WASHINGTON (AP) - David Hilfiker knows what's coming. He was diagnosed with Alzheimer's so early that he's had time to tell his family what he wants to happen once forgetfulness turns incapacitating.
"When it's time to put me in an institution, don't have me at home and destroy your own life," said the retired physician, who is still well enough that he blogs about the insidious progress of the disease. "Watching the Lights Go Out," it's titled.
Nearly half of all seniors who need some form of long-term care - from help at home to full-time care in a facility - have dementia, the World Alzheimer Report said Thursday. It's a staggering problem as the global population ages, placing enormous strain on families who provide the bulk of that care at least early on, and on national economies alike.
Indeed, cognitive impairment is the strongest predictor of who will move into a care facility within the next two years, 7.5 times more likely than people with cancer, heart disease or other chronic ailments of older adults, the report found.
"It's astonishing," said Marc Wortmann, executive director of Alzheimer's Disease International, which commissioned the report and focused on the problems of caregiving. "What many countries try to do is keep people away from care homes because they say that's cheaper. Yes it's cheaper for the government or the health system, but it's not always the best solution."
And dropping birth rates mean there are fewer children in families to take care of aging parents, too, said Michael Hodin of the Global Coalition on Aging.
"Very shortly there will be more of us over 60 than under 15," he noted.
Today, more than 35 million people worldwide, including 5 million in the U.S., are estimated to have Alzheimer's. Barring a medical breakthrough, those numbers are expected to more than double by 2050.
This week, the U.S. National Institutes of Health announced $45 million in new Alzheimer's research, with most of the money focused on finding ways to prevent or at least delay the devastating disease. The Obama administration had hoped to invest $100 million in new Alzheimer's research this year, a move blocked by the budget cuts known as the sequester. Overall, the nation has been investing about $400 million a year in Alzheimer's research.
But the disease's financial toll is $200 billion a year in the U.S. alone, a tab expected to pass $1 trillion by 2050 in medical and nursing home expenditures - not counting unpaid family caregiving.
Thursday, families affected by Alzheimer's and aging advocates said it's time for a global push to end the brain disease, just like the world's governments and researchers came together to turn the AIDS virus from a death sentence into a chronic disease.
"We need a war on Alzheimer's," said Sandy Halperin, 63, of Tallahassee, Fla., who was diagnosed with early-stage Alzheimer's three years ago.