Our 21st Century Pandemic: The Alzheimer’s Crisis
By Michael Hodin
The latest report from Alzheimer’s Disease International (ADI), World Alzheimer Report 2019: Attitudes to dementia, is impressive for both how it reflects the sustained strategic leadership of ADI on the re-framing of Alzheimer’s as one of the greatest disease challenges of our time and for the creative insights of the report itself. It’s easy to overlook how far we have come in recognizing the true risks and burdens of the disease, which is due not least to ADI’s innovative approach to educating us all about Alzheimer’s and other dementias. We have moved Alzheimer’s from a thoroughly misunderstood condition — widely seen as a tolerated, even accepted “normal part of aging” — to its current status as an epidemic of such proportions that it’s the only disease warranting its own World Health Organization focus.
This change is essential to drive greater support and urgency for private-sector solutions to address Alzheimer’s, especially the ongoing innovative efforts in biopharmaceuticals, but also including a range of other industries.
In 2010, ADI commissioned the first serious research that led to discarding the idea that “oh well, she’s 86, and, you know, that’s what happens when you get that old, a little senility, just a normal part of aging.” Instead, ADI’s research helped to establish that Alzheimer’s is as real and serious as any other disease, from cardiovascular disease to breast cancer. This research was the work of a partnership between ADI and two scholars, Dr. Anders Wimo of Karolinska Institute in Sweden and Dr. Martin Prince of King’s College London, who brilliantly came upon a methodology to measure the true prevalence, and therefore exploding costs of Alzheimer’s, as linked to the mega-trend of longer lives that have come to define our 21st century.
Based on their findings, we know that the human and economic impact is staggering and rapidly growing. According to the latest report from ADI, there are more than 50 million people living with dementia around the globe. This already enormous figure is set to triple by mid-century, rising to 152 million. Such immense prevalence, combined with the nature of the disease, its link to aging itself, and its impact on families and caregivers, leads to huge economic costs. ADI estimates that dementia generates costs of more than $1 trillion each year, and this figure is projected to more than double by 2030. Nor is it a small point that when understood through the aging lens, the longevity now extending to middle income and poor countries means that in the next decade or so we will have more Alzheimer’s (and other dementia) patients in Latin America than in the US and Canada; and, more in Africa and the Middle East than in Europe.
As a result of ADI’s work to create a better understanding of these impacts and consequences, there then emerged interest among both leaders and the general public to redouble efforts to fight the disease. These efforts had already been underway in the pharma industry, but accelerated scientific progress requires a favorable and collaborative environment that encourages perseverance even in the face of a challenge as elusive as Alzheimer’s. As the search for a cure continues, there have been significant actions in recent years from other industries are helping to spotlight the challenge and ease the burdens of Alzheimer’s and dementia.
For example, Home Instead Senior Care helped to pioneer an innovative new model of elder care — home-based care — which offers a more effective, affordable, and human-centered option for those affected by Alzheimer’s and their families. Home Instead has brought together dementia experts and developed a unique care program, including free resources for family caregivers,that is tailored specifically for the needs of those with dementia.
Perhaps most interesting is the groundbreaking work of Bank of America’s retirement business– not exactly a health care company — which has recognized that leadership on longevity and its related impacts is both good for business and good for society. Today, this leadership is underscored by the fact that its Head of Retirement & Personal Wealth Solutions, Lorna Sabbia, sits on the World Dementia Council, which is itself a creature of governments’ commitment established by the G7. Bank of America began this journey when it recognized that Alzheimer’s was a greater concern to clients than all other health conditions combined, when measuring customers’ worries relative to their financial sustainability as they grew old. Acting on that insight, Bank of America created the first-ever position of Director of Financial Gerontology and developed a ground-breaking longevity training program for financial advisors. Since then, the Bank’s retirement business has continued to focus on global thought leadership on longevity, providing expertise to help inform key policy decisions from the World Health Organization and the most recent White House Conference on Aging to the Japanese-led G20.
These are the kinds of private-sector innovation that are urgently needed in our efforts to combat dementia. And, this brings us to the latest ADI report, which — interestingly enough — largely matches what Bank of America’s research uncovered over five years ago: Alzheimer’s is one of the top concerns for people around the world. According to the latest ADI report, 78% of people are concerned about developing dementia at some point. However, there are signs that the disease is still misunderstood and stigmatized, as one-in-four people think there is nothing you can do to prevent dementia, and more than 85% of people living with dementia say their opinion has not been taken seriously by others.
ADI continues to break ground on insights, information, and data that will further underscore the mammoth challenge of Alzheimer’s — only growing more pressing as we extend longevity globally. The report found that, while we have made progress to dispel the myths and stereotypes about Alzheimer’s and aging, still two-thirds of people believe dementia is caused by normal aging. Shockingly, 62% of health care practitioners believe the same thing. The report also highlights the continuing need for new approaches to relieve the burden on family caregivers, as the majority of caregivers said that their health and social life had suffered because of their care responsibilities.
If ADI’s strategic reports have been the stimulus for greater understanding of the true dimension of the Alzheimer’s pandemic in our 21stcentury marked by the mega trend of aging, this year’s will continue that leadership. Recognition of the massive numbers of people and the truer understanding of prevalence and costs — estimated at roughly 1% of global GDP, further exploding as it is correlated with global aging — signals to regulators, government officials and the global public health community that we are all in this together. If the likes of Bill Gates — who has committed $100 million to Alzheimer’s research– can join Bank of America and Home Instead Senior Care to call for solutions, then the 2019 World Alzheimer Report should also be a call to action for public support of the private-sector innovation so many in are searching for every day, from the biopharmaceutical industry to financial services to elder care and beyond.
