WHO has put Alzheimer's and dementia on its world watch for the upcoming decade, 2010-20, and that's good news for funding for research related to dementia, said Dr. Arden Aylor, director of geriatric medicine and Alzheimer's dementia director for the Center of Geriatric Medicine at Scott & White Memorial Hospital.
"In the next four to five years, because there is always a lag time, there will be a significant amount of money available for innovative research," Aylor said.
Recent research has targeted early detection and early prevention, but there's very little money for curative measures, because no one knows how to cure a genetic disease, he said.
"But if we can detect earlier, faster and cheaper, then we can offer a long-term benefit . . . that's where we're at," Aylor said.
Researchers have a pretty good idea of what causes dementia. The responsible gene and the allele - one in a pair of genes that control a specific trait, such as eye color - have been identified.
"We know that there are two types of Alzheimer's, early onset and late onset," Aylor said.
Early onset is very aggressive, affects multiple family members and occurs on or before age 60. It also has a very strong genetic component.
Late onset Alzheimer's occurs after the age of 72 and may skip a generation. The thought is it has to do with genetic penetrance - the frequency with which the characteristics transmitted by a gene appear.
There is one allele that guarantees the person will get Alzheimer's. Another allele protects the person from the disease. There are two other alleles that people possess and they may or may not eventually develop Alzheimer's.
"The question is what's going on in the environment that kicks it on or kicks it off," Aylor said. "We know the disease, we just don't know all of the components that cause the disease to kick on."
Those involved in treating or researching dementia are pushing for changes on two fronts.
Access to care is an issue, Aylor said.
If a person breaks a hip, Medicare will pay for a stay in a rehab facility. Medicare will not pay for in-home assistance for a person in the early stages of dementia.
Alzheimer's is a terminal diagnosis, but even if it's the early onset form of the disease, a person can still live somewhat independently.
Arden said he believes people are always happiest in their own home, which is feasible with dementia patients if there is someone to check to make sure meals are being eaten, medications are taken and safety issues are addressed.
The second push is to continue to make progress in identifying the disease earlier.
There already are those who can be identified as likely candidates early on because of their family history or chronic illnesses. In the next three to five years, Aylor predicts, the process will tighten and people at risk and those with less risk will be identified.
