The 2021 Oscars Advocate for Alzheimer’s
By Michael Hodin
If you stayed up late enough for the climax of Sunday’s Oscars celebration, you would have been surprised and delighted that Anthony Hopkins received Best Actor for his truly spectacular performance in The Father. This is a stunning, inspiring, if thoroughly depressing, but very real, account of the progressive effects of Alzheimer’s on a man, his family and those around him. You also would realize why bringing greater awareness to Alzheimer’s, enabling early detection and diagnosis, and driving profound public policy change to help tackle this devastating disease must be at the very top of everyone’s agenda.
The exploding prevalence of Alzheimer’s and dementia is a result of the otherwise miraculous longevity that 20th century advances in science, medicine, and sanitation have gifted our 21st century. Due to this age demographic shift, Alzheimer’s is on track to ruin tens of millions of families; bankrupt our healthcare systems; and destroy otherwise productive, happy, and fulfilling lives — unless we take urgent, widespread action. We already know Alzheimer’s is a global plague, one that threatens to grow even worse as societies modernize and population aging accelerates. In fact, in the decades ahead, we are on track for higher prevalence in Africa and the Middle East than all of Europe and more in Latin America than the U.S. and Canada. If we thought it was bad now, just wait to see the albatross it presents in a decade or two.
But, in The Father, Hopkins brings this impact home in a way that statistics cannot. His performance is as brilliant as it is frighteningly sobering; an accurate portrayal of the havoc and destruction Alzheimer’s can deliver to its victims — the families as much as those living with the disease. Nor is it surprising that Hollywood would choose to undertake such a project, and the Academy to reward and honor it, as they did not too long ago with Still Alice.
If pop culture is finally, if belatedly, coming to terms with the realities of Alzheimer’s, our public policy elites are still struggling over their role. Just witness the recent controversy at the U.S. FDA, where its bureaucrats are in an epic struggle with scientific and medical advisors over whether to grant approval to the latest innovation to navigate the too often obsolete approval process. In a fascinating turn of events, it is the FDA bureaucrats who are calling for the approval of this desperately needed innovation, while the advisors seem to be caught in the pre-Covid world, where their assessment of risk and benefit is, simply, out of whack.
If we are going to beat our 21st-century Alzheimer’s crisis, we need an urgency that reflects the hard truths of this disease:
· We desperately need innovation. A new drug for Alzheimer’s has not been approved in nearly 20 years, despite billions invested in research and development. Alzheimer’s clinical trials are notoriously long, expensive, and difficult, with a failure rate far greater than other disease areas. While our understanding of the disease has made important strides, the fact is that patients and families still do not have access to a treatment that offers real hope.
· Our current trajectory is disastrous. Alzheimer’s and dementia already affect more than 50 million people worldwide and cost over $1 trillion. Do we really need more evidence to take action? But if you do, just consider that prevalence is set to triple to 150 million by 2050. These health impacts and economic costs are unsustainable. Action is needed.
· Now — inside the Decade of Healthy Ageing — is the time. Alzheimer’s is front-and-center as one of the age-related health challenges that should be prioritized by the UN and WHO’s Decade of Healthy Ageing. Our society’s response to this disease has too often been warped by ageism, which assumes that this is just a natural part of aging. It’s not, and public policy and health system responses must do more to dispel that ageist notion.
· Early diagnosis and advanced care planning are essential. Improving rates of early, accurate diagnosis is the only way to ensure that patients can access future Alzheimer’s treatments. But we have a long way to go. Due to low public awareness, stigma, ageism, lack of time and training for physicians, and other factors, diagnosis is often late, if it happens at all. Health systems simply aren’t prepared for the onslaught of disease or for the time (hopefully soon) when treatment is available. Diagnosis is central to preparedness. We need new tools and approaches for early detection, so that people can have as many options as early as possible. This also ties into the important concept of functional ability, recently recognized by both The Lancet and The Economist.
· The burden of caregiving is immense. For Alzheimer’s, the burden falls not just on the patient himself, but the caregiver — as shown in The Father by Hopkins’ adult daughter, his caregiver, played by Olivia Colman with equal passion and inspiration as Hopkins. And while Colman was nominated for Best Supporting Actress, in the real world, it is the Colmans of the world, the adult son or daughter who too often deserve the top award. Alzheimer’s innovations will have an even greater impact by relieving the burden on these family caregivers, the impact on their lives which itself is equally devastating and tragic.
While The Father is a powerful film, making movies about Alzheimer’s isn’t enough. We need to make progress on innovations to treat and prevent the disease even as we improve the healthcare systems in which they will be delivered and support caregivers. How about taking the lessons of Covid around risk assessment and incentives for innovation — which led to real solutions and hope for the overall health of society — in this more silent global crisis?
