Annual Alzheimer's Costs Seen at $1 Trillion by 2050

Tom Murphy

Despite advances in diagnosis, the number of Alzheimer's cases will triple by 2050, with the cost of care skyrocketing to $1 trillion a year, according to experts speaking this week at a seminar in Washington.

Alzheimer's Association CEO Harry Johns speaking to journalists. (RedwoodAge)

Already, 5.3 million Americans have the fatal disease, according to Alzheimer's Association CEO Harry Johns, who offered a grim outlook at the seminar sponsored by the National Press Foundation. An additional 11 million Americans care for dying relatives and friends, with many of the caregivers sacrificing jobs because of the time they devote to the task.

Even so, Alzheimer's remains a much misunderstood disease and receives far less research funding than other deadly diseases. The US provides $469 million a year to investigate Alzheimer's compared to $6 billion for cancer, $4 billion for heart disease and $3 billion for AIDS. Yet, Alzheimer's kills more Americans each year than prostate and breast cancer combined.

"There's nothing good I can say about this disease," said Johns, whose mother succumbed to Alzheimer's. "And there's not that much I can say good about what's been done at the federal level up to this point. The federal government has failed to provide leadership in what needs to be done about Alzheimer's disease. There's no question about that."

The association claims Alzheimer's gets less support because it remains a "hidden" disease, much like cancer was viewed for much of the past century. The attitude towards cancer changed over the past 25 years, particularly after former first lady Betty Ford announced to the world that she had breast cancer. Ronald Reagan died from Alzheimer's but was shielded from the public after his diagnosis.

"I know of families myself where family members believe a loved one has [Alzheimer's] but they have not pursued a diagnose," he said. "We see denial as one of the biggest impediments for us in moving forward. It's at the family level, it's at the community level, it's at the congressional level."

Unlike cancer or heart disease, where risk factors are well known, the onset of Alzheimer's is unpredictable. There are some genetic links, but those cases are the minority. Scientists have searched for decades for ties between the disease and environmental factors such as air pollution or diet, but the cause remains unclear and a cure elusive. Existing treatments can help some patients live more normal lives, but don't extend life.

The first symptoms usually surface late in life. About half the people who survive to 85 will die of Alzheimer's, though their deaths are often attributed to other causes like organ failure or pneumonia. The disease creates plaque around brain cells, spreading until it shuts down all bodily functions, typically over a period of a few years. What starts with foggy memories, winds up as a 24-by-7 nightmare that lasts until death.

Families in Crisis
About 70 percent of Alzheimer's patients are cared for at home, mostly because their families cannot afford the care in a specialty hospital that can easily top $100,000 a year. Medicare will cover treatment, but won't cover long-term care.

"There is, of course, a point where they cannot handle the care that is required because it is just so difficult," said Johns. "Caregivers wind up giving virtually every measure. They give up time at work. They ultimately give up jobs or lose jobs because of the time they're giving as caregivers. They spend their own money. They lose their own health."

If one member in a couple develops Alzheimer's, the surviving spouse usually ends up in poverty, having spent their combined savings on treatment.

Already, the US spends $172 billion a year just to treat Alzheimer's patients, most of it through Medicare or Medicaid. About one in six dollars spent on Medicaid goes to Alzheimer's patients, who on average generate nine times the costs as the average Medicaid patient, according to the nonprofit Alzheimer's Association.

The costs will soar to $1 trillion by mid-century, without adjusting for inflation, as life expectancies increase, baby boomers drift into their sunset years and health costs rise, according to estimates presented at the conference, which received financial support from Pfizer and the Lawrence B. Taishoff Endowment.

By 2050, the accumulated costs of caring for Alzheimer's patients will total about $20 trillion - about $2 trillion more than entire the American economy.

Rising Risk
"As more and more people live longer, we'll have more people at risk," said John Rother, AARP's executive vice president for policy, strategy and international affairs. "And we'll have more burden on the family, more burden on the couple in terms of their financial standing, as well as the caregiving stresses, and more burden on our health care systems - state and local - particularly in trying to keep up with the health needs of people who are Medicaid eligible because they've spent down [their savings] and because these are such extremely expensive places to care for people."

Johns noted there have been significant advances in finding ways to diagnosis the disease, but a widely available method is still years away. Drug companies, including Pfizer, are eagerly seeking cures that may net them billions in new revenue. But all trials to this point have ended in disappointments.

AARP and the Alzheimer's Association both see difficulties in getting more public support to find a cure or better treatments for the disease, particularly in today's gloomy economic environment. Congress is currently looking at ways to cut programs like Social Security, Medicare and Medicaid to help fight the national debt.

"Given all the other problems we face in healthcare, and the expense of our healthcare system, it seems like a real challenge to take away money... and focus it on a disease that at least right now does not have a cure," said Rother.

At the very least, the Alzheimer's Association is hoping to stimulate a broader public conversation about the disease and it's costs.

"At the top of our list to make things happen is getting the public to understand these things so that there is a public discussion about Alzheimer's," said Johns. "We need to mobilize those people because we have not had the discussions about Alzheimer's that we've had about cancer."