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Clinton calls for Alzheimer's cure, increase spending to $2 billion annually

Clinton elevates disease hitting women and minorities hard

Heidi M. Przybyla
USA TODAY

As U.S. deaths from Alzheimer’s are exploding, Hillary Clinton wants to make curing the disease a major issue for the women and minority voters who are at a disproportionate risk of developing it.

Hillary Clinton

In her last campaign speech Tuesday before the Christmas holiday, Clinton called for a dramatic increase in federal spending to find a cure for the only cause of death ranked in America’s top 10 that cannot be cured, prevented or even slowed. The Democratic front-runner proposed spending $2 billion a year in an attempt to cure the degenerative brain disease by 2025.

"We owe it to the millions of families who stay up at night worrying about their loved ones afflicted by this terrible disease and facing the hard reality of the long goodbye to make research investments that will prevent, effectively treat and make a cure possible," Clinton said in a statement Tuesday morning.

It’s the first time a presidential candidate has made Alzheimer’s a major campaign issue, said Robert Egge, executive director of the Alzheimer’s Impact Movement, whose advocates are leaning on all 2016 campaigns to take up the issue. None of them has offered specific plans. Clinton's proposal “makes this a national conversation,” he said.

Clinton made her proposal at a campaign stop in Fairfield, Iowa. On Monday, Clinton held a conference call with researchers where she underscored the urgency of raising the disease's profile.

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From 2000 to 2013, Alzheimer’s deaths increased 71%, while heart disease fatalities dropped 14%. Unlike cancer and heart attacks, there is no known cure. “Alzheimer’s is the red-haired stepchild among the top diseases threatening the aging and our health care system,” said Alzheimer’s pioneer Rudolph Tanzi, the neurology professor who discovered many of the genes, including the first ones, leading to Alzheimer's. He oversees a research center at Massachusetts General Hospital.

Congress significantly boosted funding levels in 2016, yet it’s still less than half of what researchers say they need every year. It’s an investment, they say, that would be recouped in the first three years after discovery of a treatment. The alternative is an estimated $1.1 trillion in costs for Medicare, Medicaid and caretakers in 2050.

As Clinton eyes a pivot to a general election campaign, she’s also looking for issues that transcend different generations and draw in independent female voters. Although most of the afflicted are older women, their primary caretakers are younger females carrying emotional and economic burdens. About 40% of caregivers have a household income of $50,000 or less.

It’s only been recently that researchers recognized how disproportionately women are afflicted by the disease, Egge said. “This was an eye-opening moment,” he said.

Almost two-thirds of the people over age 65 who have Alzheimer’s are women, as are a majority of Alzheimer’s and dementia caregivers. Older African Americans and Hispanics are more likely to develop it than their white counterparts. Overall, about 5.3 million Americans have the disease, leading to $226 billion a year in costs. The Food and Drug Administration has not approved a new compound to treat the disease in more than a decade, and the potential consequences for public health and the federal budget are immense.

“This disease has the potential to single-handedly collapse Medicare and Medicaid,” Tanzi said.

Currently, 18% of Medicare dollars are spent on people living with Alzheimer's and other dementias, according to an Alzheimer's Association report. Without advances, Medicare costs will more than quadruple in 2050, accounting for one in three Medicare dollars.

Clinton’s $2 billion proposal is the target recommended by a broad array of scientists, and it would bring federal spending more in line with other major diseases, including HIV and heart disease. The spending deal Congress passed last week includes a 50% increase in funding for Alzheimer’s research, pushing funds to $936 million in fiscal 2016. Clinton also announced proposals to support caregivers, especially those who give critical care and support to the millions of families struggling with Alzheimer’s.

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Alzheimer's and other dementias are caused by the buildup of microscopic clumps of a protein fragment called beta-amyloid outside of nerve cells, which causes twisted strands of a protein called tau to form tangles inside of nerve cells and to kill them.

Tanzi, named one of Time magazine’s 100 most influential people, has been on the front lines of fighting the disease. Yet, he says, most of the drug trials being conducted are from genes his lab discovered in the 1980s and 1990s. In the past 10 years, they’ve discovered nearly two dozen new Alzheimer's genes and learned what a strong role inflammation plays, especially in patients who already have the disease. “There’s very little work going on elucidating those genes, because there’s not enough funding,” said Tanzi.

Researchers have two main theories as to why women are more susceptible than men to the disease. One is that menopause leads to energy deficits in the brain, Tanzi said. The other, which he gives more credence, is that women are more susceptible to brain inflammation than men, which is also probably why women suffer more from other brain diseases like multiple sclerosis, he said.

Some markers for Alzheimer's can be detected 20 years before symptoms arise, said Tanzi. Yet there's no way to treat it. “It’s an issue people have swept under the rug,” he said. “We’re just starting to wake up.”

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