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As the population grays, Alzheimer’s and dementia threat looms

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During the next eight years, the number of Virginians with Alzheimer’s disease will swell by nearly 36 percent, to about 190,000, according to the Alzheimer’s Association.

It’s part of a global trend: The World Health Organization projects that the number of people living with dementia will triple – from 50 million to 152 million – by 2050.

Why the increase? Because the Baby Boomer generation, born between 1946 and 1964, will be advancing into the age range when Alzheimer’s is more common. This is compounded by the fact that the birth rate during the Baby Boomer years was higher than any other generation since.

The result: In the coming years, the U.S. will face an unprecedentedly large elderly population – people more prone to dementia-related diseases.

“By 2020, they’ll be 70. Typically, we’ll see Alzheimer’s emerge in your 70s,” said Harald Sontheimer, executive director of the School of Neuroscience at Virginia Tech. “It’s not that the likelihood has changed.”

On average, during the course of about four to eight years, Alzheimer’s causes the brain to deteriorate, impairing memory and cognition.

“Particularly, the cortex gets thinner and thinner as more brain cells die,” Sontheimer said. “It really begins with when it impairs the independent ability to live.”

Alzheimer’s is the sixth leading cause of death in the United States and causes between 60 and 80 percent of all dementia cases. In 2015, there were 354 dementia-related deaths in Henrico County, according to the U.S. Centers for Disease Control.

According to the Virginia Department for Aging and Rehabilitative Services, near half a million caregivers in Virginia provide assistance for a family member with dementia. At a projected 519 million hours of care in 2015, this was equivalent to $220 billion in unpaid caregiving that year.

Impact of FAMILIES

The cost of nursing homes to care for people with dementia can be staggering – between $4,000 and $8,000 per month. So three years ago, the state’s aging-services agency launched a program called Family Access to Memory Impairment and Loss Information, Engagement and Supports, or FAMILIES.

FAMILIES provides counseling and education resources to those with family members suffering from Alzheimer’s and dementia.

“Caregivers aren’t getting the information they need,” said Devin Bowers, dementia services coordinator for the Department for Aging and Rehabilitative Services. “The FAMILIES program helps build a support network. It’s meant to delay putting a family member in an institution.”

The FAMILIES program has reached more than 250 caregivers in Virginia during the past three years. Among other benefits, it lowers the incidence of depression among caregivers, according to a survey of families with a loved one suffering from dementia.

“My major concern is that people in the industry are well trained,” said Tina Thomas, director of programs and services for the Greater Richmond chapter of the Alzheimer’s Association. “People need to know what sort of care is available in their area.”

A Medicare rule put into effect last year allows primary care doctors to bill Medicare for Alzheimer’s and dementia testing. Currently, only 45 percent of doctors regularly test aging people for such disorders. Hopefully, Thomas said, the new rule will make testing more frequent, as early diagnosis and planning are key to financial planning.

“It’s great to have these conversations early on,” Thomas said. “It really comes down to drafting a road map of care.”

Researchers are not certain what causes Alzheimer’s. The most popular theory is that a protein called amyloid plaque builds up on brain cells and causes the disease. However, researchers don’t know whether the amyloid itself causes the disease or if the proteins are a biomarker of another process occurring.

A research trial is currently underway in Colombia with the hope of better understanding Alzheimer’s. Near the city of Medellin, a family carries a mutation that causes some members to develop Alzheimer’s between 45 and 50. They are being given drugs that inhibit the buildup of amyloid plaque, to determine whether the protein is to blame.

According to the World Health Organization, the global costs of dementia total more than $800 billion annually. That is why WHO has launched the Global Dementia Observatory, an online platform to track services for people with dementia and their caregivers.

“Nearly 10 million people develop dementia each year – 6 million of them in low- and middle-income countries,” Dr. Tedros Adhanom Ghebreyesus, director-general of WHO, said in a press release on Dec. 6.

“The suffering that results is enormous. This is an alarm call: We must pay greater attention to this growing challenge and ensure that all people living with dementia, wherever they live, get the care that they need.”

More information online

Help is available for families with loved ones who have Alzheimer’s disease or other dementia-related disorders.

The Virginia Department for Aging and Rehabilitative Services has created a program called FAMILIES, which stands for Family Access to Memory Impairment and Loss Information, Engagement and Supports. To find out more about FAMILIES, visit https://www.vadars.org/cbs/dementiaservices.htm; e-mail Devin Bowers, the state’s dementia services coordinator, at devin.bowers@dars.virginia.gov; or call 804-662-9154.

In addition, in 2016, the department and other organizations launched No Wrong Door, an online platform (https://www.nowrongdoorvirginia.org/) that stores patient data in one place for easy access by public and private health-care services.

The groups involved include area agencies on aging, centers for independent living, community services boards, local departments of social services, hospitals, nursing homes and organizations providing home care, home repair, transportation, meals programs and other services.

For more about No Wrong Door, email NoWrongDoor@dars.virginia.gov or call 804-662-9354.