"Unfortunately, the trajectory of the disease is faster than we can even get our hands around," said Linda Davidson, executive director of the Alzheimer's Association, Georgia Chapter.
In 2017, 4,298 people died from Alzheimer’s in Georgia, up from 1,235 in 2000, a 248 percent increase. Nationally, the number of deaths from Alzheimer’s increased by 145 percent over the same period.
Increasing age is the greatest known risk factor for Alzheimer's. Georgia's overall population and that of older adults has grown faster than the national average over the past two decades, according to the Atlanta Regional Commission, which experts say can likely help explain the divergence.
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Credit: Bita Honarvar/AJC 2015 file
Credit: Bita Honarvar/AJC 2015 file
Georgia’s 65-and-older population grew by 66 percent between 2000 and 2015, compared to 36 percent nationally, according to an analysis of census data by the ARC.
The number of people with Alzheimer’s here is on track to continue growing as baby boomers age. The ARC expects the 65-and-older population to rise from about 13 percent of the Georgia population in 2015 to close to 19 percent in 2040.
Alzheimer’s disease is now the sixth-leading cause of death in the United States, and the fifth-leading cause of death among those age 65 and older, according to the Alzheimer’s Association.
The increase in Alzheimer’s deaths comes at a time when the number of deaths from some other illnesses and diseases is on the decline. Deaths from the No. 1 cause of death — heart disease — has decreased by about 9 percent since 2000. The number of deaths from HIV has dropped by 61 percent during that same period, according to the study.
Alzheimer’s disease is a debilitating illness that progresses over time. Early signs of Alzheimer’s include problems with memory and communication, and a failing sense of direction. Ultimately, the body shuts down after years of mental deterioration.
There is no cure, and there are no medications that can prevent or slow down the process of the disease. But there are medications that can potentially help ease symptoms such as irritability and improve quality of life.
Here are some other key findings of the study:
• The number of people living with the disease will continue to jump. In 2019, the number of Georgia residents with Alzheimer's is estimated at 150,000, according to the study. By 2025 — just six years from now — the number of people in Georgia with Alzheimer's will climb to 190,000.
• The costs are astronomical. The Medicaid costs for caring for people with Alzheimer's are estimated to total $1.18 billion for the state of Georgia in 2019. And that figure is expected to increase by 33.5 percent over the next six years.
• More family and friends are serving as Alzheimer's caregivers. More than 16 million Americans provide unpaid care for people with Alzheimer's. In Georgia, there are 533,000 caregivers. They provided a total of 607 million hours of unpaid care, valued at a total cost of $7.6 billion.
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Credit: JOHNNY CRAWFORD / JCRAWFORD@AJC.
Credit: JOHNNY CRAWFORD / JCRAWFORD@AJC.
A bill to allow Gov. Brian Kemp to design "waivers" that may expand access to health insurance for poor and middle-class Georgians passed the state Senate last week. The measure, Senate Bill 106, now heads to the House, where it is likely to face stronger opposition.
Depending on what Kemp decides to do, the waivers could pave the way to a limited expansion of Medicaid and a health insurance support program for the Affordable Care Act exchange market.
A Kemp spokesman declined to comment on what a future Medicaid program might cover.
Monty VeaZey, a lobbyist with the Georgia Alliance of Community Hospitals, said the bill doesn't specifically include money earmarked for Alzheimer's under Medicaid waivers, but if someone had a Medicaid waiver and had Alzheimer's, it would likely cover Alzheimer's-related medical costs.
Davidson, with the Georgia chapter of the Alzheimer’s Association, said it’s too early to know the bill’s impact on Medicaid costs in Georgia.
Another key finding of the study is the reticence of older adults to undergo cognitive assessments. Only half of seniors are being assessed for thinking and memory issues, and much fewer receive routine assessments. While 91 percent of seniors get their blood pressure checked and 83 percent get cholesterol checked, only 16 percent receive regular cognitive assessments during routine checkups.
Dr. Monica Parker, a geriatric doctor at Emory Healthcare, said an early diagnosis can help someone get access to more treatment options to help lessen symptoms, allow someone an opportunity to participate in clinical trials and give families more time to assemble a long-term health care plan, review legal documents and set up a support network.
Peggy Lavender of Brookhaven started noticing worrisome changes in her husband’s behavior when he was only 58. She said her husband, Jim, started constantly losing his cellphone and keys, and he started repeating himself — the same story or pieces of information.
She and her husband had both changed careers and became teachers at about age 50. Her husband was a high-school AP economics teacher, and she was a fifth-grade teacher. They both loved their jobs and had planned on working well into their 60s at least before retiring.
But then within a couple of years, Jim Lavender left home to attend a funeral but came back a few hours later. Confused, he never found the church. Jim Lavender had passed simple cognitive assessments with their primary doctor but agreed to go to a neurologist for a thorough evaluation. He was diagnosed at 61. Not only did Jim Lavender retire early, but Peggy Lavender also retired early to be his primary caretaker.
“It’s all encompassing,” said Peggy Lavender. “I made the decision to stay home, knowing I was going to lose myself in it. I don’t mean to say it looking for pity. It’s to say there is never a break. He can’t be alone for a minute.”
Jim Lavender, who is now 67, can eat independently, but he needs help with other basic tasks such as bathing and brushing his teeth. Peggy said most days, her husband doesn’t realize she’s his wife or that he has two sons.
"I try to keep a sense of gratitude, but there are some days when I wake up, it's overwhelming and I just think I don't want to do this and I wouldn't wish this on my worst enemy," she said.
Lavender said she has joined a support group and leans on the support of close friends and her two sons — one of whom has moved back into their house. She said it’s painful to think about, how at some point down the road, her husband will need full-time care and no longer be able to live at home. The financial aspect alone is difficult. Medicare and their health insurance don’t cover memory care facilities, and the going rate in the Atlanta area for a memory care home is $5,000 a month. For now, she takes it one day at a time.
“The truth is this is my choice to take care of my husband and I wouldn’t want it any other way,” said Lavender, who is 64. “I am able to stay strong and positive because I count my blessings, depend on my faith, get help from my sons and support group, and Jim and I laugh a lot together, “ she said.
As the older population grows, more and more people will get Alzheimer’s. Once you reach the age of 85, your chances of getting Alzheimer’s are about 50 percent, according to the Goizueta Alzheimer’s Disease Research Center at Emory University.
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