advances in our understanding of the causes and epidemiology of this degenerative brain disease have led to a new era in possible disease modification treatments. The ability to correctly diagnose with new imaging tools as well as the finding that the infusion of monoclonal antibodies has the potential to stop or delay disease progression, has given new enthusiasm to finding treatments and a cure. Affecting nearly 5.4 million Americans, 500,000 plus Floridians and likely over 25,000 in Southwest Florida with Alzheimer’s disease, 45,000 with Mild Cognitive Impairment, these statistics are predicted to triple by 2050.
The fact that the disease starts up to 20 years before you have a symptom, with age being the greatest risk factor (up to 10% at age 65, up to 50% at age 85) places Southwest Florida at ground zero. No other three county area (Lee, Collier, Charlotte) in the state will have more individuals with Alzheimer’s disease and Mild Cognitive Impairment, (a pre-Alzheimer’s condition) in need of medical care and services from community providers.
Yet we are poorly prepared as a community to tackle Alzheimer’s disease and related memory impairments, having not put into place public policies, evaluation and treatment protocols as well as treatment standards for the increasing numbers of those that will be affected. Additionally, no matter where those with Alzheimer’s disease receive medically related services, whether in the hospital, physician’s office, pharmacy, nursing home, home health or hospice, the costs will significantly exceed the cost for those without Alzheimer’s disease.
In 2015, the United States spent 226 billion dollars on Alzheimer’s disease related care. This is expected to rise to 1 trillion dollars by 2050, funded primarily by the already fiscally challenged Medicare and Medicaid systems.
It’s time for our community to prepare for this epidemic by implementing the following short term objectives. First, we need to establish a community Dementia Care Plan that would provide an integrated health program focused on early diagnosis, evidenced based dementia care and treatment, as well as access to cutting edge research programs. Second, we need to establish a physician led Alzheimer’s disease Advisory Council, which would bring all stake holders to the table, in order to provide leadership and direction for the Dementia Care Plan.
Additionally, for the short term, we need to establish protocols in the emergency rooms of our hospitals, as well as mental health centers, in order that the cognitively impaired receive proper medical care.
Finally, we need a vigorous effort to educate health care professionals to understand the diagnosis and treatment of individuals with cognitive impairment. The conversation needs to move to action now so our community can be responsive to this major health problem.
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