Age & Reason
How a Political Push Could Help Prevent Alzheimer’s
Monday, July 22, 2013 - 2:00pm
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We may actually learn how to prevent Alzheimer’s before we can cure it.

This is one of the top insights that emerged from last week’s global Alzheimer’s conference held in Boston – formally known as the Alzheimer’s Association International Conference (AAIC). A few new studies begin to tell the story. One research project, undertaken in England and Wales, found that dementia rates among people 65 and over have fallen by 25 percent over the past twenty years.

Other research done in Denmark shows that mental ability in people over the age of 90 is now substantially higher than it was a decade ago. And a recent study from France finds that “professional activity may be an important determinant of intellectual stimulation and mental engagement, which are thought to be potentially protective against dementia.”

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Here in the U.S., a recent survey linking lower Alzheimer’s incidence to “putting off retirement” shows that activity itself may have an impact on the disease. Holding a job as a preventive for Alzheimer’s – wouldn’t that be something? 

What these studies suggest, confirmed by other AAIC research, is that healthier lifestyles and higher levels of education can increase mental acuity and decrease rates of Alzheimer’s. Behavior, diet, and exercise, as well as the use of statins, can reduce incidences of diabetes and cardiovascular disease, thus lowering the risk of the correlated diseases of dementia.

With rates of Alzheimer’s projected to reach 66 million by 2030, this ounce of prevention may be worth ten thousand pounds of cure. So why hasn’t the Alzheimer’s Association screamed this theory from Boston rooftops?

Part of the reason, I suspect, is that Alzheimer’s needs to be analyzed not only through scientific and medical lenses – but through those of policymaking and population studies. This has become standard practice with HIV/AIDS and oncology and the AAIC would be wise to follow suit. 

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The role for breakthrough disease-modifying medicines remains of critical importance, and while positive news emerged from the conference, we can’t overlook the potential role and prospects of prevention.

Even if healthier aging processes have the potential to reduce global rates of dementia to levels below current projections, the Alzheimer’s problem is still massive. In the next few years the over-60 population will surpass one billion and by mid-century will double to two billion. Globally, the fastest growing demographic segment is the over-80 crowd, otherwise (and poorly) known as the “oldest old.” And because Alzheimer’s is related to aging, it may prove to be the social, health, and financial nightmare of the coming century.

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A recent set of stories from Japan, the world’s oldest country, gives incredible life to the shocking consequence of population aging. As is the case in most of the world, Japan’s birth rates are declining as lifespans are increasing. These twin forces of population aging are producing a new demographic balance of young-to-old that the world has not seen before. 

Case in point: By 2020, adult diapers will outsell baby diapers. The adult diaper market is growing 10 percent a year. Barring a seismic change in fertility practices, Japan’s fate is sealed to mid-century. Yet last century’s policies and habits cannot work for this century’s demographic realities. Older adults need to remain active and productive both to maintain personal health and to contribute to national economic growth.

Japan’s situation should serve as a wake-up call to the rest of us. Europe, China, the U.S. and others are not far behind. The AAIC could play a leadership role by showing Alzheimer’s isn’t only a medical issue.

If the AAIC can make this political turn, it will have good company and willing partners. The OECD, Oxford University, and the Global Coalition on Aging recently held a workshop that recognized the fiscal implications of Alzheimer’s and called for aging populations to become a driver of economic growth. The G8 has called for global leadership to rally around beating Alzheimer’s; British and American political leaders have equally pledged support.

The time is ripe, so to speak, for AAIC to bring together the esoteric scientific community with leaders from politics, economics, journalism, and more. If they wish to solve one of the 21st century’s toughest problems, they need to plan for a different kind of conference in 2014. As we learned from HIV/AIDS, the scientific and medical breakthroughs need political momentum to make a real difference. 

Executive director of the Global Coalition on Aging, Michael W. Hodin, Ph.D., is also managing partner at High Lantern Group and a fellow at Oxford University's Harris Manchester College.