By Ethan Popowitz
Alzheimer’s disease, a progressive neurodegenerative disorder, continues to pose significant challenges to healthcare professionals worldwide. The statistics are sobering—one in three seniors die with Alzheimer’s, more than breast cancer and prostate cancer combined. And according to the CDC, there are nearly six million adults in the U.S. currently living with the disease, a number that is expected to more than double by 2050.
Despite this, there is reason for optimism. The landscape of Alzheimer’s treatment is constantly evolving, driven by groundbreaking research and innovative approaches. We’ll explore some of the latest trends behind how physicians understand, identify, diagnose, and treat Alzheimer’s disease.
New ICD-10 codes indicate a greater interest in Alzheimer’s diagnosis
First, it’s worth mentioning that the Centers for Medicare & Medicaid Services (CMS) have published 87 new ICD-10 codes for dementia and its family of associated behavioral disorders. Alzheimer’s disease is the most common type of dementia, accounting for about 60-80% of all dementia cases, according to research from the Alzheimer’s Association.
The new guidelines for reporting dementia (and Alzheimer’s by extension) allow for healthcare professionals to report a diagnosis with a more granular level of specificity. The new codes provide more detailed information on the severity of the disease and the presence of behavioral and psychological symptoms of dementia. Ultimately, the granularity offered by an expanded range of codes will improve how Alzheimer’s patients are identified and categorized, and our understanding of how the disease originates.
Alzheimer’s disease falls under the ICD-10 code range G30. This specific code range is dedicated to various forms and stages of the disease. The table below shows the latest ICD-10 codes as of the October 2023 update.
|Alzheimer’s disease with early onset
|Alzheimer’s disease with late onset
|Other Alzheimer’s disease
|Alzheimer’s disease, unspecified
In the chart below, I used the Atlas All-Payor Claims dataset to show an estimate of the number of Alzheimer’s patients classified by ICD-10 code, and how those values have risen or fallen from 2018 to 2022.
From the data, we can see a significantly greater number of patients have been diagnosed with Alzheimer’s disease, unspecified (ICD-10 code G309) between 2018 and 2022 than the other Alzheimer’s-related codes. This code indicates that the physician may not have had a complete understanding of the patient’s condition at the time of diagnosis and may be coded more specifically later.
Based on our current understanding of Alzheimer’s, it’s unsurprising to see a considerable gap in the number of patients with early-onset Alzheimer’s (G300) compared to the late-onset form of the disease (G301). This divide is largely due to how rare it is for symptoms of Alzheimer’s to be recognized and diagnosed in patients in their 30s, 40s, or 50s. In addition, symptoms may be incorrectly attributed to stress or the mild forgetfulness that often comes with aging.
Alzheimer’s may be linked to lifestyle and environment
One of the great mysteries of Alzheimer’s disease is why it largely affects older adults. While age and genetics play a significant role in its development, emerging research suggests that a person’s lifestyle and environment also contribute to the risk and progression of Alzheimer’s. Here are just four factors scientists are exploring today:
- The heart-head connection. According to the Mayo Clinic, research suggests that lifestyle choices with known heart benefits may help prevent or delay the onset of Alzheimer’s. One study found that taking consistent walks strengthened connections in the brain, which improved memory recollection abilities among people with mild cognitive impairment. A study by the CDC also found that high blood pressure, physical inactivity, obesity, binge drinking, and other factors increased a person’s risk of developing Alzheimer’s.
- Sexual satisfaction may be an early warning sign of cognitive decline. In a study conducted by Penn State researchers, it was found that low sexual satisfaction and decreases in erectile function were both associated with memory decline. The researchers suggested that how someone feels about their sex life is equally important as the number of sexual partners or frequency of sexual activity in boosting brain function.
- A stimulating environment may impact behavioral development. Research on animals finds that environmental enrichment could aid the prevention and treatment of Alzheimer’s disease and other brain-related conditions connected to aging. One study found that placing mice in a stimulating environment of 60 interconnected cages promoted a sense of exploratory activity. This behavior is linked to improved brain plasticity for learning and adapting to change, as well as increased resilience against the effects of aging and dementia.
- Hearing loss may be linked to Alzheimer’s. Studies suggest that hearing loss causes shrinkage in the brain. More specifically, when the sections of the brain that govern hearing grow inactive, it causes tissue loss and changes in the brain’s structure. This shrinkage is a form of brain atrophy, which is a risk factor for developing Alzheimer’s disease. In addition, the National Council on the Aging found that hearing-impaired adults are more likely to experience loneliness, depression, anxiety, and paranoia, all of which may cause that person to withdraw from life. This lack of stimulation and engagement with other people is another risk factor for developing dementia or Alzheimer’s.
The staffing shortage may heavily impact Alzheimer’s patients
The ongoing healthcare staffing shortage is affecting every area of the healthcare landscape. A report from the Alzheimer’s Association, however, indicates that older adults with the disease may be impacted the most—both now and in the future.
The rapidly growing population of older adults in the U.S. is likely one of the primary causes behind this shortage. Population data from the U.S. Census Bureau predicts that there will be more than 90 million adults over the age of 65 by 2060.
As the population of older adults grows, so will the number of those living with dementia and Alzheimer’s disease. As a result, demand for neurologists, geriatricians, and other specialized healthcare professionals will rise, shifting the balance of available providers able to serve the general population. Research by The Association of American Medical Colleges estimates that by 2034, people aged 65 and up will need up to 407,300 physicians to provide them with care.
Only time will tell if this incredible demand for specialized care can be met in the next decade, but it may certainly be a long journey. Today, there are thousands of healthcare workers across the country who are quitting their jobs, switching industries, moving into nontraditional roles, retiring early, or reinventing their ideal careers. Feelings of burnout, inadequate salaries, an overabundance of administrative work, and a growing number of providers retiring early are all contributing to the staffing shortage of today. The negative effects these all have on the healthcare industry—and the strategies in play to help mitigate them—are all discussed in greater detail in our staffing shortage whitepaper.
New technology is sparking innovative ways to diagnose and treat Alzheimer’s patients
From virtual reality technology to artificial intelligence (AI) and machine learning (ML), scientists are thinking out of the box for innovative ways to understand, diagnose, and treat Alzheimer’s disease and dementia. Here are some ways in which both are being utilized:
- Early diagnosis. A team of researchers from Massachusetts General Hospital developed a deep learning model, a subset of machine learning, to analyze data from MRIs to detect Alzheimer’s early. To train the model, the team used thousands of MRIs of patients with and without Alzheimer’s. As a result of their research, the team found the deep learning model was able to detect risk factors for Alzheimer’s with an accuracy level of 90%. Notably, the model was designed to be “blind” to variables such as age, which reduced the likelihood of the model making predictions based off features of the brain that may have been affected by age. Ultimately, the team hopes that further applications of AI can help physicians diagnose Alzheimer’s with a greater degree of accuracy early in a patient’s journey.
- Accelerate research timelines and make connections. AI and ML can dramatically speed up data analysis. Researchers can develop algorithms for AI to analyze large datasets, including genetic and proteomic information, electronic health records, patient histories, and more to quickly identify patterns and risk factors associated with Alzheimer’s disease.
- Discover early warning signs of neurodegeneration. Several studies show that the entorhinal cortex, an area of the brain that controls navigation, is often the first to show degeneration when a patient gets Alzheimer’s or dementia. VR technology can be used to test the navigational skills of people through a series of environments. The data can then be analyzed to pinpoint potentially at-risk patients at a much earlier stage of the condition, and hopefully open avenues for more effective treatment options.
- Caregiver training and support. If the healthcare staffing shortage makes it harder for Alzheimer’s patients to find the care they need, then family, friends, and unpaid caregivers will need more assistance and support. Both VR and AI can help. Virtual reality simulations can help caregivers understand the experiences and challenges faced by Alzheimer’s patients, promoting empathy and improving caregiving skills. Meanwhile, AI-powered chatbots and virtual assistants can provide caregivers with real-time information, support, and guidance on managing Alzheimer’s symptoms, medication schedules, and emotional well-being.
The emerging trends related to Alzheimer’s disease offer hope and potential for improved diagnosis, treatment, and care. Technology like virtual reality and AI, and the promising findings from new studies are opening new avenues for understanding and addressing the complexities—and mysteries of this disease.
For more information about Alzheimer’s disease, visit the Alzheimer’s Association.
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