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Cognition Nation

Alzheimer's and other dementia-related illnesses expected to reach epidemic proportions by 2050
Alzheimer's BRAIN DRAIN: A researcher with the Alzheimer's Association examines a brain sample of an individual with Alzheimer's.

Angie Carrillo knew something wasn't quite right with her husband, John, when he came home from work one day and said he got fired from his job.

John, 60 at the time, had complained about work responsibilities becoming too much; his assistant taking on his assignments; some occasional spottiness in his memory. At first, John's reasons for his dismissal were vague. It wasn't until Angie called his boss that the full extent of his problems became clear.

In October 2008, John was diagnosed with early-onset Alzheimer's, the dementia-related illness that slowly steals the memories and personalities of the afflicted. It is chronic, incurable and utterly unforgiving.

John's condition has worsened rapidly over the last several years. At first, he was able to stay home and take care of himself, leaving him and Angie a few precious moments to hastily prepare for his inevitable decline. Today, he requires around-the-clock care and cannot be safely left alone, leaving Angie as his primary caregiver.

"I think of myself as a widow," she says. "A widow with a 3-year-old who has developmental issues."

The Carrillos' story is becoming increasingly common and at an alarming pace. Approximately 5.4 million people in the United States are living with Alzheimer's disease—the vast majority 65 years and older. But a rising life expectancy rate combined with an enormous population of baby boomers will balloon that number to nearly 16 million by 2050, according to figures from the Alzheimer's Association. Over the next 15 years, the number of people over age 85 will skyrocket, and as many as 50 percent of them will be diagnosed with cognitive impairments as well.

If left unchecked, the Alzheimer's epidemic could become the defining disease of future generations. It already ranks sixth among the leading causes of death for Americans age 65 and older.

At its worst, Alzheimer's can cause people to forget how to walk, eat or bathe, to say nothing of keeping track of things like medication regimens or daily routines. Many acute-care facilities can offer Alzheimer's patients the intensive attention they require—but only for those who can afford it. Spouses, sons, daughters and friends often end up assuming the role of caregiver. Typically, that means taking on a vast array of complex emotional and financial challenges.

The Alzheimer's Association reports that the caring for people with Alzheimer's disease will cost as much as $20 trillion over the next 40 years. Last year alone, Medicare and Medicaid doled out an estimated $140 billion for people with Alzheimer's and other dementias.

Dr. Gary Steinke, founder of the renowned Alzheimer's Activity Center in San Jose, says that not nearly enough is being done to make the issue a priority. "Common sense doesn't prevail," he says. "It's all politics, and politics will probably prevent it from happening for a while until there's a major crisis.

"When you're responsible all of a sudden for paying a long-term care bill, you're going to get damned creative."

Organizations like the Activity Center take in dozens of seniors each day, feeding them lunch, leading basic exercise regimens and providing the supervision they need. Patients can spend up to 11 hours per day at the center for $65. Angie Carrillo takes her husband here several days a week so she can continue to work. After burning through most of their nest egg, John's pension is now able to cover the costs. She starts to sob over the phone when she recounts a recent day off.

"I went in to a restaurant and sat there and ate lunch by myself, and it was the most amazing thing," Angie says. "There is a cost [to Alzheimer's] that is beyond money."

In 2012, the Santa Clara County Board of Supervisors commissioned a study to examine the area's aging senior population. The report identifies a coming surge in the costs of caring for the elderly—with the burden falling squarely on the shoulders of friends and family—but provides little in the way of specific recommendations to address the issue.

In one telling excerpt, the report concludes that "affected seniors will simply rely more on family, friends and the kindness of strangers to stay in their homes as long as they possibly can." The report adds that the epidemic will "leave the county with more dire budget shortfalls."

Alzheimer's research has yielded mostly mixed results. Despite decades of data, billions of dollars spent and countless clinical trials, the disease is still incurable. But Dr. Joseph Rogers, executive director of health sciences at the Stanford Research Institute (SRI), remains confident. While it's still working its way through trial and testing phases, Rogers says a new drug his team is working on at SRI could keep the disease from taking hold of people in the first place, rather than just treating symptoms.

One of the hallmarks of the disease is amyloid beta peptide, a protein that, if improperly managed by enzymes in the brain, can clump together to form plaques that slowly break down brain tissue. The plaque buildup typically appears as thick, dark blotches on brain scans of Alzheimer's patients.

Rogers writes that his team "is pursuing compounds that both inhibit (brain) inflammation, a major cause of damage in Alzheimer's, and simultaneously inhibit the production of amyloid beta peptide, perhaps the biggest villain in this terrible disorder."

The drug may still be years away from the clinical trial phase, but since the disease can't be stopped once it's started, research aimed at prevention could prove to be the Holy Grail.

A couple years ago, Bill Fisher, CEO of the Alzheimer's Association, played a key role in getting the National Alzheimer's Project Act (NAPA) signed into law by President Obama. In addition to commissioning an annually updated national plan to address Alzheimer's, NAPA is also designed to force the feds to prioritize Alzheimer's right next to heart disease, cancer and HIV.

But for Angie Carrillo, the choices aren't getting easier. John's condition has deteriorated in recent months, and she's facing the prospect of having to place him in a nursing home. Angie says that she's been talking with her children about divorcing John in order to make him eligible for Medicaid, perhaps the only way she can pay for his increasingly expensive care.

When he was first diagnosed, Angie told John that she would take care of him as long as he remembered her—an incentive for him to hold on.

"John and I have been a wonderful, loving couple," Angie says. "If anything, he still knows I'm his sweetheart. He still tells me he loves me, he still holds my hand, he still gets anxious for me to come and pick him up." But darker days are ahead, for John and others afflicted with Alzheimer's.

"I think that there's a tsunami coming," Angie says, "and no one is paying attention to it."