14% of Americans over 71 have dementia; 32% of Americans over 85 have Alzheimer's disease (AD). In the US, the prevalence of AD in women is almost twice that in men, primarily because old age is the greatest risk factor. One third of seniors at death have AD and related dementia. Between 2000 and 2010, deaths attributed to AD increased 68%, whereas those attributed to heart disease and AIDS dropped 16% and 42%, respectively.
AD ensures an insidious, lingering death; two thirds of those dying with dementia do so in nursing homes.
The burden of AD on caregivers is valued at $220 billion. Total annual payments for health care, long-term care and hospice care are projected to increase from $214 billion in 2014 to $1.2 trillion in 2050. In 2014 there will be 470,000 new cases of AD in the US, which is anticipated to approach 900,000 in 2050; this represents 13.8 million Americans with AD.
Current cognitive enhancers are ineffective in Mild Cognitive Impairment and have significant side effects. A scenario can be envisioned in which a diagnosis of pre-symptomatic Alzheimer’s disease, regardless of the odds of progression to dementia, will be treated with a safe and effective agent that attenuates AD pathology.
Given the prevalence and the cost, the need for a pharmacotherapy that can improve cognition and attenuate the development of Alzheimer's disease pathology is urgent.