Category Archives: Dementia

Why I’m Investing in the Fight Against Alzheimer’s

In every part of the world, people are living longer than they used to. Thanks to scientific advancements, fewer people die young from heart disease, cancer, and infectious diseases. It’s no longer unusual for a person to live well into their 80s and beyond. My dad will celebrate his 92nd birthday in a couple weeks, a milestone that was practically unimaginable when he was born.

This fact—that people are living longer than ever before—should always be a wonderful thing. But what happens when it’s not?

The longer you live, the more likely you are to develop a chronic condition. Your risk of getting arthritis, Parkinson’s, or another non-infectious disease that diminishes your quality of life increases with each year. But of all the disorders that plague us late in life, one stands out as a particularly big threat to society: Alzheimer’s disease.

You have a nearly 50 percent chance of developing the disease if you live into your mid-80s. In the United States, it is the only cause of death in the top 10 without any meaningful treatments that becomes more prevalent each year. That trend will likely continue as baby boomers age, which means that more families will watch their loved ones suffer from cognitive decline and slowly disappear. Despite this growing burden, scientists have yet to figure out what exactly causes Alzheimer’s or how to stop the disease from destroying the brain.

I first became interested in Alzheimer’s because of its costs—both emotional and economic—to families and healthcare systems. The financial burden of the disease is much easier to quantify. A person with Alzheimer’s or another form of dementia spends five times more every year out-of-pocket on healthcare than a senior without a neurodegenerative condition. Unlike those with many chronic diseases, people with Alzheimer’s incur long-term care costs as well as direct medical expenses. If you get the disease in your 60s or 70s, you might require expensive care for decades.

These costs represent one of the fastest growing burdens on healthcare systems in developed countries. According to the Alzheimer’s Association, Americans will spend $259 billion caring for those with Alzheimer’s and other dementias in 2017. Absent a major breakthrough, expenditures will continue to squeeze healthcare budgets in the years and decades to come. This is something that governments all over the world need to be thinking about, including in low- and middle-income countries where life expectancies are catching up to the global average and the number of people with dementia is on the rise.

The human cost of Alzheimer’s is much more difficult to put into numbers. It’s a terrible disease that devastates both those who have it and their loved ones. This is something I know a lot about, because men in my family have suffered from Alzheimer’s. I know how awful it is to watch people you love struggle as the disease robs them of their mental capacity, and there is nothing you can do about it. It feels a lot like you’re experiencing a gradual death of the person that you knew.

My family history isn’t the sole reason behind my interest in Alzheimer’s. But my personal experience has exposed me to how hopeless it feels when you or a loved one gets the disease. We’ve seen scientific innovation turn once-guaranteed killers like HIV into chronic illnesses that can be held in check with medication. I believe we can do the same (or better) with Alzheimer’s.

I’ve spent considerable time over the last year learning about the disease and the progress made to date. There’s a lot of amazing work being done in this field to delay Alzheimer’s and reduce its cognitive impact. What I’ve heard from researchers, academics, funders, and industry experts makes me hopeful that we can substantially alter the course of Alzheimer’s if we make progress in five areas:

  • We need to better understand how Alzheimer’s unfolds. The brain is a complicated organ. Because it’s so difficult to study while patients are alive, we know very little about how it ages normally and how Alzheimer’s disrupts that process. Our understanding of what happens in the brain is based largely on autopsies, which show only the late stages of the disease and don’t explain many of its lingering mysteries. For example, we don’t fully understand why you are more likely to get Alzheimer’s if you’re African American or Latino than if you’re white. If we’re going to make progress, we need a better grasp on its underlying causes and biology.
  • We need to detect and diagnose Alzheimer’s earlier. Since the only way to diagnose Alzheimer’s definitively is through an autopsy after death, it’s difficult to identify the disease definitively early in its progression. Cognitive tests exist but often have a high variance. If you didn’t sleep well the night before, that might skew your results. A more reliable, affordable, and accessible diagnostic—such as a blood test—would make it easier to see how Alzheimer’s progresses and track how effective new drugs are.
  • We need more approaches to stopping the disease. There are many ways an Alzheimer’s drug might help prevent or slow down the disease. Most drug trials to date have targeted amyloid and tau, two proteins that cause plaques and tangles in the brain. I hope those approaches succeed, but we need to back scientists with different, less mainstream ideas in case they don’t. A more diverse drug pipeline increases our odds of discovering a breakthrough.
  • We need to make it easier to get people enrolled in clinical trials. The pace of innovation is partly determined by how quickly we can do clinical trials. Since we don’t yet have a good understanding of the disease or a reliable diagnostic, it’s difficult to find qualified people early enough in the disease’s progression willing to participate. It can sometimes take years to enroll enough patients. If we could develop a process to pre-qualify participants and create efficient registries, we could start new trials more quickly.
  • We need to use data better. Every time a pharmaceutical company or a research lab does a study, they gather lots of information. We should compile this data in a common form, so that we get a better sense of how the disease progresses, how that progression is determined by gender and age, and how genetics determines your likelihood of getting Alzheimer’s. This would make it easier for researchers to look for patterns and identify new pathways for treatment.

By improving in each of these areas, I think we can develop an intervention that drastically reduces the impact of Alzheimer’s. There are plenty of reasons to be optimistic about our chances: our understanding of the brain and the disease is advancing a great deal. We’re already making progress—but we need to do more.

I want to support the brilliant minds doing this work. As a first step, I’ve invested $50 million in the Dementia Discovery Fund—a private fund working to diversify the clinical pipeline and identify new targets for treatment. Most of the major pharmaceutical companies continue to pursue the amyloid and tau pathways. DDF complements their work by supporting startups as they explore less mainstream approaches to treating dementia.

I’m making this investment on my own, not through the foundation. The first Alzheimer’s treatments might not come to fruition for another decade or more, and they will be very expensive at first. Once that day comes, our foundation might look at how we can expand access in poor countries.

But before we can even begin to think about how we do that, we need lots of scientific breakthroughs. With all of the new tools and theories in development, I believe we are at a turning point in Alzheimer’s R&D. Now is the right time to accelerate that progress before the major costs hit countries that can’t afford high priced therapies and where exposure to the kind of budget implications of an Alzheimer’s epidemic could bankrupt health systems.

This is a frontier where we can dramatically improve human life. It’s a miracle that people are living so much longer, but longer life expectancies alone are not enough. People should be able to enjoy their later years—and we need a breakthrough in Alzheimer’s to fulfill that. I’m excited to join the fight and can’t wait to see what happens next.

This article was published November 13, 2017 in LinkedIn under the group, “Alzheimer’s and Dementia Topics”.

 

Is Your Television The Future of Healthcare Innovation?

After all the angst generated by the Affordable Care Act, and all the punditry, noise, and debate that accompanied its rollout, you might conclude that there are no practical solutions to our healthcare challenges. But, of course, there are new answers and solutions and new, creative approaches to solving healthcare problems. You just have to look at innovative, private sector enterprises. And if you do, you might find one of the more innovative answers to eldercare right there in your old-fashioned television set. Just ask Kian Saneii, CEO of Independa.

But first, a little background. One of the more troubling and difficult areas of healthcare is the growing needs of the elderly, including both preventive care and the management of long-term, chronic illnesses. This has been a well-understood fact for quite some time. Saneii and the Independa team he began assembling in 2009 set out to find practical real-world solutions to these challenges. How they did this is an instructive case study in innovation, pragmatism and common sense.
The challenge that Saneii and Independa faced was grounded in four observations:

 The U. S. population is aging . . . fast. The 65+ age group is the largest population in the United States, and this segment will double by 2040.  Overwhelmingly – and hardly surprising – the elderly want to stay in their own home, in their own communities, as long as possible.  Long-term care costs have increased dramatically. In California, for example, nearly two thirds of the elderly could not afford three months of nursing home care; over forty percent couldn’t afford one month.  But, technology is converging in the growing area of telecare in such a way as to offer affordable, life-enhancing, and practical approaches to at-home care for at-risk populations.

“One of the things that struck me as we began thinking about this challenge,” Saneii says, “was this: There were (and still are) lots of point solutions in the area of telecare and eldercare, but no one was addressing the whole person. No one was looking to figure out how you put together multiple information streams, multiple data points and multiple inputs to monitor, treat and care for the individual. Point solutions were all aimed at individual symptoms, not individuals. The result was a partial, disconnected and incomplete system that neglected the human being who was being treated.

“For me, it just seemed that given twenty-first century technology, there had to be a better way to take care of my grandma living at home, and a better way to ensure she could continue living at home for as long as possible.”
At the heart of Independa’s strategy for eldercare is a simple assumption: The longer those who are aging or who have a chronic illness can stay at their current residence, be it their home or senior living community, the better. This is both a humane approach to healthcare delivery, and a key driver of reducing costs. Today, over 25.0% of the entire Medicare budget is spent in the last year of life, and 30.0% of those dollars are concentrated in the last month prior to death. And over 80.0% of that expenditure is in the hospital. The total costs – in dollars, in family stress, in unnecessary hospitalizations, in reduced quality of life – are staggering. A significant portion of these costs is driven by inefficient delivery and the absence of simple information flows, which in turn lead to missed medications, unnecessary hospitalizations and significant strain on care givers.

This is not where the elderly and chronically ill want to spend their time.

Saneii saw the opportunity to address the needs of the individual and the individual’s family. He recognized the positive upside of social engagement for the elderly as a means of ameliorating the costs and complexities that loneliness and isolation bring to the individual and their loved ones. And he saw telecare as an opportunity to improve the entire healthcare system, while dramatically increasing quality of life. So he and his team set out to create an experience, rather than a set of treatments, and a holistic approach to delivering care that takes into account the whole person.

“Although things are never as simple as we want,” Saneii says, “they might be simpler than we think. What we deliver is a total person-centric, not patient-centric, experience that reduces isolation and loneliness and improves quality of life for the elderly and chronically ill. In doing that, we also reduce family stress, family expense and wear and tear on family caregivers. The way to do that is to acquire high-quality information about the person’s status and make that available to family and caregivers: Things like medication and appointment reminders, activity monitoring, social engagement, and physical monitoring of health and wellness indicators.”

The Independa approach links the elderly person to their caregiver network, personal and professional, and provides the critical information flows necessary to preserve and extend independence, as well as to ease the day-to-day worries of the caregiver. The results of even the most basic information sharing can be surprising.

Consider the simple act of ensuring that medications are taken on schedule. One of the most frustrating challenges in caring for the elderly is prescription regimen. The AARP estimates that nearly 1 in 4 adults sixty-five or older will skip a medication or fail to refill a prescription, with serious consequences. For example, failure to follow the prescribed regimen and dosage for medication leads to a 50% increase in falls. The simple act of creating easy to use programs to ensure prescriptions are filled and taken on schedule reduces falls, reduces hospitalizations and doctor visits and prolongs independence.

“What we set out to do was a lot more than just develop a healthcare technology,” Saneii says. “We wanted to do something that would result in happier, more independent care recipients, and provide peace of mind for family caregivers. That’s really our measure of success.”

And now, enter the television set. Saneii and his team recognized that the elderly may very well be less likely to adopt new technologies, and prefer working with technology they already know. So, they partnered with an industry leader in commercial TVs to embed their solution directly into their TVs, a service seniors can access, no training needed, through the most recognizable of tools, their remote control. There it is: innovation in a television set.

As the U. S. population continues to age, and as healthcare becomes more available, there is an ever-increasing need to do things better, to provide smart approaches that both improve quality and reduce cost. Care of the elderly and chronically ill presents the most difficult challenges, but at the same time has the most potential upside for improving care. “In this world of elderly and chronically ill care delivery,” Saneii says, “just providing a technology, or a device, or a point solution is not enough. You have to think about the individual and that individual’s family. More than anything else we want to support independence, individual dignity and peace of mind. Why else would you be in this business?”

*This article was written by Henry Doss is a venture capitalist with T2VC, a volunteer in higher education, and a student and musician.

This article stresses the importance of seniors remaining at home to effectively receive better health care and reduce the cost. HomeFree Home Modification can help you to remain at home with more independence and safety. To receive a NO COST home assessment, please call us at 770-939-0747, or email at info@homefreemods.com

8 Memory Loss Communication Tips

Did you know that spoken words only account for 7% of communication? The remaining 93% is conveyed through body language, vocal tone and pitch. Communication style becomes especially important when someone in your life is living with memory loss.

When communicating with someone suffering from memory loss:

  1. Stand at eye level in front of them so they benefit from seeing your body language and facial expressions.
  2. Slow down your speech because their brains process information more slowly.
  3. Don’t interrupt: take time to listen to the person’s response. If they are especially stuck on a word, kindly supply the word and see how they react. If they don’t appear to want the help, let them manage on their own.
  4. Ask one question at a time and ask questions that require simple yes or no answers. For instance, “Do you want scrambled or fried eggs this morning?” instead of “How would you like your eggs this morning?”
  5. Where possible, supplement your communication with visual cues. Smile often, not only because it conveys warmth and caring, but also because smiling can make you feel better too.
  6. Touch is a powerful communicator. When used positively, touch can convey caring and warm feelings. It only takes a moment to offer a pat on the shoulder or a gentle hand squeeze.
  7. Phone calls are especially challenging for someone who has memory loss because the only communication cues they receive are words (7%) and vocal tone and pitch (38%). Limit phone conversations to a minute or so and say something positive like, “I was thinking of you and just wanted to call and say hello.” Consider using Skype or another one of the visual software methods on a computer, tablet or iPad to communicate.
  8. Spend time together in companionable silence. It can be exhausting for someone living with memory loss to continually process communication. Sit across from the person or at 90 degrees so they can easily see you.

Be aware of how you are communicating and whether it is having desirable results such as smiles, nodding, and looking contented, happy, or relaxed. If not, review your style to see if you should adjust an aspect of your technique.

*Adapted from an article by Karen Love with Advancing Person-Centered Living

Heavy drinking, slow walking may signal future dementia

Researchers make strides in identifying who is at risk.

By Mark Huffman

Two new research studies have shed new light on who will be afflicted with dementia, like Alzheimer’s disease, and why. They join the growing body of research that is giving doctors better insight to the aging-related disease that robs seniors of their memory. It’s of growing concern since the large Baby Boom generation is now entering old age and is at risk.

The first study, by researchers at the University of Exeter Medical School, links dementia with heavy alcohol consumption during middle age. It found that middle-aged adults with a history of problem drinking are more than twice as likely to suffer from severe memory impairment in later life.

“We already know there is an association between dementia risk and levels of current alcohol consumption – that understanding is based on asking older people how much they drink and then observing whether they develop problems,” said lead author Iain Lang. “But this is only one part of the puzzle and we know little about the consequences of alcohol consumption earlier in life.”

To find answers Lang and his team investigated the relatively unknown association between having a drinking problem at any point in life and experiencing problems with memory later in life.

“This is a public health issue that needs to be addressed,” Lang said. “More research is required to investigate the potential harms associated with alcohol consumption throughout life.”

Older people drinking more

The finding is particularly troubling in light of recent evidence that more middle-aged and elderly people are abusing alcohol. The National Council on Alcoholism and Drug Dependence says alcohol and prescription drug problems among adults 60 and older is one of the fastest growing health problems facing the country.

It says thousands of older people who need treatment for alcohol dependence aren’t receiving it.

Meanwhile, an international study of 27,000 patients has established an unusual test to determine whether a patient is likely to develop dementia. The test measured how fast the subjects walked and answered a short series of questions. The slower the gait and the more wrong answers, the higher the risk of developing dementia.

Scientists at Albert Einstein College of Medicine, who conducted the study, said people who failed the test were twice as likely as others to develop dementia within 12 years.

Low-tech test

What makes the test important, the researchers say, is that it does not rely on sophisticated or expensive equipment, making it accessible to physicians in remote regions of the world. Testing relies on measuring gait speed and asking a few simple questions about a patient’s cognitive abilities, both of which take just seconds.

“In many clinical and community settings, people don’t have access to the sophisticated tests – biomarker assays, cognitive tests or neuroimaging studies – used to diagnose people at risk for developing dementia,” said senior author Joe Verghese. “Our assessment method could enable many more people to learn if they’re at risk for dementia, since it avoids the need for complex testing and doesn’t require that the test be administered by a neurologist.

Early diagnosis, of course, is critical because it allows time to identify and possibly treat the underlying causes of the disease, which may delay or even prevent the onset of dementia in some cases.

The U.S. Centers for Disease Control and Prevention estimates that up to 5.3 million Americans—about 1 in 9 people age 65 and over – have Alzheimer’s disease, the most common type of dementia. That number is expected to more than double by 2050 due to population aging.

We at HomeFree Home Modification are not experts on “dementia”, but we are experts on helping you to remain at home through home modification. Call us at 770-939-0747, or email us at info@homefreemods.com , and we will come out to your home and provide a NO COST home evaluation to determine what steps can be taken to create a safer environment and more independence for you.

*Mark Huffman has been a consumer news reporter for Consumer Affairs. This article was taken from the issue dated 08/01/2014