Google and Apple have changed the way we live and now some leaders of those companies are working to change how long we live. Their California Life Company startup, or Calico, has hired expert researchers in the field of aging and may one day extend the average life expectancy far beyond the 2010 figure of 78.7 years recorded by the Centers for Disease Control.

 

Before daydreaming about what that future might look like, let’s take a sobering look at where we stand today with an aging population. According to the Alzheimer’s Association, someone in the United States develops the disease every 67 seconds and by 2050, the number of people age 65 and older with the disease may nearly triple barring the development of medical breakthroughs.

 

As medical director of the Holy Cross Neuroscience Institute at Holy Cross Hospital in Fort Lauderdale, I offer a snapshot from the front lines of healthcare’s current ability to meet this oncoming wave of patients with Alzheimer’s.

 

Hearsay Evidence: Talking with the patient and a family member or friend who can corroborate the patient’s memory loss is the first step to determine if physical and cognitive changes are part of the normal aging process or if they are indicative of mild cognitive impairment and Alzheimer’s.

 

Process of Elimination: Decades of research has not devised a definitive test for Alzheimer’s. Before we can begin treating the disease, we must first eliminate other possible causes of memory loss. Depression is a common disease that occurs as we age and someone with severe depression can appear to have Alzheimer’s. Parkinson’s disease also shares common symptoms. The list goes on and even sleep medications and analgesics taken for the aches and pains of aging can make us forgetful.

 

State of the Art: Out of all the most advanced medical devices in use today, not one treats Alzheimer’s. They are merely the tools we can use to confirm a diagnosis. MRI brain imaging can help rule out hydrocephalus and benign or malignant tumors as well as damage caused by silent strokes. Low-tech blood tests are used to uncover low thyroid, vitamin deficiencies and liver and kidney conditions that can cause memory loss.

 

Pills, Patches and Ipods: Although research has failed to give us a good medication, it has created multiple lines of treatment which offer, if anything, modest improvement. The FDA has approved medications from two classes (cholinesterase inhibitors and memantine) and alternative treatments include vitamin and food supplements. While many of these can be quite expensive, increasing socialization, exercise and just listening to music have also shown improvement in brain function.

Research: As with diagnosing the disease, research to date can be seen as ruling out possible biological markers or genetic profiles. MRI’s are looking at the size of memory centers in the brain as PET scanning is being performed to understand if abnormalities in glucose metabolism create plaques in the brains of older individuals. Genetic research is investigating the apolipoprotein E (APOE) gene found on chromosome 19. According to the NIH’s National Institute on Aging, most researchers believe that APOE testing is useful for studying Alzheimer’s disease risk in large groups but not for determining an individual’s risk. In practice, APOE testing is considered for patients with a family history of early-onset Alzheimer’s disease but is not generally recommended for people at risk of late-onset Alzheimer’s.

 

In the last 30 to 40 years, hospitals have become very good at treating heart attacks, and have created impressive cardiovascular institutes followed by centers of excellence for orthopedics and oncology. Now is the time to devote resources to neuroscience.