>> Alzheimer's disease is the most common type of the men shah.

Right now more than six million people are living with it in the United States.

A number that is expected to double over the next two decades.

Earlier this year, the F.D.A.

approved a new drug that is offering hope in the fight against this devastating disease.

The drug, called leqembi, appears to slow Alzheimer's but in the without risks.

Patients are also finding it hard to get coverage for the treatment.

Than all comes amid a recent report from the Alzheimer's association warning that the national cost of caring for patients with Alzheimer's will rise dramatically over the coming years.

The report also reveals that too often individuals with memory concerns do not tell their doctors, missing a critical first step toward diagnosis and potential treatment.

Joining me now to discuss both the promising new treatment as well as the finds of the latest report on Alzheimer's is Dr. Nicole percell.

She's a neurologist and senior director for clinical practice for the Alzheimer's association.

Thank you for joining us.

>> Thank you for having me.

>> So let's, for some context for this conversation, let me go back to what I just mentioned here in the introduction.

And that is the numbers of people that we are finding who are suffering from Alzheimer's.

Your reaction to that.

Are you surprised at the numb we're talking about?

And then talk about what the projected numbers are in the near future.

>> So currently there's more than 6.7 million individuals living with Alzheimer's disease over the age of 65 in the United States alone.

And there are more than 11 million caregivers providing care to those affected individuals.

It's a staggering number.

When you look at the cost of that care, it's approximately $345 billion this year alone.

>> Were you surprised, again, you live in this world, and I've been involved in this with the Alzheimer's association for a number of years, yet I was Jarred by the numbers.

Are you, who are living in this world, who are dealing with this and trying to find cures and treatments, is that number surprising to you?

>> It is surprising.

And when you look at the projections that the number will increase to close to 13 million people by the year 050 it's even more staggering.

It's a tremendous amount of people in the United States and worldwide that have the disease.

>> Let's talk about one of the headlines here in the introduction.

And that is the approval for a new drug.

We called it leqembi, I believe, is the name that's being used for it.

Talk about what it's designed to do and what the find have been in terms of its efficacy.

>> New medications approved by the F.D.A.

for treatment of Alzheimer's disease are designed to reduce the amyloid plaques that accumulate in the brain and cause pathology for this disease.

There are currently two of them, Leqembi is the most recent as of January, 2023.

These medications are approve prd the indication of early Alzheimer's disease or mild cognitive impairment.

That means it's very important if you or a loved one are experiencing symptoms of memory loss or cognitive difficulty, talk to your primary care physician as soon as you notice the symptoms.

>> In terms of what this is, because I know that when you hear something being developed for Alzheimer's, most people's initial instinct is, is this a cure?

Have we found a cure here?

What's the answer to that in terms of the drug?

And what's the answer in terms of how close are we at all to a cure?

>> So these new medications are not a cure.

But they have been shown to slow the progression of cognitive decline.

We do know that there are other proteins that are involved with being deposited in the brain with Alzheimer's disease.

So it may be that it may take a combination of medications.

So there are new medications that are in the pipeline, on the horizon, undergoing clinical tries -- trials at this time.

It may be a matter of needing a combination of medications to attack this complex disease in multiple ways.

>> I'm going to come back in a moment to this drug and how accessible it is to patient, but let me come back to something you mentioned a moment ago that I think is very important.

And that is the reluctance that patients have to talk about the onset or at least questions that they might have about their cognitive ability with their medical providers.

Clearly there's no uniform answer to the question why, but generally speaking, what are you finding in terms of why patients are so reluctant to talk about it?

>> That was the other strike finding in our report of facts and figures this year is that individuals that are experiencing difficulty with their memory and cognition, they are not talking to their primary care physicians.

They feel more comfortable talking to their family or friends about their issues, they feel that maybe they can compare their symptom to what their friends are experiencing to see if they're normal or abnormal.

And individuals also expressed concern that if they do talk to their primary care physician they may get a diagnosis of dementia and that's not something they necessarily want or they may have a misdiagnosis.

They maybe get -- they May be told they have something else they don't have.

So they did report several things as reasons for why they aren't approaching their primary care physicians.

>> So how do you get, we lived through this, my mother-in-law had Alzheimer's before she passed away, my wife had always been very close, show saw -- she saw it yet my mother-in-law wouldn't admit to it.

What's the advice you can give to family members at this point if they see something happening, how do they communicate with their loved one to try to say to them, all right, we need to get to a medical provider and we need to accept that this is happening.

>> You bring up a very good point that many people experiencing difficulty with their memory don't have insight into it so they don't realize it.

We encourage, you know, loved ones or care partners, to discuss it with the individual that they're seeing the problem, and encourage them and actually attend the physician's visit with them.

It's very helpful on the physician's end to not only have the individual with symptoms but their loves one that's seeing changes or things going on with the person.

It gives up mutt -- gives us much better insight into what's going on.

I think the other thing that's important besides care partners or loved ones encouraging the individual, primary care providers also reported that they generally wait for the patient or a loved one to bring up their symptoms of memory concerns instead of making ate routine part of clinical care.

Buttic we need to reduce the stigma and make this a part of every clinical visit.

>> You mentioned stigma.

That is such a hurdle for so many different medical maladies and ailments.

This, I think, carries wit, carries with it fear.

Along with the stigma.

I think you start thinking, I can't remember where I left my keys today.

And then your next thought is, oh, dear, am I getting alz himmers or some other form of dementia?

So what do you say to, again, patients or family members and primary care physicians so they they can be invested in this, what do you say to them about how do we deal with the fear of a diagnosis that causes this reluctance?

>> It's been my experience with seeing patients that if I can assure them that they're not going to go through this process alone so that they do have a loved one there that's with them or they do have family and they have their physicians that will guide them through this.

Hopefully enabling them to develop a trust so that as they progress through the disease, they're trusting that their physicians and their care partners are going to act in their best interests always.

And I think it's very important for primary care physicians to just bring up memory concerns at every visit.

So just seems to be a normal part of routine care and the discussion and it'll help patients feel more at ease while trying to have these conversations with them.

>> Let me come back to Leqembi, the drug we talked about before you discussed what it's designed to do, what hopefully it -- it can do, but it's not a cure.

Sit readily available to patients?

>> It is not readily available as far as coverage goes for care.

Most of the patients over the age of 65 are Medicare beneficiaries.

Medicare is currently not covering the drug outside of experimental clinical trials.

Recently, the veterans health administration did release a report indicating that they are going to cover it for their beneficiaries that are qualifying for the medication.

>> I suspect people are going to have the same reaction I'm having right now, I'm say, I'm on Medicare, I'm that age.

So I'm especially concerned about the availability of drugs that might be more necessary for me as an older person.

And I suspect that viewers are watch, listening to this, and they're puzzled.

They're saying if the F.D.A.

approved this, why is Medicare who is supposed to be taking care of us in our older ages, where this is more prevalent, why are they not jumping in with both feet and applauding this and say, absolutely.

Let's get it to everybody we possibly can.

Is there an answer to that?

>> Part of the answer lies with the F.D.A.

approval.

So the medications were approved under an accelerated approval.

And so medicare has not agreed to cover this unless the medication received full approval.

It's my understanding that that information is sitting with the F.D.A.

currently and at some point they will review it in the near future.

>> Are there other drugs or treatments that are in the pipeline right now that you, the Alzheimer's association, are familiar with that at least have some potential for providing additional care?

>> There's approximately 140 medications that are in the pipeline, and these medications are effective at a wide variety of strategies.

Some of them are against the amyloid.

Some are against tau, another protein that accumulates in the brain with Alzheimer's disease.

Some are anti-inflammatory medications.

There's a variety of medications coming through the pipeline, so it's very hopeful.

>> We've got about Maine or so left.

For folks watching this, watching our conversation, say, this sounds frar, some of these symptoms sound familiar either for me or a loved one or a friend, where do they go to find information and guidance?

>> The first place they should go is their primary care physician and discuss their symptoms with their primary care physician to get an assessment and get a diagnosis.

And if there's additional information, certainly, come to the Alzheimer's website which is alz.org, and you can find information there.

We also have a help line and that number is on our website.

>> Dr. Nicole purcell thank you for sharing this information, giving us a better understanding and thank you to you and everybody at the Alzheimer's association for the wonderful work you're doing.

We'll check back with you soon to see what kind of progress we're making.

You be well.

>> Thank you.