Big increase expected in Alzheimer's cases

ST. LOUIS -- By 2030, the number of Alzheimer's patients will double or triple unless ways are found to delay onset of the progressive, degenerative brain disease, an Alzheimer's expert said Wednesday as a conference began at Saint Louis University.

Alzheimer's disease affects 4 million Americans and is the fourth-leading cause of death, said Dr. George Grossberg, keynote speaker at the Summer Geriatric Institute. He is also director of geriatric psychiatry at Saint Louis University.

Grossberg said data from Saint Louis University's Community Brain Bank, which he founded in 1995, indicate Alzheimer's patients typically die of pneumonia, sepsis and other infections after the brain disease has debilitated them, he said.

Risk factors for Alzheimer's are advanced age, being female, genetic predisposition, and family history. Possible risk factors include head trauma, low education level, and cardiovascular problems, he said.

The geriatric conference, which runs through Friday, drew 400 participants from 20 health care disciplines. They're exploring topics ranging from breakthroughs in Alzheimer's to caring for the family caregiver to helping elders remain in their homes.

It's timely, registered nurse Julie Hess said, as the elder population grows and nursing facilities struggle to maintain services and staff despite cuts in Medicaid and Medicare.

Three-fourths of Alzheimer's patients end up in a long-term-care facility -- the average is two or more years. Delaying onset of the disease or institutionalization would save significant amounts of money per year, Grossberg said. He noted, however, that managing the disease is so taxing that many family caregivers turn to institutions, out of exhaustion, despite the cost.

"They're emotionally drained and burned out," Grossberg said of caregivers, whom he described as the second patient.

"They're so dedicated ... they ignore their own health care needs. They're emotionally and physically exhausted."

Grossberg said genetic testing combined with metabolic screening potentially could identify the disease years before symptoms emerge.

Only an autopsy can confirm Alzheimer's, characterized by an atrophied brain and dramatically decreased brain cell activity. Healthy brain tissue degenerates, causing a steady decline in memory and mental abilities. Doctors typically diagnose a person exhibiting symptoms as having probable Alzheimer's.

One promising drug, under U.S. government review, could help patients with moderate to severe Alzheimer's. Memantine was approved as a treatment for advanced Alzheimer's last year in Europe, where it has been available in Germany for two decades to treat dementia.

There is no cure or known prevention for Alzheimer's, and the only medications are approved for earlier stages of the disease.

Last fall, Grossberg began testing a device that may slow or even halt the progression of Alzheimer's disease.

The device, which is surgically implanted, is a pump that increases the flow of cerebrospinal fluid in the brain. One theory about Alzheimer's is that stagnation of the fluid causes proteins in the brain to build up as plaque deposits -- causing cell death.

When activated, the pump keeps the fluid circulating and prevents protein build-up -- offering hope of a new therapy, especially for those in early stages of the disease.

So far, Grossberg's research team has implanted 17 of the devices in patients.

------

On the Net:

Alzheimer's Association: http://www.alzheimers.org

Alzheimer's Association, St. Louis chapter: http://www.alzstl.org