Managed Care

 

Can anything stop the coming Alzheimer’s explosion?

MANAGED CARE March 2013. © MediMedia USA
Managed Care Outlook

Can anything stop the coming Alzheimer’s explosion?

The journal Neurology’s release last month of a study on Alzheimer’s generated headlines across the United States because of the daunting conclusion: The number of patients with the disease will nearly triple by 2050. What didn’t attract as much attention, but will concern physicians and health insurers, is the researchers’ contention that there may not be a way to stem this trend.

“It has been suggested that these numbers would decrease substantially if an intervention was identified that merely delayed the onset of AD dementia,” says the study “Alzheimer Disease in the United States (2010–2050) Estimated Using the 2010 Census.”

Yet, it would take time for the intervention to decrease the prevalence of the disease, the authors argue.

“An intervention whose effects were most pronounced in the earliest stage of disease would also have delayed impact on future prevalence. For instance, if the measure was effective only if implemented by age 50, there would be no change in the projected bulge from the baby boomers because all baby boomers are at least 50 now.”

As Thomas Morrow, MD, who writes Managed Care’s Tomorrow’s Medicine department, pointed out in May 2011(http://tinyurl.com/AD-column), “The course of AD is highly variable and can be present in mild forms for long periods of time. In fact, detailed neuropsychological testing can detect mild cognitive impairment” years before a diagnosis is confirmed.

About 5 million people suffer from Alzheimer’s currently. That’s expected to rise to about 14 million by 2050, the study says. To project incidence and mortality, the study’s authors relied on statistics from the Chicago Health and Aging Project, along with 2010 U.S. Census estimates of population growth.

The changed projections “were not attributable to a single factor, but rather to small variations in multiple components…. The update to the projected population numbers for 2050 contributed the largest change to the projected [Alzheimer’s] prevalence for that year. The population aged 65 years or older projected for 2050 increased to 88.5 million from 81.7 million in the previous projections. However, this is also the time most distant from the present and therefore the most difficult number to estimate.”

Estimated number of people with Alzheimer’s disease (AD) in the United States in 2010 and projections through 2050, in millions

Predicted number of people in the United States with Alzheimer’s disease in percent of the group affected, by age group and year

Source: “Alzheimer Disease in the United States (2010–2050) Estimated Using the 2010 Census,” Neurology

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