Alzheimer’s Disease: A Potent and Growing Force (Part I of II)
Last week, when trying to interpret the outcome of a generational shift in leadership in Saudi Arabia, New York Times columnist, Tom Friedman, advanced a creative thesis:
To understand the upheaval that is taking place in Saudi Arabia today, you have to start with the most important political fact about that country: The dominant shaping political force there for the past four decades has not been Islamism, fundamentalism, liberalism, capitalism or ISISism.
It has been Alzheimer’s.
While one may legitimately argue the soundness of this assertion, Friedman has happened upon an undeniable truism: Alzheimer’s disease is a potent force, and it is only getting stronger.
November marks Alzheimer’s disease (AD) awareness month. For the last several years, the Milken Institute Center for Strategic Philanthropy (CSP) has been digging deep into the role philanthropic capital can play in tackling the toll of Alzheimer’s disease. We are currently working to update and expand our Alzheimer’s Disease Giving Smarter Guide that evaluates a range of questions, including the current state of research, major barriers to progress, and systemic leverage points where philanthropic capital can be invested.
Since its initial discovery over a century ago, scientists have made substantial progress on understanding the pathology of Alzheimer’s. From large genome studies, we now know that Alzheimer's—a progressive, neurodegenerative disease that destroys memory and other vital mental functions—has specific genetic risk factors that predict the onset and shed light into the underlying mechanism. With new methods in imaging, we can now take a peek into patients’ brains and monitor changes, which provides much-needed clarity into long-held questions on disease progression, and also allows for a definitive diagnosis—something that cognitive tests alone did not deliver.
Although some progress is better than none, what we really need is a quantum leap forward.
An Epidemic on the Rise
The number of Americans living with Alzheimer's disease is growing—and growing fast. Currently, an estimated 5.5 million Americans of all ages are living with this disease, which disproportionally affects the aging population. In fact, one in ten people over the age of 65 has Alzheimer’s dementia, and over two-thirds of those affected are women.
Minority populations are particularly hit hard. The risk of Alzheimer’s is two times higher in African Americans, and one and one-half times more likely in Hispanics. As the aging population is projected to double by 2050, the number of new cases of Alzheimer’s and other dementias is expected to soar.
An Emotional and Financial Burden
Alarmingly, Alzheimer’s disease is expected to overwhelm the national health care system, affecting a projected 16 million Americans and costing Medicare and Medicaid $1.1 trillion by 2050. At the same time, the emotional toll of watching a loved one slowly slip away can be debilitating and can leave families struggling to provide the near constant care necessitated in the late stages of the disease. In spite of the relentless march forward, the stark reality remains that there is not one approved therapeutic to prevent, slow, or cure Alzheimer’s disease. Not one.
Alzheimer’s disease is a true epidemic with rising prevalence, skyrocketing costs, and an absence of treatments. Yet, research in this space has been massively underfunded. For example, cancer research has historically received ten times more government funding than Alzheimer's, even though it cost the U.S. approximately 50 percent less in direct medical costs and led to a similar number of deaths.
Hope on the Horizon
Now for the good news. The Alzheimer’s Accountability Act, which was passed with bipartisan support in 2015, introduced a national goal of preventing and effectively treating Alzheimer’s disease by 2025. This act dramatically increased federal spending—calling for an additional $350+ million per year—on Alzheimer’s research. Additionally, the Building Our Largest Dementia (BOLD) infrastructure bill, which aims to build centers of excellence to support AD research and distribute funding, was introduced this month in the House with bipartisan support. The $350 million increase and focus on infrastructure is a good start. But it is only a start.
While federal funding may finally be catching up, there are still not enough resources in place to offset the realities of our future. To change the game, we need new thinking and bold breakthroughs. To this end, philanthropic capital has been stepping up to fill the void. For example, earlier this week, Bill Gates announced that he invested $50 million of his personal funds into the Dementia Discovery Fund, a venture capital firm set-up with backing from the U.K. government and several drug companies. He also plans to invest another $50 million in startups taking unorthodox approaches to treating Alzheimer's. This is a great example of how philanthropic investments can de-risk a sector and jumpstart new discoveries.
Not all investments need to be $100 million to make a difference though. Another great example of philanthropic innovation was the creation of “Alzheimer’s in a Dish,” a project funded through the Cure Alzheimer’s Fund, a venture philanthropy that funds pioneering science. This game-changing invention provides researchers with a powerful and inexpensive tool to conduct basic scientific studies to accelerate the drug discovery process. In this instance, philanthropic capital was able to be more nimble and less restricted, thereby accelerating progress in one of the most challenging areas of research.
Experts and politicians alike agree that more funding is needed to stave off the economic disaster expected from the growing aging population. At the same time, it is imperative that all funds—public, private, or philanthropic—be used as strategically as possible to accelerate the research and discovery process and alleviate barriers. In part two of this article, we take a deeper look at the obstacles that are inhibiting progress in the development of therapeutics for Alzheimer’s disease. Particularly, we explore the issue that a subset of Americans struggles to gain access to clinical trials, which are in desperate need of patients. We are confident that we can meet the ongoing and oncoming challenges of Alzheimer’s disease. We just need to be smart and move forward with urgency.
Read more about how philanthropic capital can battle Alzheimer’s disease in our Giving Smarter Guide.
If you’d like to learn more about Alzheimer’s disease in general, please visit the Alzheimer’s Association.
Interested in getting involved in a clinical trial? Visit this site to learn about trials near you.