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Cliff Singer is the director of Northern Light Memory and Aging at Northern Light Acadia Hospital.
Many older adults fear disability and dependency more than death. That’s why the fear of Alzheimer’s disease or other forms of dementia are second in their minds only to the fear of cancer. The thought of slowly losing the qualities that make us who we are and becoming a burden to loved ones who must help with everyday care is terrifying.
I am a physician who specializes in the diagnosis and treatment of dementia. Currently, there are more than 1,000 Mainers waiting to see my colleagues and me at Northern Light Memory and Aging at Acadia Hospital.
The story is the same all over Maine, which has few dementia specialists and the oldest population in the country. We are experiencing a rapid increase in conditions causing dementia, including Alzheimer’s disease, the most common cause. Other forms of dementia, such as vascular dementia, Lewy body disease, frontotemporal dementia, and limbic predominant age-related TDP-43 encephalopathy (LATE), are also on the rise because of our aging population. It is perhaps particularly tragic that these conditions are not limited to old age. We have patients still working and raising their own families who have these conditions or are starting to show symptoms.
But there’s good news. Promising results from funded research studies have motivated many Mainers to live healthier lives that can reduce their risk of dementia. There is good evidence that diets rich in fruits and vegetables, vigorous physical activity, adequate sleep, staying socially engaged, treating high blood pressure, reducing vascular risk factors, wearing hearing aids, and even having an optimistic attitude towards aging can significantly reduce one’s risk. Building a “cognitive reserve” through life-long learning also enhances brain resilience to age-related neurodegenerative diseases.
Additionally, with the help of federal research funding, Alzheimer’s disease can now be detected by blood tests in people with mild cognitive impairment, which can lead to earlier diagnosis at a time when new disease-modifying treatments are much more effective. More promising treatments are on the way, but for the thousands of Mainers, waiting for treatments in the clinical trial stage is frustrating.
We need to do better. Under the leadership of U.S. Sen. Susan Collins and other members of the Bipartisan Congressional Task Force on Alzheimer’s Disease, there’s an opportunity for a major increase in investment in dementia research and care that could accelerate our progress in making new treatments available. First there’s the bipartisan Alzheimer’s Screening and Prevent Act (ASAP). Medicare is currently prohibited from covering FDA-approved screening tests. By passing the ASAP act, Congress can help Medicare keep up with progress in the clinic and cover tests that are necessary, accurate, and in high demand.
Closer to home, Northern Light Memory and Aging is completing a federally funded project secured by Collins that will yield long-term benefits in improving the ability of primary care providers to diagnose and treat dementia. And the University of New England’s federally funded Geriatric Workforce Enhancement Program and annual Geriatrics Conference provide dementia education to all disciplines in health care.
Finally, there is a growing consensus that a major federal investment is necessary for prevention of Alzheimer’s. Maine’s Center for Disease Control and Prevention is leading the Maine Healthy Brain Initiative to promote healthy brain aging with the help of another federal grant. These investments in Maine institutions, including The Jackson Laboratory, Roux Institute, University of Maine, University of New England, Maine Health, and Northern Light Health, are bringing leading-edge research and its full range of benefits to communities across Maine. The pace of discovery is accelerating, helped by some of the work being done right here at home.
It’s easy to be pessimistic, both about the slow pace of development of new treatments for dementia and the political environment in Washington, D.C. I remain hopeful that the science, the policies, and the political will to invest in this critical issue are lining up for a major effort to overcome one of the greatest threats to Mainers who wish to remain active and independent into old age.
There are thousands of people in Maine and millions around the country – and the world – who are counting on us to make progress. We must continue to increase federal investments in research and education. The momentum is building, and right now is the time to lean in and push forward with even greater commitment.