I am in Washington at the National Press Foundation’s Alzheimer’s Disease Issues 2011 Fellowship with about 15 other journalists. The program runs through Wednesday. Today’s session was a half-day, with presentations by Richard Jackson, director of the Global Aging Initiative, Center for Strategic and International Studies, and Harry Johns, President and CEO of the Alzheimer’s Association.
Global Age Shift
Trends that struck me in Jackson’s global aging presentation were as follows:
1. Falling fertility is near or beneath replacement in countries, including China, Brazil, Mexico, and Chile. In Turkey, Iran, North Africa, and Indonesia, fertility is also falling fast.
2. Rising life expectancy is bringing added financial burdens that few developed countries can handle.
3. As the population ages, productivity in the workforce goes down and growth slows.
4. Savings and investment drop.
5. As a result, families get smaller and people become more risk averse. Smaller families may find it more difficult to socialize their children to care for elders as they did traditionally.
6. A rising share of the population does not have a child to look after them, which in my mind, puts more elders at risk of poverty in old age.
7. Right now, Germany and Sweden look the best in terms of funded retirement savings. Germany and Japan both have mandatory long term care insurance deducted from income.
8. There have been Draconian cuts in pensions worldwide.
9. However, Germany stands out as one country where you don’t have to become poor to get old age/long term care.
Planning for Alzheimer’s Disease Burden in the United States
Turning to the United States, Johns compared the stigma surrounding Alzheimer’s to where cancer was in 1961, when many doctors did not tell patients about a diagnosis of cancer. He pointed out that available treatments are at best “”symptom improvers’ that don’t work for everyone and when they work, they may not work for long.”
Legislative changes at the federal level are promising, including the National Alzheimer’s Project Act (NAPA), which passed in December, as part of the lame duck session in Congress. It requires developing a strategic plan for Alzheimer’s in America, according to Johns. As part of the “Welcome to Medicare exam,” including an annual cognitive measure will be added to the annual physical.
The HOPE (Health Outcomes, Planning, and Education) for Alzheimer’s Act (H.R.5926), sponsored by the Alzheimer’s Association, is currently making the rounds in Washington. It is endorsed broadly, with bipartisan support. Change.org has a petition on the web urging the public to sign it and “Stand with the Alzheimer’s Association and urge members of Congress to support” it.
According to Johns, the Hope for Alzheimer’s Act will encourage discussion about Alzheimer’s, promote charting in the medical record, and advance discussion about Alzheimer’s and care.
The change.org petition states: “Too many of America’s baby boomers will spend their retirement years either living with Alzheimer’s disease or caring for someone who has it. Even worse, many of the estimated 5.4 million Americans with Alzheimer’s disease do not have access to a formal diagnosis or care planning services preventing them from planning for the future. As we work for Alzheimer’s research, we must ensure individuals living with the disease have access to services that can improve their quality of life today.”
This is the second time that the Foundation has run this event, which is underwritten by Pfizer,the Lawrence B. Taishoff Endowment, and the National Press Foundation Program Fund. A few journalists and bloggers have criticized the program in the past because of Pfizer money. Pfizer is in the Alzheimer’s market so anyone could argue that in supporting an educational program on Alzheimer’s, journalists who cover Alzheimer’s information gained at the meeting, could use that information to enhance Pfizer’s market share. That’s why I am being up front about this here. According to NPF President Bob Meyers, Pfizer has absolutely no editorial impact on the program, but before the program, Pfizer receives a proposed agenda and budget.
I don’t know whether I’ll have the energy to blog every day of this meeting (it’s Alzheimer’s all day for 2.5 days ahead), but if you have any concerns about Alzheimer’s patient care, caregiver issues, or funding, please point them out in the comments.
I was struck yesterday by MARGARET MORGANROTH GULLETTE’s piece in the NY Times, “Our Irrational Fear of Forgetting.” It poses a counter to the despair in the face of dementia, insisting that one’s humanity is not so readily disposed of or overwhelmed. There may be a romantic tendency that ignores the disease’s devastation, but the cynicism that discards a life in decline warrants a counterbalance.
The growth in this population, with its needs for creative and stimulating care programs, should only be considered with implementation of Single Payer, or Medicare-for-All health insurance.