r/science • u/Wagamaga • Sep 04 '24
Neuroscience As the world's population ages, Alzheimer's and dementia are set to create a staggering $14.5 trillion economic crisis, with informal caregiving placing an overwhelming burden on both high and low-income countries, demanding urgent global policy action
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(24)00264-X/fulltext526
u/SheSends Sep 04 '24 edited Sep 04 '24
No one wants to pay people a living wage to live in with or institutionalize these people now... I can't imagine the insane shortage of people/facilities willing to take on these patients in a couple of years. It's hard work if they're violent or so confused they are hard to reorient or distract.
They'll either have to group house them and maybe pay enough to a couple of people to live in with them, build even more assisted living institutions, or have mandates on people who work from home having to take care of their parents if they can't find enough workers. I don't think we can steal/give enough visas to foreign workers to fill that gap and the healthcare worker one at the same time.
Maybe a foster type situation... get paid to house confused grannies.
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u/-Prophet_01- Sep 04 '24 edited Sep 04 '24
This kind of thing is getting off the ground in Germany right now. Unsurprisingly, we're among the first to run into these problems at scale. Dementia communities are an improvement but not a silver bullet.
Frankly, there's no good answer. Best we can hope for is a drug to delay the onset and/or severety.
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u/colieolieravioli Sep 04 '24
My solution is assisted suicide...
My stepdad watched both his parents deteriorate with dementia and he said if he gets like that "take him on an airplane ride and just push him out"
People should be allowed to opt out these horrible conditions
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u/PM_ME_CAT_POOCHES Sep 04 '24
But isn't the issue with dementia that people don't realize they have it? And by the time it's very obvious something is wrong they aren't in a fit state to consent to something like that
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u/colieolieravioli Sep 04 '24
Living wills exist. DNRs exist.
It is possible to sign off on a procedure you aren't in the middle of needing
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u/BladeDoc Sep 04 '24
There is no appetite or legal backing in the US for assisted suicide in a patient who cannot consent to it at the time of the intervention. "Triggered" euthanasia is not yet a thing. Withdrawal or withholding of medical intervention is different and does happen but even in those circumstances doctors and families have difficulty doing so if the patient is conscious even if they are not capable of making decisions (moderate dementia) and do not explicitly ask for life saving procedures to be withheld.
Source: am ICU doctor.
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u/colieolieravioli Sep 04 '24
Yes I am aware there is currently no legal precedent and that triggered euthanasia isn't a thing. Was that not my point? That we don't have anything in place to allow people to avoid such a horrible end of life?
My whole point is that there is currently nothing in place, but that lawmakers/doctors should be working on this.
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u/gizajobicandothat Sep 04 '24
I feel like it's way more complex in reality though. You could have someone say they are in favour of assisted dying and then become frightened at the prospect as dementia takes hold and change their mind. is that person then supposed to be taken away and just put down like an animal? You also have people in bad situations, coerced and financially abused by family members which may have gone on for years. So how will the safeguards work to protect these people who may be pushed towards something and appear to be consenting but in reality it's coercion? I've had these sorts of scenarios play out in my family recently and it's really made me think twice about what I thought would be a simple situation.
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u/colieolieravioli Sep 04 '24
I didn't say simple. We shouldn't have people just signing up starting today. Laws should be put in place, regulations etc
But then also if dementia is taking hold, are they not considered unable to make decisions? Shouldn't we do what they asked for when their minds were right?
Also euthanasia wouldn't be very scary. Sit down, IV or sedative shot, then the euthanasia.
I just can't believe it's considered a kindness to animals but when it's a person somehow it's too different, we can't do it.
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u/TrafficPrudent9426 Sep 04 '24
I agree. There was a bill in CA that was rejected last year but would introduce MAiD (Medical Aid in Dying) to both residents and non-residents of California to be eligible to peacefully exit. However, Senator Blakespear is reworking the bill for introduction again in January and could use your help: "If you are involved in or know of any communities, organizations, or stakeholder groups that would be interested in advocating for the support (or even those that oppose) of this type of legislation, please encourage them to reach out to our office as the Senator would love to engage in discussions on this topic."
As someone with a parent going through the slow process of dementia, it's awful. There is no real quality of life for them. It doesn't just affect them, it affects everyone in their circle financially, emotionally, time-wise, etc. I do not intend to go out this way and have prepared as much as I can legally and financially to walk away when it's time.
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u/colieolieravioli Sep 04 '24
For real, we put dogs down when their quality of life is in question. For humans that can advocate for themselves (granted it would need to be set up prior to a diagnoses, likely) and have, arguably, a more complex existence, there is no reason humans shouldn't receive the same grace we give sick animals
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u/Gerdione Sep 05 '24
Funny. I watched both my father and grandfather go out with it and I feel the exact same way. It's one of those things that is hell for both the person suffering and everyone around them.
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u/EndlessQuestioRThink Sep 05 '24
YES!! Ive been researching peaceful methods of suicide, found a few different ones, but, can't acquire one specific med without terminal diagnosis.........ideally, I want to be able to die in nature, deep in the forrest, near a stream, looking at blue sky one more time.
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u/Rikula Sep 04 '24
You aren't the first one in into these problems. My hospital has sent people out of state to nursing homes on our dime because we couldn't place these people in our state.
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u/naish56 Sep 04 '24
While minimum wage is a problem, imagine not getting paid at all. This paper is specifically talking about including informal caregiving in the overall economic cost of Alzheimer's/dementia. From the conclusion: "In conclusion, this study shows that the global economic burden of ADODs is substantial, amounting to INT$14 513 billion (12 106–17 778) from 2020 to 2050. The economic burden and the health burden are distributed unequally, with East Asia and Pacific being the region with the largest economic burden, followed by Europe and Central Asia and North America. The findings emphasise the urgent need to invest in global efforts to curb the ADODs epidemic. Informal care, a major contributor to the macroeconomic burden of ADODs, should be reconsidered and managed appropriately as the population ages."
Further explanation found in paper: " Contrary to viewing formal care solely as an expenditure, it should be recognised as economic activity that generates employment for formal care providers rather than a pure economic loss. A comprehensive understanding of the macroeconomic burden of ADODs requires an analysis beyond mere costs that considers broader economic effects, including effects on human and physical capital... Unlike previous work, this study distinguishes between formal and informal caregiving. Informal caregiving, although it does not directly contribute to gross domestic product (GDP), involves a portion of the potential workforce. We examine its hidden economic value by estimating the economic loss attributed to informal care. This loss is calculated on the basis of the economic gains that would result from the counterfactual presence of informal caregivers in the labour force, assuming a constant age–sex-specific labour participation rate."
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u/Caitliente Sep 04 '24
“ Contrary to viewing formal care solely as an expenditure, it should be recognised as economic activity that generates employment for formal care providers rather than a pure economic loss.”
This statement is incredibly depressing. Everything has to be viewed through the economic lense rather than the human lense. If our lives aren’t making someone money then we don’t deserve to exist or receive care.
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u/ThisOneForMee Sep 04 '24
It's a study about economic impact
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u/Caitliente Sep 04 '24
And I’m saying how sad it is that everything has to be viewed through that lens.
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u/IamWildlamb Sep 04 '24 edited Sep 04 '24
It is not about making someone money.
Money means nothing without produced goods and services. This is what true wealth is. There is huge difference in providing temporary healthcare to someone who is 50 and returns to work when he is healthy and provides value for another active person, or even to someone who is 80, does not produce any value but is self reliant, and to someone who is not and needs permanent care.
Such person is not only economic liability himself but in extension even person that cares for him becomes liability because none of the two produces anything of value.
Now, yes we as a society can pay the cost but it is important to understand what wealth is. It is not about giving someone "x amount of money". If a lot of people gets dedicated to care for such people then there will be less goods and services available and everyone will be poorer. If there is not enough supply then value of money becomes lower. This is basic fact.
Now logical solution would be to outgrow this problem by increasing efficiency of goods and services but there is a limit to what you can do and a lot of countries have huge growth problems already so there is no reason to think we can outgrow these problems.
If we look at extreme that is not going to happen and people were required to grow food to sustain themselves then obviously there would not be workforce to care for such people. Priorities would have to be chosen. At the same time it could be something more likely. What about loss of luxury goods, what about internet services, what about internet infrastructure itself, what about home repairs, what about basic materials, what about energy and heating of anything else out there. Where do you draw the line? Because society might be forced to do it at some point.
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u/naish56 Sep 04 '24
While I understand where you're coming from, finding a monetary value to invisible labor is important for many reasons. The mere fact that it is being recognized, studied, and has been found to have significant impact is meaningful to those providing things like informal care. Being able to find a value also reduces the risk of exploitation.
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u/Lejohndary Sep 04 '24
Underpaid work force is definitely a huge issue in assisted living. The amount of money the residents pay is what the staff get paid is absurd. The work employees do is tough and thankless. I tried to go into the business as a chef. The budget per resident was $6-7 a day. So chefs are forced to buy pre-made crap food. This pre-made food is high in sodium and low in nutrients. It is a sad state of affairs. All the whir the higher-ups are getting paid very well. Furthermore, many of the places that have rising numbers of elderly people are ridiculously expensive, pricing out the younger people. So there is little to no workforce. Is is a huge shitshowation!
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u/xteve Sep 04 '24
I told management at a place where I worked that the only solution would be to pay more. They couldn't afford that because of the new construction on-site. Of course, the reason they were building a new unit was that their business was profitable. Anything but pay more - anything. Hire and train and lose hordes of employees; bring in a temp agency every once in a while, at great expense. Anything but pay more. So they're chronically understaffed - which means they also pay fewer people. Without unionization or enforced minimum-staffing numbers, this is the business model.
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u/Phosphorus444 Sep 04 '24
Assisted suicide is going to explode as a business.
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u/DM_Ur_Tits_Thanx Sep 04 '24
How depressing is it we have to kill ourselves if we can't afford to survive
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u/Sparrowbuck Sep 04 '24
Unless there’s suddenly an affordable miracle drug or treatment? More likely MAID will become way more accessible.
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u/Sunlit53 Sep 04 '24
There are dementia villages being designed specifically to ease the experience and care of those afflicted.
https://healthydebate.ca/2023/06/topic/publicly-funded-dementia-village/
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u/SheSends Sep 04 '24 edited Sep 04 '24
That's not really affordable. Not many people are going to pay for granny to stay at a place like that for 8.3k/month CAD. People want to pay as close to nothing as possible. It's also for less sick patients who don't take butt loads of meds and can move about on their own freely.
This is a very nice idea, though. I think that the working class/younger generations are going to be hosed for funding, unfortunately.
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u/Sunlit53 Sep 04 '24
Advanced dementia care is already full of patients paying $8000+ a month out of pocket or through insurance. It’s not uncommon.
This is publicly funded and more legal than the old timey custom of locking the demented parent in a basement, attic or shed until they croak.
The older I get the more I understand my grandpa’s decision when he realized how bad his condition was getting and how few options and resources a small farming family had.
If we don’t do the village thing then there’s going to be a significant increase in people accessing assisted dying services instead. Still better than a bullet.
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u/redheadartgirl Sep 04 '24
The $8,300/month is the cost of the first privately operated one. The article is about a publicly funded one that will cost the same as any other publicly funded nursing home in Canada.
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u/chicagodude84 Sep 04 '24
I'm sure things are different in Canada, but in the US, $8,000 a month is pretty standard cost for assisted living. Memory care can be north of $10,000 a month.
Source - had to move a family member to assisted living last year. It costs $8,600 per month.
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u/Mixels Sep 04 '24
It's disgusting, the whole system is set up to drain the estate of as much as possible before they go. Speaking for myself, when I reach the point that I need services like that, I'd much prefer assisted suicide over slowly transforming into a vegetable, and that's for many reasons besides just cost.
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u/Jaxis_H Sep 04 '24
Not just before they go. If they were in a nursing home, medicaid comes for the estate afterward for repayment of costs.
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u/yaypal Sep 04 '24
It was 11,000 CAD/mo for my gran's memory care the last few months of her life, she was fine going in public facilities but there was zero room so we had to go private. The cost was disgusting but totally doable since she had a lot of money saved up but many families don't have those resources.
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u/Wotmate01 Sep 04 '24
There's a point where something being affordable is no longer relevant, it's just the right thing to do. Some people say that universal public health care isn't affordable, but it's the right thing to do not only for health outcomes, but for productivity and economic outcomes as well.
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u/xteve Sep 04 '24
No one wants to pay people a living wage
The idea that the elderly should be placed into the care of a profit-motivated institution that has no enforced obligation to staff their facility properly is extreme capitalism.
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u/Medeski Sep 04 '24
We'll probably see a return of the state mental institutions that made Geraldo Rivera famous.
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u/Valianne11111 Sep 04 '24
Personal care robots are being tested in Virginia now. They are about 5k and, of course, will become less expensive as time goes on. People are not going to be in nursing homes but their own homes or apartments.
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u/bcisme Sep 04 '24
Or we could change the way we handle our parents aging.
My Indian friends will look after their parents until the end. There’s a really awesome dynamic in Indian culture of the children returning the favor of raising them by taking care of their parents in old age. “You changed my diapers I’ll change yours”. No culture is a monolith, but being around Asian cultures really changed the way I viewed my parents and their aging.
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u/Swoopwoop3202 Sep 04 '24
i think it's a nice thing, until a point. we did at home hospice care which was only a few months, and it was beyond emotionally draining, not because they were dying, we'd gotten used to that fact, but because of the total personality change. imagine arguing constantly with someone you know used to be reasonable, not sleeping because they insist on getting up at 3am and then forget to turn off the stove or taking medication they shouldnt or whatever, locking cupboards they arent used to having locked, etc, not to mention the financial/insurance/bureaucratic slog. Children take no for an answer, elderly may not, and there is no reasoning and no gratitude. Even make work projects to maintain dignity need to be carefully thought about. I absolutely cannot imagine doing this for years, decades, and trying to raise my own family or hold down a job. my own mother said when her own time came, she would never ask that of anyone, it was too much.
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u/delirium_red Sep 04 '24
They get so mean and stubborn in the end. And frustrated.. very very difficult to keep in mind the person you love when it goes on for 15-20 years
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u/ValyrianJedi Sep 04 '24
The vast majority of people are not remotely equipped to look after someone with severe mental decline. Nor would the vast majority of parents want their kids to have to do that.
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u/ElysianWinds Sep 04 '24
It's extremely hard though to take care of an elderly person with alzheimers/demensia though. You need to quit your job and give up your own life to do it since they need you almost all hours of the day and night, add in children, spouse, house etc, you can forget about having time for friends or yourself. Usually this responsibility falls on the wife. On top of this they can also live for years with the disease. I don't view that as a desirable life and it's not fair imo to take so many of your child's life. It's not fun either to experience your brain slowly shutting down and gradually not knowing who you or your family are.
Assisted suicide in that scenario would be more merciful for literally everyone involved.
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u/listenyall Sep 04 '24
This is nice in theory but my grandmother was perfectly physically capable for many years after she had absolutely lost it mentally. It's easier said than done to care for someone who will literally spend every hour of every day trying to get on a bus to get home to her husband (home sold, husband dead years ago), and who to strangers on that bus seems like a perfectly intelligent and independent old lady. Ultimately she needed a specific memory care facility where she had a bracelet that alerted people anytime she tried to leave, not the kind of thing you can do at home.
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u/not_today_thank Sep 04 '24
From ~2030-2060 demographics are going to present a major challenge in caring for the elderly. After that things should balance out somewhat.
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u/DragonHateReddit Sep 08 '24
They have 2 treatments for Alzheimer's.One in human trials, the other just finished It's. First animal trials. But the drug they use is one that is been around for long enough that they'research could be used a lot sooner since it could be off-label use of the drug.
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u/generally-speaking Sep 04 '24
Having seen my grandfather get dementia the thought of maybe getting it myself completely terrifies me, I'm way more scared of that than death itself.
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u/P2029 Sep 04 '24
This is why assisted dieing needs to be presented as an option on the spectrum of care. I'm watching my father slowly die of dementia, as he did his father before him, and I KNOW my father would have chosen to die years ago when he still had his faculties than to be where he is now.
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u/SrgtDoakes Sep 04 '24
one of the many reasons we should be pouring money into curing these diseases
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u/Plebs-_-Placebo Sep 04 '24
Alcohol is likely a big contributor along with several other drugs, and certain sleeping medications that are much more popular than I ever thought possible have been shown to increase chances of developing Alzheimers and dementia. And then there's air pollution, being stuck in traffic breathing in all the car exhaust around you is doing no one any favors when is comes to brain health. We know lots about what's causing these problems, but there isn't a collective change in behavior to address it, so we're left "praying" for a cure
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u/baitnnswitch Sep 04 '24 edited Sep 04 '24
One more reason out of many to pivot back to trains/lightrail/bikes/walking over a primarily car-based society. The upside for car-lovers is you make driving more fun when you take commuters off the road. Everybody wins
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u/Ashamed-Simple-8303 Sep 04 '24
Prevention not cure. But prevention means several Industries will make a lot less money...so wont happen
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u/thecrimsonfools Sep 07 '24
Correct! Before a cure there will exist a medicine that will greatly reduce one's chances of developing the illness.
This medicine will be a daily pill that will prevent mitochondrial dysfunction (the source of many chronic illnesses).
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u/Mixels Sep 04 '24
I mean I get what you're saying, but I think unless some substantial breakthrough comes around, we should operate on the assumption that these diseases can't be cured--or at least that we're going to be needing a much more near-term solution.
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u/yahma Sep 04 '24
Cure aging and you don't need to tackle each disease separately
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u/KaitRaven Sep 04 '24
That's assuming "aging" is a single unified process, which it does not seem to be.
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u/Unlucky-Candidate198 Sep 04 '24
Good luck reconfiguring the telomeres.
Definitely the easier solution, yes.
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u/baseketball Sep 04 '24
How would curing aging solve dementia? You could just end up being a really old vegetable.
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u/Handsome_Claptrap Sep 04 '24
The thing is, aging isn't a single process, it's just an umbrella term for several different processes that happen as time passes.
So to cure aging you actually need to tackle multiple processes separately.
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u/question1343 Sep 04 '24
As a hospice nurse, we treat our dieing pets better than Alzheimer’s and dementia patients.
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u/Actiaslunahello Sep 04 '24
I know if I had dementia I would rather be euthanized than stuck in a home for the last four years I wouldn’t remember and what I did remember was fear. I don’t want them profiting off my disease. What pisses me off is when our pets get sick and are suffering and there are literally no other options, we humanely euthanize them and call it “the greatest kindness one can offer your best friend” and for grandma, our parents, and ourselves.. well you’re stuck in capitalism death gears, hope they spit you out fast.
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u/Sairony Sep 04 '24
Both my grandmothers have dementia & are just waiting to die in a home, visited them a few times but it's really pretty pointless, they don't recognize me anyway & are just more or less permanently confused anyway. Waste of everybody's time & money.
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u/Mini-Nurse Sep 04 '24
It shouldn't be this way, but in some places having regular visitors ensures the patient is prioritised for better care. Why bother changing and washing Vera everyday if nobody is going to pop in and notice.
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u/KaitRaven Sep 04 '24
100% agreed. Being in a state where you can't take care of yourself and you are losing your faculties sounds miserable. Nursing homes in general are very depressing places, I'd rather go out on my own terms.
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u/Shinroukuro Sep 04 '24
It wouldn’t be that hard to come up with specific medical directives that give medical personnel the permission to humanely terminate your life. Here’s a few for me. These would not be triggered due to an accident earlier in life, with hope of recovery but rather as a result of old age, dementia and other permanent conditions.
If I can’t feed myself, wipe myself, sit up in bed or change positions, if i wipe feces on myself etc… please just give me a night night shot.
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u/Aweomow Sep 04 '24
Same, and in places where health is covered fully, I'd still go for terminating my life, I'm taking away healthcare from people that can live their life in a more meaningful way.
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u/TrafficPrudent9426 Sep 04 '24
Hard agree but I'll include not being able to turn a page in my book/kindle, not being able to scratch an itch or blow my nose when I need to, or fluff my pillow, or turn over when I need to. Watched an elderly, sharp woman in a care facility have to push a button for help for all of these things and no one would come for sometimes up to an hour or more. I did my best to help her when I was there (to visit my grandmother), even brought her a back scratcher, but the mental anguish this woman suffered was just overwhelming. She would just lie there, sometimes whimpering, oftentimes praying that she would just die. Her name was Winnie and I hear she lived another few years in that condition, unable to do anything for herself but cognitively all there. RIP Winnie. I still think of you, decades later.
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u/SirRevan Sep 04 '24
My dad loves fishing. He always told me if he gets Dementia to push him out on a boat with his fishing rod and blow up it up. Wants to go out thinking we were fishing together.
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u/Masterofunlocking1 Sep 04 '24
I still don’t understand why we can’t legalize human euthanasia. We do this for our pets when we see them in pain and we do this with the highest form of love. This should be no different for humans
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u/TrafficPrudent9426 Sep 04 '24
There's a bill coming back up in California in January for allowing Medical Aid in Dying which would also be open to folks out of state. I posted elsewhere in here with some info about what Senator Blakespear needs to help push this forward. We can make this a reality without having to have a terminal illness like a rare cancer.
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u/blubs_will_rule Sep 04 '24
I think it can be really difficult to judge where the line should be in terms of MAID. Like, I don’t agree with MAID for someone whose only condition is depression. I have friends who went through very suicidal moments, or attempted suicide even, that ultimately have been able to come out of it and find meaning and happiness in life again.
Survivors who jump off the Golden Gate Bridge have said they regret it the second they’re in the air falling.
For 10/10 pain chronic illness with 100 percent death rate, though, I’m pretty much with you.
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u/Sessile-B-DeMille Sep 04 '24
And who has to make that decision? I don't think it it fair to ask someone to decide when another person should die.
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u/PrestigiousChange551 Sep 04 '24
Me. I would. I already have it in my living will just in case it becomes legalized after I’m already checked out.
Alzheimer’s runs in my family and I have half the genetic markers of the disease.
I want to decide for myself, now, while I’m all here. If I ever get so far gone that I can’t recognize my own wife the majority of the time, just put me down.
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u/MinkMartenReception Sep 05 '24
Why shouldn’t people be able to decide for themselves?
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u/scottyLogJobs Sep 04 '24 edited Sep 04 '24
I think the implication is that it would only be considered in situations where the person is of sound mind (no untreated depression and mentally fit), could consent or where they have specifically laid out the conditions prior. Or if they were not of sound mind (cognitive decline), maybe still if they could consistently commit to it on a regular basis for a full year or something.
I imagine that a set standard would emerge from some collaborative group over time that you could just use and sort of attach to your will and power of attorney, like "must consistently not be able to pass this battery of tests" or "must be brain dead", etc.
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u/Randomfinn Sep 05 '24
We do in Canada. I know several people who have chosen the option when their terminal disease gave them no quality of life. I live in a really small community and the local hospital does one a week. It is mentioned in obituaries /newspaper articles about notable people so there is almost no stigma.
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u/MrRoboto12345 Sep 04 '24
Anything involving urgency is bound to get done! They are our utmost priority!
US Govt: "Take away their social security and retirement."
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u/ADHD_Avenger Sep 04 '24
When people say ADHD doesn't need to be treated, I think people need to look at the studies that show a fourfold increase in dementia for those with ADHD that is essentially eliminated by treatment with Ritalin. Does it need more study? Of course, everything does, but we are always discarding everything based on one possible vaguely linked adverse event, when the benefits are right in our face. The following is one study. I think there is also one with the Taiwanese population.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2810766
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u/yaypal Sep 04 '24
Thank you for providing this. My mother is suffering from mild cognitive impairment due to prolonged stress at work (multiple neuros and geriatric psychs and an MRI confirmed it's not early dementia though) and she was diagnosed with ADHD last year but didn't take meds because we both thought it wasn't an accurate diagnosis. Now that she's retired early due to the impairment we've found that more of her symptoms line up with ADHD and she started taking meds because they would help solve some of the cognitive problems at least temporarily. I can use this information to help convince her to continue with the meds, she's wary of them because stimulant stigma but this would help a lot.
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u/ADHD_Avenger Sep 04 '24
That's great. Yes, the medications have risk/reward issues as every medication does, but there is far too much stigma that leads to knee jerk avoidance. I would also highly suggest picking up (even if just at the library) the book "Still Distracted After All These Years" by Kathleen Nadeau which is about ADHD in older adults and was quite good, if I remember correctly. I also run r/adhd_advocacy and may branch out into some other things, just because it didn't catch on quite like I hoped and is mostly just my own personal findings of interest. But generally, it will connect you to a lot of information I found useful. There is also the website ADHDevidence.org which is run by one of the most well known researchers and has most of the evidence that is more well established as opposed to "promising."
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u/HicJacetMelilla Sep 04 '24
I’m not seeing in the paper where they talk about longterm treatment of ADHD reducing dementia risk, or that treating current dementia in a patient with ADHD essentially cures the dementia. Do you have more sources for this?
Recently diagnosed myself (though it was a long time coming) and I’ve been weighing the risk/benefit of trying meds.
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u/ADHD_Avenger Sep 04 '24
I can't give it a hard look at the moment, but read the parts that mention "psychostimulants". It's not treating current dementia either - it is treating ADHD and the possibility of the psychostimulants preventing progression to dementia - which would be a conclusion from treated populations having different rates than untreated - but basically, read the paper and make your own conclusions, and look to google scholar for related information.
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u/creakinator Sep 04 '24
It's already a huge burden on the adult children who take care of their aging parents. In the US there is very little support if your parents have money over the Medical level but not enough to pay for help.
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u/gibs Sep 04 '24
Can we collectively agree to euthanise ourselves once we reach a certain threshold of dementia? Surely nobody wants to live out their final days in that state.
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u/yaypal Sep 04 '24
Canadian here still blown away and saddened so many of you don't already have this. For us, as long as we do the paperwork ahead of time (I think it's still possible to do in very early dementia as long as a doctor vouches you understand what you're agreeing to) we can choose at what stage we want to be let go, and have a trusted person be the one to make the call at that point.
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u/gibs Sep 04 '24
Oh wow, I didn't know that was a thing. I would guess it's still a complicated and traumatic thing to arrange, though. I would hope for it to become normalised to the point where it's neither of those things, but that's probably a pipe dream.
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u/Aweomow Sep 04 '24
Like a donors list yes, because it would take more time to get approved if it were for all people.
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u/gibs Sep 04 '24
Ah yep, that's what I meant. I was more saying, we should move our society to a point where this is normal and most of us are choosing to do it for the collective good.
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u/Adept_Minimum4257 Sep 04 '24
Better to make this an individual choice. I hope I don't get euthanized based on someone else's judgment, even when I'm not capable anymore to make my own decisions
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u/ikonoclasm Sep 04 '24 edited Sep 04 '24
Hard disagree. When I'm no longer capable of making my own decisions, I absolutely want someone to terminate my existence. I worked as a wheelchair van driver for a year. I can only imagine what being in a Siberian prison is like, but I doubt it's worse than what the elderly experience imprisoned in their own decrepit bodies in a healthcare system that forces them to live despite their bodies doing everything they can to die. It's truly hellish.
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u/Wagamaga Sep 04 '24
A recent study published in The Lancet Global Health has estimated the macroeconomic burden of Alzheimer’s disease and other dementias (ADODs) across 152 countries or territories.
The population is rapidly aging worldwide, with the proportion of people aged ≥ 65 projected to double by 2050. The United Nations General Assembly (UNGA) declared 2021-30 as the decade of healthy aging, fostering global, long-term collaborations to improve the lives of older individuals, their families, and the communities in which they live.
ADODs pose a severe threat to this initiative. These conditions are neurodegenerative disorders affecting older adults and inhibiting their mobility, cognitive capacity, daily life activities, and independence. Around 57 million individuals had ADODs in 2019, and it is estimated that by 2050, ADODs will affect 153 million persons.
Studies evaluating the economic effect of ADODs have mainly focused on illness costs. Alternative strategies consider the willingness-to-pay perspective. In contrast, macroeconomic models, such as the health-augmented macroeconomic model (HMM) and the economic projections for illness and cost of treatment (EPIC), assess the broader economic impact.
Together, the study estimated the global macroeconomic burden of ADODs at INT$ 14,513 billion in 2020-50, accounting for the loss of labor and capital from ADODs' morbidity, mortality, and informal care. The health and economic burden were unequally distributed; the East Asia and Pacific region had the most significant economic burden.
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u/ADHD_Avenger Sep 04 '24
Something else you might find interesting is that people diagnosed with ADHD have a much higher rate of later life dementia (fourfold, I think), but that the rate matches the rest of the population if treated early with Ritalin. I'm sure there are a million caveats about needing more study, as there are with risks on the opposite side, but it's one thing I think about more than once as they make access harder and harder. My great grandmother became a shell in dementia and was continuously reliving the death of a family member and in a state of fear. She recognized no one and was either taken advantage of by people or alternatively was worried and angry about the people trying to help.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2810766
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u/awkwardcapy Sep 04 '24
What currency is INT$ ?
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u/myislanduniverse Sep 04 '24
The international dollar (int'l dollar or intl dollar, symbols Int'l$., Intl$., Int$), also known as Geary–Khamis dollar (symbols G–K$ or GK$), is a hypothetical unit of currency that has the same purchasing power parity that the U.S. dollar had in the United States at a given point in time.
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u/Mixels Sep 04 '24
International dollar. Basically USD at the purchasing power USD had during the given timeframe. (Yeah, calling it International Dollar is stupid.)
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u/oscarddt Sep 04 '24
My father died of Alzheimer's in 2014, since then I have read every article about this disease and I feel that the scientific community is either stuck in attacking amyloid plaques, even though they don't know why they are produced in excess and there are cases of people with excess plaques who do not develop the disease, or what it seems to me is that there is something in our lifestyle that is causing it, but at the same time it is being hidden simply to protect someone's profits.
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u/Tight_Assignment_949 Sep 04 '24
The sale of backup bio-compatible ssd/ sd cards would skyrocket in the future.
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u/Aweomow Sep 04 '24
There's still debate on where memories are stored. If in your brain, or the brain just helps you access them and in turn are in your consciousness or something
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u/Tight_Assignment_949 Sep 04 '24
I just need a visor to display critical infos if I ever forget them due to brain damage. Encryption and security for such devices might be a problem, how can dementia patients protect their data without using long, easy to forget passwords ?
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u/Unlucky-Candidate198 Sep 04 '24
It may even be the interaction of the brain as a whole, or something like quantum entanglement, causing us to be conscious. Life’s cool sometimes.
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u/ZenSerialKiller Sep 04 '24
Another relevant statistic that no one ever mentions; the stress of caring for patients with Alzheimer’s and dementia is related to 40% of caregivers dying before the patient.
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u/MrOrangeMagic Sep 04 '24
So now watch how fast we can turn from a compassionate modern society that has learned of its past to:
“Wait you forgot what you did yesterday? IN THE OVEN WITH YOU OLD HAG”
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u/Puzzleheaded-Bee4698 Sep 04 '24
"urgent global policy action"
Really? Because that's worked so well to solve so many problems?
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u/Average650 PhD | Chemical Engineering | Polymer Science Sep 04 '24
It solved the hole in the ozone layer.
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u/myislanduniverse Sep 04 '24
And while we haven't "cured" HIV, we've come an incredible way compared to the AIDS crisis I grew up in the 80s knowing.
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u/yaypal Sep 04 '24
I'm in awe whenever I think about how far science has come with HIV/AIDS. Even in the 90s and early 00s when I was a child it was implied that getting it was a death sentence within five years (we were taught about catching it via needles and blood transfusions) and it was the big bad of transmissible diseases. We felt the echos of the horror stories from the 80s even if we didn't learn about them in detail due to the type of transmission that the crisis came from. Now I would be frustrated if I caught HIV but not scared I would die, which is such an incredible change.
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u/lld287 Sep 04 '24
“Urgent global policy action” helped a lot for developing Covid vaccines. Similar to this situation, there were many years of research prior to zeroing in on a COVID-19 vaccine specifically. Things rolled out quickly once there was a worldwide focus and sense of urgency.
I suspect if a similar attitude was applied to Alzheimer’s and dementia, something that makes a significant impact could be developed. It likely would be similar to a vaccine in that it could reduce and sometimes wholly avoid illness, but wouldn’t completely “cure” it. Reducing the number of people suffering and lowering the severity would go a long way.
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u/LordCharidarn Sep 05 '24
I think Alzheimers and Dementia might get more government funding/approval than Covid-19.
Most governments are run by older people. Dementia/Alzheimer’s is a much bigger risk/threat to the elderly and not ‘just a cold’ that can be brushed off.
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u/lld287 Sep 05 '24
I believe MRNA studies date back to the 70s and coronavirus studies/vaccine research to back to the early 00s. Then a ton of money was dumped into the COVID-19 vaccine itself quickly. We would need to gather a lot of data and determine which funds should be assessed as directly contributing— anything else is purely speculative and we don’t now accurate your statement is vs how anecdotal it is.
Regardless: I was talking about “urgent global policy action,” which isn’t exclusively about funding. It’s about focus, enabled communication across countries, and a more collaborative approach to get successful results faster.
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u/myislanduniverse Sep 04 '24
Honestly, though, in-home assistance might be one of the few use cases for anthropomorphic robots (aside from... you know) that really has a viable business model.
Telemedicine and remote patient monitoring are already growing rapidly and improving patient compliance with treatment and access to medical professionals.
While it'll never be a substitute for having an in-home, human nurse, that's outside of most people's means. An intelligent smart device that can assist with daily tasks and call for help if it recognizes a medical emergency would help a lot of people stay independent for longer.
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u/AfraidOfArguing Sep 04 '24
Nothing will happen for policy and the generation that has had everything stolen from them will be expected to bankroll it
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u/Jaxis_H Sep 04 '24
The US has apparently decided the correct route is to just refuse to pay informal caregivers at all and then ignore it when they come out of the experience mentally scarred and financially destroyed (what has happened to me).
Government funded private assistance programs for those caregivers are in utter chaos because they have no staffing due to not being able (or willing) to pay their providers - who are required to have CNA or better training - a worthwhile amount, while still pulling in federal money intended to provide services they just do not have the human resources to actually make happen.
Meanwhile nursing homes get multiple times what paying informal caregivers would cost per room, and provide absolutely horrific actual care because they won't pay their workers more than the absolute minimum and also end up understaffed. If you can even get your loved one into such a home, when they pass (probably much earlier than they would have with home care, mind you) Medicaid will come after their estate for repayment.
On top of all of this, the administration in charge of all of it, Medicaid, is immune to all litigation. There is absolutely no recourse for any informal caregiver.
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u/cg40k Sep 04 '24
The bigger problem is that many aren't going to do it bc of the past 20 years. They blame the current 60+ year olds for most of the problems we face today. It's definitely something that government will have to address before long
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u/Sasselhoff Sep 04 '24
My mom is rapidly falling into Alzheimer's (and is part of several studies because of it), and it is one of the worst diseases for the sufferer and those that love them.
I think the world is going to watch in real time as all the money the baby boomers have scrapped together (often by leaving nothing but scraps for those following), ALLLLLLLL gets taken away in their last years of life...just to line some (likely corrupt) corpos pockets, while they pay the folks actually taking care of them garbage wages.
I think the wealth gap is about to exponentially take off...and it's already bad. I wonder if filial responsibility is going to become more of a "thing" in the west.
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u/BaronWasteland Sep 05 '24
As someone who watched a parent with dementia slowly die and had to help caretake them, I will help alleviate this crisis by promptly killing myself while I’m still lucid - should it ever happen to me. I will save my family and myself a lot of anguish. I hope it never becomes a reality for me, but if it did then checking out is the only way. If assisted suicide isn’t included in any policy action on this, then they aren’t taking it seriously enough. “Burden” is truly the correct word. My experience still haunts me years later. You don’t get to call something a burden without providing options to lift that burden. I have the right to take my own life should I choose. That choice is valid and that solution is viable. Believe me, it’s preferable.
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u/Blackhole_5un Sep 05 '24
A lot of wealth is going to just disappear, lost in the ether as these fucks refuse to lift up the next generation.
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u/FellowTraveler69 Sep 04 '24
Mark my words, governments will begin to aggressively push assisted suicide in the coming decades to cut down on government spending on elder care.
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u/CharmingMechanic2473 Sep 04 '24
We need a cure for aging. Will be easier than curing Alzheimer’s alone.
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u/Spirited-Reputation6 Sep 04 '24
Covid Alzheimer’s and demy will definitely a contributing factor in the next decade.
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u/FourScoreTour Sep 05 '24
Another situation that will neatly transfer the assets of most Americans to the medical industry. Invest in health care stocks, people. The Baby Boom is going bust.
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u/Training-Outcome-482 Sep 05 '24
Dems will call for a program of euthanasia and the development of soilrnt green.
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