Brendan Kelley, MD: Standing up to Alzheimer’s Disease

People shaking hands in front of a screen with a brain on it.

Brendan Kelley, MD (left), meets with medical residents during a recent lecture. Photo by UC Academic Health Center Medical Communications.

Brendan Kelley, MD, uses the phrase “potential healthcare disaster” to describe an anticipated surge of patients with Alzheimer’s in the next 20 years, from 5.3 million Americans today to more than 8 million in 2035. At the same time, he remains optimistic that scientists will develop drugs that can slow the degenerative process.

“There are over 100 different medications in various stages of clinical trials,” says Dr. Kelley, an assistant professor of neurology who heads up UCNI’s emerging program for Alzheimer’s and other cognitive disorders. “I think the next five years will be a very exciting time because many of these medicines will be entering into Phase 2 and Phase 3 trials with large numbers of patients. Although many of these compounds may not have the anticipated positive effects, this is the only scientific way to identify medications that are truly effective.”

Cincinnati has been mostly absent from clinical Alzheimer’s research during the last several years. But that changed with Dr. Kelley’s arrival 18 months ago. UC is expected to become a participating center in a national Phase 4 Alzheimer’s drug trial in the next couple of months. The trial will enroll patients in the advanced stages of the disease. “We expect that as we establish a track record we will participate in more trials,” Dr. Kelley says.

Step by step, Dr. Kelley has worked to establish the new program as a destination for people with Alzheimer’s, non-Alzheimer’s dementia, and rare forms of dementia, such as primary progressive aphasia. “Over the past year we have established a regional center where patients experiencing cognitive changes can come for accurate diagnosis and thorough investigation of their problem,” Dr. Kelley says. He follows well over 500 patients and continues to see new patients, who are typically referred by their primary care physicians or neurologists.

“Brendan Kelley has an affinity for dealing with complex problems that involve behavioral and cognitive neurology,” says John M. Tew, M.D., Clinical Director of UCNI. “That means decline in thinking, dementia, Alzheimer’s disease: all problems that are difficult to distinguish but are associated with aging – something that affects all of us. I am excited about his addition to the UCNI team and know we’ll see rapid recognition of his contributions to the community.” While building the program, Dr. Kelley has forged community partnerships with the Alzheimer’s Association, the Council on Aging of Southwest Ohio and the Ohio Geriatrics Society. His program also will continue to partner with the Lindner Center of HOPE in both clinical and research endeavors.

The average survival with Alzheimer’s disease is about 10.3 years. Statistics related to cost are harrowing and include treatment, caregiving and lost productivity of both patients and caregivers. “We balk at the costs of new federal healthcare initiatives, but the fact of the matter is that we already expend similar amounts of money,” Dr. Kelley notes. “The personal and societal costs necessary to provide adequate care for people suffering degenerative diseases that affect thinking, cognition and behavior is astronomical.”

Total payments for health and long-term care for people 65 and over with Alzheimer’s disease or other forms of dementia are expected to be $172 billion this year, according to the Alzheimer’s Association’s 2010 report. “This figure does not include lost productivity of these persons and their family members, unreimbursed costs for personal care and the often under-recognized effort of family members who provide important aspects of care,” Dr. Kelley points out.

The Alzheimer’s Association estimates that family and other unpaid caregivers provide 12.5 billion hours of unpaid care annually, with a conservative valuation of $144 billion. In Ohio, more than $5 billion in unpaid care is provided annually.

While America struggles to meet the needs of the 5.3 million people with Alzheimer’s today, Dr. Kelley remains optimistic that effective treatments will become available within the foreseeable future. “If those treatments can be found,” he adds, “We will be able to curb the impending healthcare disaster and the burden of those healthcare costs for the next generation.”

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