In the United States alone, the prevalence of AD is expected to more than double from six million people in 2019 to nearly 14 million people in 2050. Meanwhile, the track record for developing treatments for AD has been marked by decades of failure. But recent progress in genetics, neuroscience and gene editing suggest that effective treatments could be on the horizon. The arrival of such treatments would have profound implications for the way we diagnose, triage, study, and allocate resources to Alzheimer’s patients. Because the disease is not rare and because it strikes late in life, the development of therapies that are expensive and efficacious but less than cures, will pose particular challenges to healthcare infrastructure. We have a window of time during which we can begin to anticipate just, equitable and salutary ways to accommodate a disease-modifying therapy Alzheimer’s disease. Here we consider the implications for caregivers, clinicians, researchers, and the US healthcare system of the availability of an expensive, presymptomatic treatment for a common late-onset neurodegenerative disease for which diagnosis can be difficult.

中文翻译：

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好问题？症状前迟发性阿尔茨海默病疾病缓解疗法的政策和社会影响

仅在美国，AD 的患病率预计将增加一倍以上，从 2019 年的 600 万人增加到 2050 年的近 1400 万人。与此同时，开发 AD 治疗方法的记录却以数十年的失败为标志。但最近遗传学、神经科学和基因编辑方面的进展表明，有效的治疗方法可能即将出现。此类治疗的到来将对我们诊断、分类、研究和为阿尔茨海默病患者分配资源的方式产生深远的影响。由于这种疾病并不罕见，而且发病时间较晚，因此开发昂贵且有效但无法治愈的疗法，将对医疗保健基础设施构成特殊挑战。我们有一个时间窗口，在此期间我们可以开始预期，以公平和有益的方式适应阿尔茨海默病的疾病修饰疗法。在这里，我们考虑了对一种可能难以诊断的常见迟发性神经退行性疾病的昂贵的、症状前治疗的可用性对护理人员、临床医生、研究人员和美国医疗保健系统的影响。