Hoover Daily Report

Brain Research and the Challenge of Aging

via Wall Street Journal
Tuesday, July 5, 2011

The human brain has produced truly remarkable advances in medical science, creating new medical devices, pharmaceutical products, and diagnostic and surgical procedures that enable us to enjoy longer, healthier lives. Consider, just as examples, the Salk vaccine, which has virtually eliminated polio; and the MRI, which makes it possible to do internal examinations noninvasively.

But this very success—living longer—demands that we urgently address diseases of the brain that often accompany aging. Three out of five Americans will suffer from a nervous-system disease at some time in their lives. These illnesses are often chronic and debilitating. The list of these ailments is long—Alzheimer's disease and Parkinson's disease being among the most widely known—and there are no cures for many of them. For Alzheimer's and Parkinson's there are medicines that diminish the symptoms, but these drugs do not halt or even slow the underlying degenerative processes.

Clearly, greater investment in researching diseases like Alzheimer's and Parkinson's is needed. With healthy brains, Americans will do more than just live longer, they will remain productive longer and contribute to the well-being of our nation instead of adding substantially to the costs and other burdens of health care.

We now know that some of the same brain problems linked to aging underlie the delayed effects of traumatic brain injuries being seen in our wounded warriors coming back from Iraq and Afghanistan as well as in boxers and hockey and football players.

Today, over five million Americans suffer from Alzheimer's and nearly one and a half million from Parkinson's. Alzheimer's disease is rare before age 60 but afflicts about one in 20 by age 70 and one in three by age 85. Even a modest increase in life expectancy over the next 40 years will nearly triple the number of people in the U.S. with Alzheimer's, and that means huge expenditures for their care.

So if you escape cancer, heart disease and stroke and live to 85, you have a 35% chance of developing Alzheimer's. Those are terrible odds. Currently, patients with Alzheimer's occupy half of all nursing home beds in the country; cognitively impaired people occupy half of the remaining beds. The majority of people suffering from cognitive impairment will go on to develop Alzheimer's disease. In 40 years, the cost of caring for 14 million Alzheimer's victims will likely exceed $1 trillion annually.

Despite the world-wide market for medications that prevent or halt both Alzheimer's and Parkinson's diseases, no such drugs exist. In large part, this is traceable to the diminutive spending on research on these and other neurodegenerative diseases. Ironically, as dementia in older people has grown more common, it's come to be thought of as an inevitable consequence of aging, even though the majority of elderly people aged 80 to 100 have well-preserved memories and intellect.

Remarkable discoveries in the neurosciences over the past three decades demand exploitation. We need to develop new therapeutics from recent scientific advances and to expand our knowledge of how the brain both functions and fails. Nevertheless, research on Alzheimer's and Parkinson's diseases consumes less than 2% of the entire National Institutes of Health (NIH) budget. Large dividends will likely flow if Congress and the president enhance the allocation of NIH funds to studies of the brain.

The budget is now in the limelight, and federal funds for biomedical research are reportedly on the chopping block. A thorough look at priorities is essential. The bottom line is that biomedical research can change the history of mankind, resulting in a healthier America that derives large savings from preventive medicine and from the use of innovative and less costly means to treat diseases.

So, lawmakers, as funding priorities are set, think. Use your brain. If you don't, your brain may leave you before you leave it.

Dr. Prusiner, director of the Institute for Neurodegenerative Diseases at University of California, San Francisco, was the recipient of the Nobel Prize in Physiology or Medicine in 1997. Mr. Shultz, former U.S. secretary of state, is a distinguished fellow at Stanford University's Hoover Institution.