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Friday, August 12, 2016

AAIC 2016: Useful Data for AD and Related Public Health Policy

Dear Readers:

We thought it would be useful to summarize some of the data reported out of the Alzheimer’s Association International Conference (AAIC) held in Toronto in late July. AAIC is the most expansive and inclusive gathering of the AD-related research community and this year more than 5,000 people were in attendance in Toronto. Overall, researchers reported significant momentum in identifying specific actions, interactions, and activities that may compensate or offset AD pathology and costs of care.

And for those folks keeping track of investigational drugs in late stage clinical trials in AD, Tau RX reported that the Phase III trial of the anti-tau intervention (LMTM) did not meet its primary endpoints. However, most of the research news from AAIC 2016 didn’t really involve drug therapies.

A vast amount of new research on pathways, biomarkers (especially tau), and novel genetic data was presented. There were invaluable economic and other metrics reported out at AAIC that will fill data gaps and provide much needed context for an increasingly dynamic global AD public health dialogue.

Below you will find summaries of reports monetizing the public costs of AD in the US, as well as a check up on implementation of the US Annual Medicare Wellness (AMC). The reports will help to focus the AD public health research agenda, programs and public investment.

AD Health Economics: A Crib Sheet of the Stats from AAIC

AD is now the most expensive medical condition in the US based on cost of care.
• $226 billion spent annually in US
• ½ of total is Medicare expenditures

First generation AD drugs help!
•People using first generation treatments require fewer hospitalizations
• People using first generation treatments have a lower mortality rate in first 12 months post-diagnosis

Unfortunately, only 35% of people diagnosed with AD receive treatment.
• Diagnosed, untreated AD results in significant and avoidable healthcare costs
• US spent 2.5 billion in avoidable hospitalizations for diagnosed but untreated AD
• A combination of diagnosis, treatment and care planning result in savings
• Stressful for the system and the patient – reduce quality of life and increases caregiver burden
From the Frontlines: The Medicare Annual Wellness Visit (AWV)

The Medicare Annual Wellness Visit (AWV) was instituted in 2011 and offers physicians and Medicare patients an opportunity to assess cognition and to track cognitive changes. The Allina Health care system in Minnesota was an early “early adopter” of the AWV

• Allina used the Mini-Cog (three word recall and clock drawing)
• In the Minnesota system, 44% of eligible people underwent one or more AWV from 2011-2015
• The Allina system increased participation in the AMV from 20% to 30% from 2011-2015.
• Nationally, the AMV participation rate is 11%.
• Participation increased over the years, from about 20% in 2011 to about 30% in 2015.
• Nationally, 11% of Medicare patients used the AWV
• Women are more likely to use the AMV benefit
• Approximately 6% of the population studied were diagnosed with a cognitive impairment

World Health Organization Research Priorities

Hiral Shah, MD, from Columbia University Medical Center, presented the results if the World Health Organization’s dementia research priorities exercise. Truly a global initiative, with more than 160 researchers participating, the results will provide guidance to policymakers and researchers regarding future potential funding decisions related to AD research.

• The exercise was based on a similar process called the Child Health and Nutrition Research Initiative (CHNRI)
• The proposed priorities were scored by 162 researchers/stakeholders
• 39 countries were represented in the process
• The exercise used five criteria including the potential for success, burden reduction, conceptual breakthrough, translation and equity

The following research priorities were identified:
• Basic research into disease mechanisms (identified as the biggest potential for conceptual breakthrough).
• Prevention and reduction of risk and burden on quality of care for people and caregivers

Overarching research goals identified by the exercise were:
• Prevention and risk reduction
• Diagnosis, biomarker development and disease monitoring
• Drug and non-drug treatment research
• Quality and delivery of care for people with dementia and their caregivers
• Physiology and progression of normal aging and disease
• Increasing public awareness and understanding

Thanks for reading,
ADCS Staff Compilation
Author: Guest at 3:53 PM 0 Comments

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The Alzheimer's Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California, San Diego. The ADCS is a major initiative for Alzheimer's disease (AD) clinical studies in the Federal government, addressing treatments for both cognitive and behavioral symptoms. This is part of the NIA Division of Neuroscience's effort to facilitate the discovery, development and testing of new drugs for the treatment of AD and also is part of the Alzheimer's Disease Prevention Initiative.

The ADCS was developed in response to a perceived need to advance research in the development of drugs that might be useful for treating patients with Alzheimer's disease (AD), particularly drugs that might not be developed by industry.