Major Problem and Challenges for Disease Control: Why Does the Disease Burden Persist?

A cure for AD is still not available and clinicians and caregivers are challenged with caring for an increasing aging population affected by dementia. Increased life expectancy has seen a rise in chronic medical disease and associated illnesses, including dementia. For example, there will be an estimated 400% increase in population of North Americans aged 85 and older by 2050, 40% of whom will develop dementia. 26 Clinicians providing care for patients with dementia are confronted with numerous challenges in managing AD. Some of which include employing unique social and environmental interventions; knowledge and use of increasingly sophisticated medications, and providing individualized therapy to patients, working with care givers or varying systems providing care. The burden for the general practitioner is not necessarily an increase in sophisticated medicines - it is really the lack of specific medicines for AD that is the problem - the physician has a limited range of therapeutic options, e.g. frequently used neuroleptics have mixed pharmacologies that can cause memory impairment, etc. Management of AD is also complex since it requires differentiating and managing various changing neuropsychiatric and behavioural problems. A balance also has to be reached between aggressive intervention and palliative care continued treatment versus withdrawal of medicines, and patient benefit versus caregiver burden. Managing AD is complex and presents a major public health concern for the today and the future.