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Patricio Reyes M.D., F.A.N.N.
Director, Traumatic Brain Injury, Alzheimer's Disease & Cognitive Disorders Clinics; Phoenix, AZ; Chief Medical Officer, Retired NFL Players Association

Barrow Neurological Institute
St. Joseph's Hospital and Medical Center
"2 NEW THERAPIES FOR ALZHEIMER'S"
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"2 NEW THERAPIES FOR ALZHEIMER'S"
Patricio Reyes M.D., F.A.N.N.
Director, Traumatic Brain Injury, Alzheimer's Disease & Cognitive Disorders Clinics; Phoenix, AZ; Chief Medical Officer, Retired NFL Players Association

St. Joseph's Hospital and Medical Center



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Patricio Reyes M.D.
Director, Traumatic Brain Injury, Alzheimer's Disease & Cognitive Disorders Clinics; Phoenix, AZ; Chief Medical Officer, Retired NFL Players Association

Barrow Neurological Institute

St. Joseph's Hospital and Medical Center
"PRESERVING BRAIN FUNCTIONS "
Runtime: 50:22
Runtime: 50:22
"2 NEW THERAPIES FOR ALZHEIMER'S"
Runtime: 10:27
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ALZHEIMER'S AWARENESS PROGRAMS
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BIOMEDICAL RESEARCH IN ALZHEIMER'S DISEASE
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Robert F. Spetzler M.D.
Director, Barrow Neurological Institute

J.N. Harber Chairman of Neurological Surgery

Professor Section of Neurosurgery
University of Arizona
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Michele M. Grigaitis MS, NP
Alzheimer's Disease and Cognitive Disorders Clinic

Barrow Neurological Clinics
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Tuesday, August 2, 2016

 

Alzheimer's Disease Patients Are The Last Casualties Of The Cold War


























A pen used by former U.S. President Lyndon B. Johnson to sign Medicare into law is seen with another during a press preview at the National Archives on March 18, 2014 in Washington, D.C. (BRENDAN SMIALOWSKI/AFP/Getty Images)

This past week, Alzheimer’s disease researchers from all over the world have gathered in Toronto. Much of the talk at the Alzheimer’s Association International Conference is about how Alzheimer’s disease is a big problem and it’s only getting bigger. In the U.S. alone, my colleagues and I struggle to care for 5.3 million patients. By 2025, there will be 13.8 million.

Why did this happen? The standard answer follows a three-step, fact-filled narrative: (1) the 20th century has seen tremendous advances in longevity; (2) aging is among the chief risk factors for Alzheimer’s disease; and (3) there are no effective treatments.

In Toronto, we say that these facts add up to a crisis. The solution? Biomarkers and drugs that allow Alzheimer’s doctors like me to diagnose and treat patients before they suffer disabling cognitive impairments. I’m actively trying to make this future possible, but this week, I’ve been looking backward as well—back 51 years to the birth of Medicare, the U.S. social insurance program that pays for older adults’ healthcare.

I’ve made a discovery. The facts above are true, but they’re not the whole story. The elderly, particularly the elderly with dementia caused by Alzheimer’s and other neurodegenerative and vascular diseases, are among the last casualties of the Cold War. We had a hand in making this crisis.

The Cold War had real casualties, including hundreds of Berliners who died trying to flee the soul-sucking oppression of the East German state and tens of thousands of U.S. soldiers and Korean and Vietnamese citizens who died or were permanently wounded. I’d like to add to this casualty list the millions of older adults with dementia and their caregivers.

They’re casualties because the healthcare system fails to deliver the care they need. Few physicians are trained in geriatrics and even fewer as Alzheimer’s doctors. Older adults with cognitive complaints are typically consigned to a hasty diagnosis and even when they receive a diagnosis, they find minimal guidance on how to live with the disease. Many patients don’t even receive a diagnosis. They come to my memory center taking the mildly effective Alzheimer’s drugs and asking whether they have Alzheimer’s, or it is dementia, or just aging, and what’s the difference between them? Their experiences kindle fear and even suspicion about the healthcare system, feelings reinforced when they go out into the world and experience their autonomy under siege. Assessments of their capacity to make life’s important decisions are reduced to a single score on a simple test of cognition. And the system expects them to pay the majority of the costs of their care.

Biomarkers and drugs will certainly help me care for my patients, but I’ll use these technologies in a healthcare system that’s not able to care for these patients. The more we understand why it’s not able to, the more we’ll understand how we got into this crisis, and so the better we’ll be able to address it.

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