If only it were true.

Contrary to a recent newspaper headline, the state has not predicted it will “stop Alzheimer’s disease” by 2025.

That’s a pity, because now that people are living longer, dementia is a public health crisis.  

Last week, Hawaii’s Executive Office on Aging released a comprehensive plan that had been carefully researched for over three years. A consortium of experts has been working on developing a program to help with the early diagnosis and multi-faceted treatment plan for our seniors.

Hawaii is one of several states that has been working on this as part of the national plan to address Alzheimer’s disease under the U.S. Department of Health and Human Services.


Signs of Alzheimer’s: Under a microscope, they look like tangled hair in knots.

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In fact, we are one of only six states that have received grants from the National Association of Chronic Disease Directors  to help implement the Healthy Brain Initiative:  A National Public Health Road Map for State and National Partnerships 2013-2018, under the Centers for Disease Control and Prevention.

“Unfortunately,” states Jody Mishan, from the Executive Office on Aging, “the article in the Star-Advertiser misquoted our director and didn’t accurately represent what was going on.” The headline read: “State vows to stop Alzheimer’s disease during next 11 years.”

According to the latest statistics from the Alzheimer’s association, almost every minute someone in America is diagnosed with the disease. It is the sixith-leading cause of death in the U.S., and one in three seniors dies with some form of dementia.

Alzheimer’s disease is  more common in women, and at the age of 60, they have a one in six chance of developing this over their lifetime. For men, it’s one in 11. Take a look at your friends, family and loved ones — that’s who is going to get dementia.

By 2015, the number of people diagnosed with dementia in Hawaii is expected to increase by over 40 percent, to 35,000. That’s enough people to fill over two-thirds of Aloha Stadium.

So, what is happening with aging and dementia in our state, and what are we going to do about it?

A little history might help.

Alzheimer’s  is a disease that scientists have been working on for over a century, since its discovery in 1906 by Dr. Aloysios Alzheimer, a psychiatrist and neuropathologist.

Word-finding, losing car keys and forgetting names can be common occurrences for all of us, but when it progresses to affect daily activities, Alzheimer’s is suspected.

He was following a patient, Auguste Deter, who at 51 exhibited strange behavioral symptoms along with short-term memory loss.

Upon Deter’s death, Dr. Alzheimer did special testing on his brain and found the now pathognomonic findings of amyloid plaques and neurofibrillary tangles. Under a microscope, it looks like tangled hair in knots.

The disease was named after the doctor, and is now recognized as the cause for 80 percent of all dementia cases in the elderly.

The symptoms of Alzheimer’s disease start early, often with a little memory lapse that happens more and more frequently.

Word-finding, losing car keys and forgetting names can be common occurrences for all of us, but when it progresses to affect daily activities, Alzheimer’s is suspected.

By that time, most of the brain damage has already been done. Amyloid plaques made up of protein deposit on the nerves in the brain, while neurofibrillary tangles, or bundles of protein, clog connections between nerve cells.

Part of the problem is that there is no definitive test, at least not while someone is alive. Different types of tests lead to the significant possibility of Alzheimer’s, but patients need to have other more treatable conditions excluded first.

In one study, more than 10 percent of people were misdiagnosed with Alzheimer’s. In many of these cases, the true cause of memory loss is left untreated.

Currently, there are no supplements, exercises, or activities that can stop the hostile takeover of the brain by the amyloid plaques and tangles. 

As for that definitive post-mortem diagnosis, special testing of brain matter can be done during an autopsy to see the actual changes that are characteristic of Alzheimer’s dementia. 

New studies are being done to look at early biological markers, such as amyloid and tau proteins in spinal fluid and also genetic testing for APOE-e4, a marker that indicates an increased likelihood of developing the disease.

Our population here in Hawaii is aging rapidly. We have the greatest life expectancy in the nation, and our elderly growth rate has exceeded the national average.

However, simultaneously, we are struggling with the lack of medications to treat Alzheimer’s disease when it is suspected. 

For the past few decades, pharmaceutical companies have tried to find a medication that can stop the brain decay in Alzheimer’s disease. They have, at best, found a way to delay the worsening of symptoms. Aricept, Exelon, Namenda — none of these can improve memory or prolong life. They can slow down the inevitable progression of memory loss, which might help keep people from needing more assistance in care homes a little bit longer.

Yet, where are the rallying cries to help with dementia?

Our population here in Hawaii is aging rapidly. We have the greatest life expectancy in the nation, and our elderly growth rate has exceeded the national average.

The Hawaii Executive Council on Aging is hoping to help. The state’s plan to prevent and effectively treat Alzheimer’s disease by 2025 consists of five major goals and objectives:

• Connect local Hawaii health care professionals with those doing dementia research both nationally and worldwide. Rather than doing independent studies in isolation, collaboration is the key to finding the latest treatment methods and bringing them  right here to the islands.

• Provide the best quality of care effectively and efficiently. This includes looking at the activities that people with dementia are still capable of doing, and helping to create a one-stop resource for information and guidelines for the latest in care available.

• Expand support services for people with Alzheimer’s and their caregivers. Families are being relied on to provide care for those with memory loss and dementia. But the increasing burden of care needs to be shared by society as a whole. The needs of people with dementia change over time, and the services available should be able to increase with changing needs of the individual.

• Get the public involved. We are all at risk for this, and if you ever wondered what it would be like to be lost, confused, and not able to know where to go for help, drive to a different part of the island and see if you can navigate your way back home without a map, cellphone, GPS, or stopping to ask for directions. It’s not easy. Now multiply that times 10, and you see how hard it must be for our vulnerable seniors.

• Track the data. Find out what works, by monitoring the efforts, and eliminate what doesn’t. This is uncharted territory. Never in the history of mankind has the population been at a greater risk for memory loss.

The state has taken a bold approach to engage all of us, since we are all stakeholders in this fight, in an effort to help our aging population.

Despite the misrepresentation of the plan as a way to cure dementia in 11 years, the program to take a multi-disciplinary, comprehensive approach is admirable, and one we all need to champion.

After all, any one of us could be diagnosed with dementia when we get older, and that is a fact none of us should forget.

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