Alzheimer’s Disease A Burden On Caregivers

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Neurodegenerative Disease The Fastest-Growing Cause Of Death

Someone in the world develops dementia every three seconds. There were an estimated 46.8 million people worldwide living with dementia diagnoses in 2015 and this number is believed to be close to 50 million people in 2017. This number will almost double every 20 years, reaching 75 million in 2030 and 131.5 million in 2050. The X factor is the number of people who have dementia, but have not been diagnosed. It’s estimated that the real number is drastically higher.

Much of the increase will be in developing countries. Already 58 percent of people with dementia live in low and middle income countries, but by 2050 this will rise to 68 percent.

The total estimated worldwide cost of dementia is US$818 billion in 2015, which represents 1.09 percent of global GDP. By 2018, the global cost of dementia will rise above a US$1 trillion.

This figure includes costs attributed to informal care (unpaid care provided by family and others), direct costs of social care (provided by community care professionals, and in residential home settings) and the direct costs of medical care (the costs of treating dementia and other conditions in primary and secondary care).

In the U.S. alone, it’s estimated that Alzheimer’s disease is already costing citizens $277 billion annually, including $186 billion in Medicare and Medicaid payments. 

Between 2000 and 2015, deaths from Alzheimer’s disease as recorded on death certificates increased 123 percent, while deaths from the number one cause of death (heart disease) decreased 11 percent. Unfortunately, Alzheimer’s disease isn’t always diagnosed and it isn’t accurately reported as the cause of death in the majority of cases. Eighty-three percent of the help provided to older adults in the United States comes from family members, friends or other unpaid caregivers. Nearly half of all caregivers who provide help to older adults do so for someone with Alzheimer’s disease or another dementia.

Direct medical care costs account for roughly 20 percent of global dementia costs, while direct social sector costs and informal care costs each account for roughly 40 percent. The relative contribution of informal care is greatest in the African regions and lowest in North America, Western Europe and some South American regions, while the reverse is true for social sector costs.

This means that if global dementia care were a country, it would be the 18th largest economy in the world. The annual costs exceed the market values of companies such as Apple (US $742 billion) and Google (US $368 billion).

Research shows that most people currently living with dementia have not received a formal diagnosis. In high income countries, only 20-50 percent of dementia cases are recognised and documented in primary care. This ‘treatment gap’ is certainly much greater in low and middle income countries, with one study in India suggesting 90 percent remain undiagnosed. If these statistics are extrapolated to other countries worldwide, it suggests that approximately three quarters of people with dementia have not received a diagnosis, and therefore do not have access to treatment, care and organized support that getting a formal diagnosis can provide.

Earlier diagnosis and early intervention are important mechanisms by which the treatment gap can be closed. Among all people alive today, if those who will get Alzheimer’s disease were diagnosed when they had mild cognitive impairment (MCI) — before dementia — it would save trillions of dollars in health and long-term care costs.

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Gary Chandler is a prion expert. He is the CEO of Crossbow Communications, author of several books and producer of documentaries about health and environmental issues around the world. Chandler is connecting the dots to the global surge in neurodegenerative disease, including Alzheimer’s disease, Parkinson’s disease, Creutzfeldt-Jakob disease, chronic wasting disease and other forms of prion disease. The scientific name for prion disease is transmissible spongiform encephalopathy. The operative word is “transmissible.” Even the global surge in autism appears to be related.