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Alzheimer’s Disease is expected to become a massive medical burden in an aging American population, with the expected number of cases doubling over the next 20 years, from 5.5 million to more than 11 million by 2040.

Ten therapies for potential early interventions are in development. But even if those prove to be viable and effective, the current health-care landscape presents bottlenecks that present serious hurdles, according to a new report by the Rand Corporation.

A lack of doctors, diagnostic scanners, and infusion centers would be a significant limiting factor when and if Alzheimer’s treatments become available, they write.

Their scenario is based on treatments appearing soon, they explain.

“Within as little as two to three years, one or more disease-modifying therapies for Alzheimer’s disease could become available, finally offering hope to patients and their families affected by this devastating condition,” they write. “But, as our analysis shows, the U.S. health care system is ill-prepared to handle the potentially high volume of patients who would be eligible for treatment.”

The problems include the burgeoning burden – and the projected lack of a corresponding increase in the resources in the American health system.

The availability of experts to guide treatment is the most pressing need, they write. For instance, even as tens of millions more people in the U.S. will need screening for cognitive impairments as they age, the total number of neurologists, geriatricians, and geriatric psychiatrists will remain relatively level through the year 2040. The number of neurologists is expected to modestly grow by about 2,000 (from 17,000 to 19,000), but there are expected to be 1,000 fewer geriatricians in the same time frame, and several hundred fewer geriatric psychiatrists, they forecast.

PET scanners are another crucial factor. Some 2,000 were installed at a base level in 2009, and the current operational devices run at about 50 percent capacity, they write. For the added Alzheimer’s burden, projections indicate there would be 4 million more scans by 2040 – meaning newly installed devices would have to be dedicated to amyloid scans, and run at approximately 80 percent capacity, they write.

For infusion centers for the still-projected drugs, approximately 33 million infusions would be required even as early as 2020. That number would be three times the overall number of infusions estimated this year (excluding chemotherapy and immunotherapies, they add).

The 10 drugs have still yet to be developed, they add. (Last year, a drug that had previously fallen short in clinical trials was re-proposed and repurposed at one of the major Alzheimer’s conferences).

“While there is no certainty an Alzheimer’s therapy will be approved soon, our work suggests that health care leaders should begin thinking about how to respond to such a breakthrough,” said Jodi Liu, the lead author of the study, a policy research at Rand.

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