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"The Current and Future National Landscape of Alzheimer's Disease" - Alzheimer's Day Keynote

FACT:Alzheimer’s disease (AD) claimed 68 percent more lives in 2010 than 2000.

FACT: More than 5 million Americans are estimated to be living with Alzheimer’s. By 2050, it is projected to be 13.8 million.

FACT: While annual research funding for cancer, HIV/AIDS, and cardiovascular disease is approximately $6 billion, $3 billion, and $2 billion, respectively, AD receives about half a billion dollars.

It was in this environment that the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern held its 19th annual Alzheimer’s Day in May for patients and their caretakers, scientists, and other interested parties to heighten awareness, share information about Northwestern research, and discuss state-of-the-art care and treatment options.

Activities included a poster session, panel presentation, town hall meeting, and a keynote address by a respected researcher in neurocognitive studies, Ronald Petersen, MD, PhD, director of the Mayo Alzheimer’s Disease Research Center. Petersen, chair of the Alzheimer’s Disease Advisory Council, the 26-member group created in 2012 that was charged with advising the U.S. Secretary of Health and Human Services on how to develop a plan to address Alzheimer’s disease (AD), spoke about the work being done. Here we share highlights from his speech.

“The ultimate goal of the plan is to effectively treat AD and related dementias (delay onset, slow the progression) by 2025,” says Petersen, professor of neurology at Mayo Clinic. “It’s an ambitious statement but is important as to what’s happening in the field. The deadline was not a trivial issue. Some people said, ‘That’s a long way out there. What about people today? Shouldn’t it be 2020?’ But is that realistic?”

To hit the ground running, the National Institutes of Health held the Alzheimer’s Disease Research Summit 2012: Path to Treatment and Prevention. The Summit brought together experts to review many aspects of AD research, diagnosis, and treatment, resulting in a number of activities over the past year, including a research index, applications for additional studies, a small increase in funding, and new AD criteria.

Alzheimer's Day keynote speaker Ronald Petersen, MD, PhD, director of the Mayo Alzheimer's Disease Research Center and chair of the Alzheimer’s Disease Advisory Council

To provide a view of the current national and international landscape, the International Alzheimer’s Disease Research Portfolio (IADRP) was created. This undertaking by the National Institute on Aging and the Alzheimer’s Association is an index of studies with information about the projects, including goals, timelines, funding, and when each is likely to produce results.

“It allows us to measure whether we’re making progress and if we are funding the right stuff,” says Petersen.

Work has also been done to develop new criteria to help diagnose AD and other neurodegenerative disorders.

“Didn’t we know how to diagnose the disease 10, 20, 30 years ago?” queries Petersen. “Yes, in fact, the guidelines were quite good, but we have learned a lot about the underlying pathophysiology and our abilities to detect the disease earlier and earlier… Heretofore, we have diagnosed AD at the dementia stage, but now we know that it probably begins back at the memory impairment stage, or even at the normal stage.”

Dr. Petersen went on to share information about AD biomarkers such as the laying down of amyloid protein―a study from Australia indicates these changes may happen 10 to 15 years prior to symptoms―and damage done to the central nervous system by defective tau proteins. Structural, functional, and molecular imaging, PET scans, and spinal fluid collection are all part of the clinicians’ current arsenal of tests to detect changes.

In addition to a focus on research, the plan has clinical care goals to stimulate clinicians’ interest in identifying the disease sooner. As a result, the Medicare Annual Wellness Visit now includes a required cognitive component to improve detection.