The document discusses dementia and Alzheimer's disease. It defines Alzheimer's disease as the most common type of dementia, accounting for 60-80% of cases. Alzheimer's is a progressive brain disorder that causes problems with memory and thinking abilities severe enough to interfere with daily life. A definite diagnosis of Alzheimer's requires examination of brain changes after death. The document also provides statistics on the prevalence and rising cost of Alzheimer's disease in the United States.

1. Elizabeth Chapman, MD
University of Wisconsin Hospital
and Clinics, Division of Geriatrics

2. • Decline in memory and in at least one of the following
cognitive abilities:
• Ability to speak coherently or understand spoken or written
language.
• Ability to recognize or identify objects, assuming intact sensory
function.
• Ability to perform motor activities, assuming intact motor abilities
and sensory function and comprehension of the required task.
• Ability to think abstractly, make sound judgments and plan and
carry out complex tasks.
• The decline in cognitive abilities must be severe enough
to interfere with daily life.
http://www.alz.org/downloads/facts_figures_2013.pdf

3. Percentage
Alzheimer's Disease
8%
7%
Vascular Dementia
15%
Mixed Dementia
65%
5%
Dementia with Lewy
Bodies
Other
There are many types of
dementia, Alzheimer’s Disease being
one of them.
Adapted from: http://www.alz.org

4. • Most common type of dementia – 60-80% of all cases
• Progressive neurodegenerative disorder
• Clinical diagnosis is based on symptoms:
• Problems with memory AND one or more other cognitive
disturbance
• Symptoms develop gradually
• Definite diagnosis is based on characteristic changes in
brain pathology (plaques, tangles)
http://www.alz.org/downloads/facts_figures_2013.pdf

5. 72 million people
~20% of US population
Baby
Boomers
turn 65
42 million people
~13% of US population
http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/2012_Documents/Docs/EntireChartbook.pdf

6. http://www.alz.org/downloads/facts_figures_2013.pdf

7. Baby Boomers
turn 85
http://www.alz.org/downloads/facts_figures_2013.pdf

8. #5
#6
http://www.cdc.gov/nchs/data/databriefs/db115_fig4.png
http://www.cdc.gov/injury/wisqars/pdf/10LCID_All_Deaths_By_Age_Group_2010-a.pdf.

9. http://www.alz.org/downloads/facts_figures_2013.pdf

10. PLUS $9.1 billion in indirect costs related to
caregiver health care use resulting from the
physical and emotional strains of
caregiving
$1.2 T
$203 B
NOW
Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf
2050

11. Cost (Billions)
$450
$400
$350
$300
$250
$200
$150
$100
$50
$0
$419
$216
$27
Estimated Cost of
Unpaid Caregivers
2011 Walmart Sales
(17.5 billion hours of unpaid
care) Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf
2011 Total Sales at
McDonald's

12. Cost (Billions)
$450
$400
$350
$300
$250
$200
$150
$100
$50
$0
$419
$216
$27
Estimated Cost of
Unpaid Caregivers
2011 Walmart Sales
Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf
2011 Total Sales at
McDonald's

13. Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf

14. Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf

15. • 53% of caregivers report “a good amount” to “a great
deal” of financial strain
• Higher rates of depression in caregivers (39%) than noncaregivers (17%)
• Caregivers rate their personal physical health more
poorly than non-caregivers
Adapted from : http://www.alz.org/downloads/facts_figures_2013.pdf

16. • In 2012, the Obama Administration announced a plan to
commit $156 million to address Alzheimer’s Disease
• The US Department of Health and Human Services’
National Plan to Address Alzheimer’s Disease aims to:
• Prevent and Effectively Treat Alzheimer’s Disease by 2025.
• Enhance Care Quality and Efficiency.
• Expand Supports for People with Alzheimer’s Disease and Their
Families.
• Enhance Public Awareness and Engagement.
• Track Progress and Drive Improvement.
http://aspe.hhs.gov/daltcp/napa/NatlPlan2013.pdf

17. Research Goals:
1.A. Identify Research Priorities and Milestones
1.B. Expand Research Aimed at Preventing and Treating
Alzheimer’s Disease
1.C. Accelerate Efforts to Identify Early and Presymptomatic
Stages of Alzheimer’s Disease
1.D. Coordinate Research with International Public and Private
Entities
1.E. Facilitate Translation of Findings into Medical Practice and
Public Health Programs
http://aspe.hhs.gov/daltcp/napa/NatlPlan2013.shtml

18. Understand
the how
Alzheimer’s
Disease
affects
brain cells
Identify the
triggers for
Alzheimer’s
Disease
Find ways
to diagnose
the disease
earlier
Discover
better ways
to treat
Alzheimer’s
Disease
Uncover
ways to
prevent
Alzheimer’s
Disease

19. Courtesy of Dr. Neil Buckholtz; Lennart Mucke, Nature, Vol 461|15 October 2009

20. • AD genes
• Presenilin-1, Presenilin-2, and Amyloid
precursor protein (associated with earlyonset disease)
• Apolipoprotein E-e4 (increases risk of lateonset AD)
• Still trying to understand what these genes
do
• Cardiovascular risk factors
• High blood pressure, high
cholesterol, diabetes
• Dietary risk factors
• Relationship with exercise

21. FDG-PET
CSF Aβ42
Cog
CSF tau
Amyloid imaging
Function
Courtesy of Dr. Neil Buckholtz
MRI
hipp

22. Courtesy of Dr. Neil Buckholtz; Klunk et al. Annals of Neurology 2004

23. • Treatment Targets
•
•
•
•
Drugs that reduce beta-amyloid levels in the body and brain
Preventing tau protein from forming tangles
Reducing inflammation in the brain
Decrease insulin resistance, cholesterol build-up in blood vessels
X X
X X
http://www.alz.org/research/science/alzheimers_treatment_horizon.asp

24. D
E
M
E
N
T
I
A
People with a risk of developing
Alzheimer’s Disease
Medications, physical
exercise, mental exercise, healthy
http://www.alz.org/research/science/alzheimers_treatment_horizon.asp
diet, vaccines

25. NIA Alzheimer’s Disease Education and Referral Center (ADEAR)
Toll-free information line, 1-800-438-4380
Web site (English & Spanish) :
www.nia.nih.gov/alzheimers
HHS Alzheimer’s.gov
http://www.alzheimers.gov/
Alzheimer’s Association
Web site: www.alz.org
Courtesy of Dr. Neil Buckholtz