The Bullpen

Why President Obama (or Romney) must tackle Alzheimer's

Here's a Big Idea: America's leader — whoever he is — ought to call on the country to tackle this painful, debilitating disease of the mind

Bill Frist

Bulletin to the post-election president of the United States: Americans are hungry for a Big (nonpolitical) Idea that will not only inspire and uplift, but also improve the daily lives of their families.

That Big Idea, I respectfully submit, should be a War on Alzheimer's disease.

Why Alzheimer's? Because it is a demographically driven, rapidly expanding condition that is incurable and fatal. It wrenches apart families emotionally and economically. And it will, if not reversed, inevitably affect every family.

Alzheimer's disease, the sixth-leading cause of death in America, is the only cause in the top 10 that cannot be prevented, cured, or even substantially slowed. While death rates for killers like stroke, heart disease, breast cancer, and HIV/AIDS have all declined in the last decade, Alzheimer's has risen 66 percent.

If you live to retirement, you are at risk for Alzheimer's. Currently, 1 in 8 Americans over 65 years old have Alzheimer's, which means that it's likely that someone in your family or someone you know is suffering through this agonizing ordeal.

1 in 8 Americans over 65 years old have Alzheimer's.

Making it the Big Idea and unleashing the American spirit on this terrible disease could prevent so much suffering.

When was our nation's last Big Idea? Most of my generation cites the race to the moon. A Big Idea, of course, is a goal that inspires, stimulates, challenges, and even asks for sacrifice of the American people to address a seemingly insurmountable problem. It spins off benefits that advance the well-being of mankind, many times in unanticipated and serendipitous ways. With the last Big Idea, we landed on the moon. And in about 65 years, roughly one person's lifespan, Americans went from Kitty Hawk to the Sea of Tranquility, a land-bound species to one that soared to other planets. 

Consider Alzheimer's: The disease is a degenerative neurological disorder that attacks the brain's nerve cells, resulting in progressive loss of memory, thinking and language skills, and behavioral changes. It is irreversible. This translates into the deep and tragic pain of watching your loved ones, your husband or mother, slowly drift away from you. The emotional toll on the individual is heartbreaking — the anguish of your own children becoming strangers, the helplessness caused by losing your independence, and the final horror of forgetting how to swallow or breathe.

The direct, tangible benefits alone that a cure could bring to our nation are astounding. Currently, 5.4 million Americans are living with Alzheimer's disease and by 2050, this number will leap to 16 million. The annual economic burden in direct health care costs is roughly $200 billion, which will surge to $1.1 trillion by 2050. That is roughly the size of this year's entire federal budget deficit.

The disease's impact is felt globally. Eighteen million people around the world suffer from Alzheimer's and that number will double over the next decade. It is estimated to cost 1 percent of the world's GDP. As the world's population grows and ages, especially in developing countries, the prevalence of Alzheimer's will escalate dramatically. The risk of Alzheimer's rises exponentially as we age, typically starting about the time we turn 60. 

We know little about Alzheimer's. We don't know what causes it, but there is increasing evidence that genetics plays a role. How much does diet, lifestyle, or even where you live affect the chances of getting Alzheimer's? All we know for certain now is that the risk for Alzheimer's increases exponentially as we age and that those with a genetic predisposition carry a higher risk. 

Some promising foundations for understanding and discovery are being established. Last year, a genetic analysis of more than 11,000 people with Alzheimer's disease and a nearly equal number of elderly people who have no symptoms of dementia was reported in Nature Genetics. Led by Vanderbilt University, the University of Pennsylvania, the University of Miami, and Boston University, the study engaged no less than 44 universities and research institutions in the United States, and identified four new genes linked to Alzheimer's.

Researchers are testing new drug therapies to attempt to control and slow symptoms. A few have been approved by the FDA, including drugs like Aricept, Exelon, and Namenda, and these can in some cases provide a measure of symptom relief. But we have seen no major breakthrough.

Now, calling for the president to push America toward a Big Idea on Alzheimer's does not mean asking for a new government program.  

Here's what it does mean: Rallying the nation and its creative minds around an unwavering commitment to find a cure. It means developing the science of biomarkers, establishing a macro-environment friendly to innovative research for care, prevention and treatment, sharing best clinical protocols and practices, evolving new care delivery models, and improving the regulatory environment for discovery and translational research. It means identifying risk factors and early diagnostic markers and developing novel treatments and preventative measures for memory loss and abnormal cognitive aging. 

The Big Idea will find a cure, halt the human cost and suffering, and lead to a wave of further clinical and medical innovations, inventions and devices that will improve all of our lives.

Ostensibly, past Big Ideas have been for national pride, but the actual benefits cascaded out into our country and the world. NASA technology helped create the artificial heart pump, weather satellites that warn of threatening storms like Hurricane Sandy, and ATMs. Technologies designed for exploring space now help in increasing crop yields, restoring antique paintings, and treating illnesses like multiple sclerosis.

To align the nation around curing Alzheimer's would have similar effects. Medical innovation, from devices to procedures to pharmaceuticals, have been a crucial strength of the American economy over the last few decades, but these leads are rapidly being eroded by increasing competition from China and a resurgent Europe. 

Americans are hungry for the Big Idea. Mr. President, make it a reality.


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