The Toll on Patients

The greatest costs to people suffering from AD have little to do with economics but instead speak to the fears of a foreshortened future and the eventual loss of dignity and independence. People with AD lose the very qualities that make them human—memory, reasoning, personality, and language.[3]

Many experts believe that AD first appears as a syndrome known as mild cognitive impairment (MCI), a transitional stage that is characterized by memory impairment without other signs of cognitive loss or impaired function.[14] It is estimated that 40% of those identified as having MCI will go on to a diagnosis of AD within 3 years.[2] As scientists and clinicians learn more about MCI, they will be better able to predict at-risk individuals who might benefit from early therapeutic intervention.

In patients who go on to develop dementia, the rate of deterioration varies. However, over the course of several years, impaired judgment, increasingly severe memory loss, and confusion inevitably ensue. Patients become less able to manage even the simplest tasks or perform their usual activities of daily living. They also often develop behavioral problems, such as agitation, delusions, wandering, and physical aggression. Eventually, full-fledged dementia occurs, motor and sensory skills are lost, and patients become bedridden and unresponsive to their environment.[5]

The Consequences for Caregivers

The 24-hour-a-day task of bathing, toileting, dressing, feeding, and ensuring the safety of a loved one is exhausting and often leads to psychological problems and medical illness for caregivers, some of whom are elderly and in poor health themselves.[15] Spouses of persons with dementia are at an approximately 25% higher risk of dying within a 9-year period vs persons whose spouses do not have dementia.[16]

Caregivers of parents with AD, who in many cases are working women, are also susceptible to personal or work-related problems.17 A survey of caregivers conducted by the Alzheimer’s Foundation of America found that those who were caring for a parent with AD felt abandoned by their extended family, had less time for their own family, and often had to resign from their job.[18] Indeed, caregiver distress, not patients’ behavior problems or inability to care for themselves, is often the decisive factor leading to nursing home admission.[15]