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Brian Kaskie, Mike Splaine, A World Without Alzheimer’s Disease?, Public Policy & Aging Report, Volume 32, Issue 2, 2022, Pages 43–44, https://doi.org/10.1093/ppar/prac009
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It is known that diabetes results from the inability of pancreatic islet cells to make insulin in amounts sufficient to control the blood glucose level. As efforts continue to identify an ultimate prevention or disease-modifying treatment (DMT) for diabetes, researchers have worked tirelessly to improve the lives of persons with diabetes, such as by developing more effective and user-friendly patient insulin monitoring and delivery devices. Public health researchers also have worked to lower the population risk of ever getting diabetes, and clinical researchers have identified secondary treatment strategies that mitigate problematic symptoms, improve function, and increase quality of life. So, as the search for a DMT continues, the diabetes research community has substantially improved the lives of persons who live with the condition. Finding a cure and improving treatment for persons who live with diabetes has occurred in tandem.
Consider now Alzheimer’s disease and related dementias (ADRD), which have emerged as both a leading health-care and public health priority. With no known DMT, the increasing number of persons with ADRD and their caregivers has begun to stand apart among aging Americans, including those who live with diabetes and have been offered evidence-based treatments that address symptoms and improve quality of life. In comparison, persons with ADRD endure deterioration in cognitive abilities, passing through mild to severe clinical stages, that can last up to 20 years. During this long journey, more than one-half present affective, behavioral, and psychiatric disturbances, and many persons with ADRD are diagnosed with other health conditions and experience problems with nutrition, sleep, and chronic pain. Persons with ADRD use emergency rooms more than other older adults and they have greater numbers of ambulatory-sensitive inpatient hospital visits, overnight observations, and nursing home stays. Eventually, persons with ADRD may require full-time care, which is most often provided by a spouse, child, or other relative who has no formal training. Expensive and inefficient use of health care and long-term services and supports persists even though researchers have identified several pharmaceutical and nonpharmaceutical interventions proven to mitigate symptoms, delay unwanted residential placements, and reduce costs. There is a large and growing gap between what can be done to help and what is actually being done, and this gap only widens with the lack of public education, provider training, and implementation of proven care approaches (Kaskie & Stamy, 2018).
