Sunday, August 14, 2016

Health care costs and management of Alzheimer's patients

Before discussing these 2 choices here are some interesting facts  regarding Alzheimer's that I extracted from  internet searches   :
Data  for  USA  : Alzheimer's  ranks as the 6th  leading  cause of death surpassing  breast and  prostate cancer deaths combined ; currently   every minute someone develops Alzheimers  (thats 60 new cases every hour, 1440 for each day (24x60) and  525,600  for each year (1440x365);  predictions are that  by 2050 this rate  will double to a new case of Alzheimer's  developing every  30 seconds  doubling the number  to over 1 million new cases annually ;   the   medicare costs today to treat Alzheimer's in the USA is 236 billion annually excluding the $5000 that care givers also spend annually with  predictions based on increase in number of people over agen85  that   by  2050   these costs will  rise to over one trillion dollars annually .
Canadian picture-just as gloomy : according to Canadian vital statistics for  2013  Alzheimer's  ranked as the 5th major cause of deaths behind, cancer, heart disease,stroke, and chronic respiratory disease; because the elderly are currently the fastest growing segment of our population  there are now more people over age 65 than  those under age 17  with the prediction that by 2050 half of the elderly will be over age 85; since incidence is related to age viz.  at age 65 only 8% of the Canadian population have   some degree of Alzheimers but by  age 85 this incidence increases to 35%; since  by  the year 2050  half of the elderly will be over the age of 85 you arrive at the alarming conclusion that Alzheimer's  could have 35% of more of the population having Alzheimer's and become the become the number one cause of death;    the  current annual health care costs for Alzheimer's is  around 30 billion,  by 2050 it could increase  to over 300 billion  and it alone could bankrupt our healthcare  system for Canada.
We desparetly need a solution now . In the title of this post I suggested there were 2 routes available.-  more nursing home beds or basic research to find the cause and cure  of Alzheimer's.  As with other  pandemics in the past we also had similar 2 choices . For example In the 1940's and 50s with the polio epidemic , governments were facing a similar policy decision- should they   invest their resources to build more and better iron lung machines with   hospitals to house the iron lungs with patients in  these machines  or should they invest in basic medical research to find a cure for polio. The National Foundation for Infantile Paralysis as it was called in those days  chose the latter- a wise decision.  Regarding Alzheimers we have the same 2 choices-more nursing home beds or medical research.  I especially like the comments by Dr. Roy Walford in his text book entitled Maximum Life Span. Here is part of his quote found on  pp17-18   "... My point is that old age homes and all the vast social support structures continuously accumulating to care for the helpless aged are the iron lungs of gerontology. Improvements in the social, economic and medical support system for the elderly will merely provide symptomatic relief for an expanding problem. ..." .
By giving top priority to constructing 1200 more nursing home beds the province of Manitoba would seem to have made their decision. Of note in  Saskatchewan the government claims that everyday there are 10 new cases of Alzheimer's. Thats over 3600 cases each year. If eventually 25% of these cases require nursing home beds , then the  province would have to build over 900 beds annually. In the 19th century  tuberculosis- known also as the white plaque- was the leading cause of death claiming over 35% of the population.  Sanatoria like the Manitoba one had at  Ninette were quickly constructed . With the discovery of antibiotics which  specifically killed the  tuberculosis bacterium   patients no  longer had to go to sanatoria  and these buildings soon  became museums.
I have become quite fascinated with the advances made in Alzheimer's research, and will discuss topics like the role of Vitamin D and the 7 common ways I have outlined to slow the aging process. These  together with 3 special procedures - 1)  hyperspectral endoscopy to view the retina and the brain. According to Swati More "... the retina is not only connected to the brain , it is part of the Central Nervous System...-" ;  2)perispinal etanercept administration to neutralize tumor necrosis factor-alfa (TNF-alpha) which is believed involved in the pathogenesis of Alzheimer's disease- this drug is currently used to treat rheumatoid arthritis.; 3) deep brain stimulation - Dr. Andres Lozano has used this procedure to treat Parkinsonism and there are trials with Alzheimer's patients. Look for these to appear in my future posts.




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