i am not going to use my limited budgets on folks who refuse to work. [laughter] [applause] >> forget that. what is important for the future is which one of us speaks no space command that

is me. as as the media keeps reminding us, neither one of us beach spanish. >> spanish content starting now. >> your on. [laughter] [speaking in native tongue] >> josé cuervo. >> dude, that's not spanish, that's canadian. [laughter] all right. all right. in brigade lysias. >> the macarena. >> mentos, the fresh maker. >> don't cry for me, argentina. >> enough of that. let's get back to ted cruz. an open senate seat in texas >> yeah,. >> yeah, but that campaign did not have the best launch.

the website did not work. even republicans said that it was a bad idea. >> he is obama care. that is why it is about time for texas to turn blue seriously. seriously. texas is so read that they approved a textbook that has moses as a founding father. moses is someone to look up to. he only believes in ten laws. and the only reason he has name recognition is because of a boy's. [laughter] >> speaking of burning bushes maybe that is why he thinks the world is on fire. >> today's colleagues are not the best at being diplomatic. >> the 1st draft was addressed to two angry

dudes. not just dudes. not just the senate, a colleague and shocker just resign from office. you think that eugene gregory from a talk about what it is like to have to leave. well it sounds like these guys have heard that one before. >> we have to stop getting our jokes from. [inaudible] >> there are a lot of characters in congress. don't worry. now that lead is legal in the districts. >> who is counting. >> yeah, yeah, yeah. i 1 in 12 chance of not going to the state of the union. >> he has always been a little defensive like that.

>> i was born at 2:40 a.m. in the morning. so when we were kids every year i set the alarm on our birthday. i am a minute older than you. why are you still talking about this? >> the great political philosopher taylor swift once said, shake it off. haters are going to hate. if that dreaded call comes in, we will most likely be ready. >> what this is about is you are used to being the opening act. tonight we are excited to be the opening act. [applause] a long time show at the daily show less than a month

after. >> as secretary of housing it is disappointing to have to report that it now extends the cable. >> why are know republican speaking tonight? >> three minorities on the program but decided to filibuster. [laughter] >> there are a lot of powerful people here tonight. also here tonight. >> top of the record. i would never make a joke. actually, thank actually, thank you for making my brother chief deputy. our mother. fifty shades of gray fan very, very happy. [laughter] >> we can be serious for

just a moment. we grew up in a family that had a profound respect for public service. it made sense that we went to college with dreams of becoming journalists and spent the spring break of our sophomore year in college back in san antonio •-ellipsis internship opportunities. and one of the things that my brother has spoken a lot about his building an infrastructure of opportunities an and infrastructure that makes it possible for each person in our nation to reach their full potential. it is no secret we believe government has a crucial role to play in building that infrastructure, but we believe an equally important role is played by the inquisitive press. opportunities are denied and

elected officials fall short of promises. thank you not just for having us here tonight, but for everything that you do. you love of country chinese through in your work. even rudy giuliani would agree with that. thank you very much. [applause] >> all right. all right. all right. all right. i am extremely excited to introduce an actor and comedian widely known for his work at the senior booking correspondent on the daily show and has recently developed a comedic series in an effort to combat

islamic islam phobia. please join me in welcoming him. >> thank you for inviting me here and making me follow the dancing mexicans. [laughter] >> you were great. you were great. i am honored to be here in a room which so many esteemed radio and television correspondents correspondents, i'm sure some of them will get here soon. it is tough. you have a tough job reporting on congress although it is not that tough. i have walked around dc a lot. i'm sorry. that was a tough job.

to be fair, i did not write that joke. i don't know how it got in here. i don't read the judge before i sign off on them. i cannot be expected to read all the jokes. there are a lot of jokes. i don't know if it is one of my staffers that put the joke in here. maybe you are saying why would you not read the jokes? isn't that your job? to which i responded by i responded by saying, now you decide to ask tough questions. and yes even though not reading the jokes undermines the productivity we are still talking about jokes. not talking about the human trafficking bill. you he might draw that

parallel, and shame on you for doing that. although it is astounding. reading astounding. reading would be a basic requirement to be a congressperson. a bus driver needs to know directions. a presidential candidate needs to believe in climate change. i am talking to you ted cruz. it is a tough job. i do not mean to make fun of you. firstly, everyone these days with twitter, histogram your job is becoming obsolete. this might be the last that you get invited to. i would steal that plastic silverware right now. take it home is a momento.

secondly it has to be really boring to a port on the most ineffective congress in 100 years. nothing happens. come on. nothing to report on. i we will report on. i will write you a copy for the next three years. a bill fell apart today. democrats today. democrats complain there was not enough funding. a bowl. you are done. go home. that's it. nothing is happening. reporting on congress is like me telling -- writing a tell-all book about my sex life in the 8th grade. a lot of grandstanding. [applause] and finally, it ends finally, it ends with me in my room alone filibustering myself to sleep. congress has a ridiculously low approval rating. ridiculously low.

americans hate congress. it congress. it seems congress people get reelected 90 percent of the time. it is one of two things. one indicative of a tragically flawed campaign and election system which includes gerrymandering and fake money that subverts the will of the american people or it is number one. [laughter] so what happened? the prime minister of israel gave a speech to congress that was exciting. say what you will about pres. obama but it took a black a black president to make republicans finally wish for a jewish one. however, i wonder if

netanyahu is aware that there is only one republican jewish congressman, only one the the republicans love israel, the jews, not so much. we will get them our money, but the votes are going too far. i am excited to be on c-span. thank you. here is the thing. everyone rags on c-span. i'm c-span. i'm not going to do it. i won't stoop that low. also. also, no one is watching c-span, so who cares. in fact the only people who would watch c-span are in this room right now. i give them credit. what they do is hard. an unfiltered view of the workings of congress and the federal government. no one cares. you might as well put up a

gas station security camera. no one cares. c-span needs to be more like cnn and forget about the news. [laughter] seriously i saw anthony board a break into the situation with breaking news about the most amazing philly cheesesteak he had ever had. that was riveting. that is what americans care about. the only way we will care about the budget is if the budget suddenly mysteriously disappears. then you create a budget simulator you put me right in the middle of the non- action. or you go the fox news route, get the budget to shoot an unarmed like it and

rushed to the budget's defense arguing that the budget was written on white paper and that is why this is happening. listen, i listen, i don't care how this goes because tomorrow it will say muslim bombs. muslim kills. bad for me either way. [applause] i'm just saying, scare me show me that being reasonable is treasonable. that is what i want. or they can cover it like msnbc. ratings are so much better to have better that it does not matter. i we will not make fun of c-span. i am honored to be representing the american muslim community tonight. thank you.

to muslims allowed in here. not a lot of muslims in the media or the government. both bullets or eight a falafel once. brian williams interviewed the muslim mohammed mohammed, but i do not know about that. i am just saying, besides those guys, myself, the pres., the president, there are not a lot of muslims. we know he is a muslim. you don't. we do. you think he is black? he is not. wait until two years from now. for beard, four wives, the whole thing. he is not here.

like you would be in the back. i don't know. you don't know what happens. you might start doing that terrorist fist pump, handshake, and pretty soon we have sharia law. it will would prove to congress it is possible to pass a law. i don't think obama is a muslim. he is a terrible hagler. handle that budget. handle the closing of guantánamo. every member of congress 50 percent off. i don't mean to make jokes about the pres. before i came up your i i was assured by 47 senators that any jokes i i make about the president we will be no and

void. talking of sharia law it could never pass in this country because of the constitution and also because they cut off your hands, stone you for adultery, cut out your time for line. washington dc will come to a standstill. without without those perks no one we will run for public office. as a muslim a muslim american, i want you to know that i denounce terrorism. get that off the table. it is done. we're denouncing things. whenever somebody does anything bad all the others have to come out and announce everything that has been said. i am used to it. it. as a comedian, i can denounce carrot top. as a new yorker, i denounce the washington redskins.

but. but i we will announce them, whatever. i am used to it. we are used to denouncing. it is actually quite cathartic. cathartic. i we will say stuff, and you will announce it. ready? don't like that idea? i feel you. i feel you. you are just not used to it. it. that's all. white people never have to denounce anything. i we will make it easy on you. peggy -- khaki pants and barbershop quartets before we work our way up to the big stuff like crystal meth and the pleading the world's natural resources. it is tough. it is immediately islam. bad.

a white person can write a christian manifesto, shoot hundreds of people with a submachine gun, and it is bad parenting. he is mentally unstable. he went off of his meds. why can't i be mentally unstable? i want to be mentally unstable. i would love to be mentally unstable. i get it. i get it. being given an ak-47 and 11 years old and told that god is on your side as part of what it means to be an american. [laughter] all i am saying stop pouring the crazy. and it affects the way that even i think about it. a white person storm i. i thought, that guy's a jerk.

if a muslim steals my cab i think, i think that building is going to blow. [laughter] a white person with a beard and a beard and i want to buy his art is no honey. a muslim with the beard and i am hoping he is getting pulled out of line at jfk. three right and -- three white guys walk into a strip club, i think that's the party. muslims, i'm getting a hell of town. but the crazy thing, i read a statistic recently where only 32 percent of americans no a muslim person. amazing. here i am. i want to be a muslim friend. to that aim i went one step further and e-mailed a bunch of high-level individuals in media and government and asked them to ask me anything that they want to ask a muslim american. and i got interesting

responses. the 1st person that e-mailed me back was joe scarborough. i did not read it. i don't think anyone does. and then john lennon them unit -- john lemon e-mail me back. thank you for your e-mail. i don't know much about islam i was wondering if the quran tells us whether that dress is blue and black or white and gold. hillary clinton emailed me back, not the 1st time she and i have corresponded. as usual, she responded using only a modicum on's, but facebook messenger. i don't think that is the way the former secretary of state should be corresponding with people. former pres. george w. bush wrote to me and said i am constructing a diorama about islam. [laughter] i got a touching e-mail from

sean hannity@foxnews. dear austen, i would like to know more about american muslims, their beliefs and customs, exact locations contact lists, e-mail passwords weaknesses. i don't even know what he means, weaknesses. a lot of islamic phobia right now, but i try to be positive about it. i try to see the silver lining. a lot of americans are burning quran's but at least they are buying quran's which has to be good. there are many who are protesting the building of mosques but for the 1st time they now know that that building is not a mexican restaurant. and that is good. i have fun with the whole

thing. i no i do not have to look both ways suspiciously before putting my luggage in the overhead compartment, but i do. it is fun. i no i do not have to count my steps from my seat to the bathroom in an arabic accent. 11000, to 1000, 31,000. [laughter] i do it. scares whitey. look. people don't want to make the distinction between a muslim in a terrorist. why should i? y? since i was sending i was sending out e-mails to high-level people. i am a muslim. it's a good thing. they're doing their job and applaud that. i get an e-mail at 4:00 a.m.

that said you up? i did not answer. i get another email. seriously, dude. e-mail. seriously, dude. are you up? yes. sure. i am up. how much to our her temper? she will get out of my room. what is the exchange rate columbia? i am freaking i am freaking out and want nothing to do with this. a lot of misspellings that said, i am moaning and e-mailing at the same time right now. i shut off my computer at that. having getting a lot of flack. it is not fair. i wrote a letter to the pres. in support of the job that they do. i would mail it, but i hand wrote it and ran across the

right house lawn and gave it to them in person. you can do that now. [laughter] he has not gotten back to me. but but i got an e-mail from representative aaron shock who just resigned his office because of the campaign financing scandal. it's true. to be fair you are all hypocrites. everyone in washington is doing the same thing. talking about the way he decorated his office. office. talk about his office, people. don't get nervous. many notables are now decorating their offices based on famous tv shows. doctor amnesty.

i get the most interesting e-mail from vp joe biden who wanted to know what the 72 virgins. everyone wants to know about the 72 virgins. well, this is something i can actually answer. it is an interesting point. as some of you may not know 72 virgins are promised in heaven if you die as a martyr. recently they have discovered it is not virgins at all but raisins. the translation mishap in the old arabic and raisins were very rare at that time. seventy-two raisins. imagine the terrorist showing up after he has died i am here for my virgins.

teeseven crackers. it is not the same. so why would you incentivize terrorists with 72 72 versions? the worst sex on earth time 72. [laughter] seventy-two strippers and the lamborghini, now i'm joining. i'm always trying to think of ways to bring our country together. overcome prejudice. racism. this time for muslims to come together and do what african-americans and number of years ago when they did the million man march.

it's time for the million muslim march. am i right? we march down, surround fox news. [laughter] just to watch bill o'reilly p his pants. you know thank you. it has been a pleasure talking pleasure talking to you. i want to leave you with this. you might feel like a

congressional dinner is the junior varsity of the white house correspondents dinner which is probably because it is. otherwise i would be cow pen. but i do not want you to fred because there is hope for you yet. i i want you to remember the words of our president. the junior varsity of al qaeda. look how well there doing now. i want to leave you with this. remember congressional correspondence, if isis can do it, so can you. good night. thank you. [applause] >> thank you.

i can't leave without thanking the number of people who made this possible. ken strickland for your support. the countless others at the peacocks. they make me proud to be a part of the nbc team. thank you from the company club. for that i am deeply, deeply grateful.

i want to thank someone who inspires me to be a better person every day of my life. you are my rock. i love you. [applause] it has been an honor to serve as the chair of the rcc executive committee and am humbled to be able to represent you. brett have a stick. one quick thank you. we would like to see you all at the after party. with that we are adjourned.

[inaudible conversations]

[inaudible conversations] [inaudible conversations] s] [inaudible conversations] [inaudible conversations]

>> on the next washington journal retired u.s. army colonel talks about the desertion charge filed against a us soldier recovered in afghanistan next year. and a a member of the armed services and homeland security committee discusses the debate over defense spending and the pres.'s president's decision to stay in afghanistan through 2015.

[inaudible conversations] >> this hearing will come to order. it is my pleasure to accept

our nation's progress in combating alzheimer's disease is the enactment of the national alzheimer's project act which i co-authored with then senator evan by in 2011. i don't need to tell the people in this room what a devastating disease alzheimer's is. it exact's a tremendous personal and economic toll on the individual family, and our society. in addition to the human suffering that causes alzheimer's cost the united states within $226 billion including 153 billion. these cuts already our nation's most costly disease

projected to cost more than $1.1 trillion in 2050 if nothing 2050 if nothing is done to change its current trajectory. alzheimer's is also one of our nation's leading causes of death. they list alzheimer's as the 5th leading cause of death overall and the 5th leading cause of death for those 65 and older. number three right behind cancer and heart disease. moreover and most frustrating it is the only one of our nation's deadliest diseases without an effective means of prevention treatment, or a cure. it is now estimated that now

wanted to a baby boomers reaching age 85 we will develop alzheimer's. spending our golden years with alzheimer's were caring for someone who has it. if we are to prevent alzheimer's from becoming that of finding disease and the next generation to made is imperative we dramatically increase our investment in alzheimer's research. at a time when the united states is spending an astonishing $226 billion per year to care for people with alzheimer's we are spending

less than three tenths of 1 percent of that amount less than the $600 million per year on research. believe it or not that is that is an increase that many of us have worked for. you can barely see the expenditure level on that chart. alzheimer's receives funding that is clearly disproportionately low compared to its human and economic toll. look at the 2nd chart. we currently spend $5.4 billion per year for cancer cancer research, 3 billion per year for research on hiv-aids and 2 billion for cardiovascular research all investments that have paid dividends. these investments have

yielded tremendous results. patients have access to knew treatment. death rates for some diseases are decreasing. at the same time mortality due to alzheimer's is escalating dramatically. surely we can do more for alzheimer's and other diseases of dementia given their tremendous human and economic price. fortunately there is promising research that holds hope for alzheimer's patients and their families. research community is poised to make important advances through clinical trials and investigating new therapeutic targets. adequate funding is critical to address the research.

to meet that goal the chairman of the advisory committee on alzheimer's research care and services, doctor ron peterson home we will hear from shortly told our committee last congress that we we will need to devote at least $2 billion per year to alzheimer's research. well, at 1st glance that may seem like a lot of money. when you money. when you compare it to that 226 billion that we are spending caring for people with alzheimer's, it is less than 1 percent. and that is the context that we need to put it in. and that is why i have introduced a resolution with several of my colleagues stating that the senate we

will strive to double the amount of funding that our country spends on alzheimer's in fiscal year 2015 and develop a plan to meet the target of 2 billion over the next five years. this afternoon or perhaps tomorrow the budget is on the floor today. i we will be offering an amendment to the budget which i am pleased to say is cosponsored by my ranking member sen. mccaskill as well as senator warner senator toomey, and senator mentioned command we will also be calling on the budget to reflect that kind of investment. this is an investment that we simply must make to alleviate suffering and present our healthcare programs. i want to acknowledge all of

the advocates here today from all over the country. we need your help. we need you to educate members of congress and we hope that your presence today will be a powerful statement to all of our colleagues that they too need to help us solve this devastating disease. sen. disease. senator mccaskill. >> i want to thank the chairman for her commitment to this issue. i think it speaks volumes to the people in this room that the chairman is scheduled this hearing so early. that should be a signal that she is committed command i can assure her and you that i am committed to the issues she has eloquently outlined in your opening statement.

i think that with the chairman as an advocate, on your behalf we are in a good place. i want to thank you for being here today. from all across the country your spirit is inspiring have faced enormous personal challenges, years of frustration pain sorrow moments of hopelessness, and find the strength to come here from all over the country and make your voices be heard. i like forward to hearing the testimony of 11 11 opportunity to meet her more thoroughly. i like forward to hearing

her testimony and saying what we can do specifically to help those who are helping care millions of americans. the tremendous economic toll. we need toll. we need to do something soon. this is a crisis. set to reach one 1 trillion over $1 trillion in 2050. think about that. individuals, families, or our federal budget. family caregivers are the

unsung heroes providing the largest portion of care for individuals with the disease typically experiencing more sadness, anxiety and lost productivity as a result. about caregivers provided needs -- provide needed support, support, many patients in the later stages require around-the-clock care and i moved to nursing homes. according to the cdc half of all nursing home residents have residents with alzheimer's disease. with a few long-term care financing options many families coming including -- in fact probably most depend on the medicaid program for nursing home funds. estimated 28 percent of the budget is spent on long-term care services. much of it for alzheimer's patients. i no she can speak to some of the challenges of accessing medicare.

her mom worked hard all her life and retired with a pension, but that was not enough to cover the high cost of nursing home care. important that we talk about these issues because it is a week we're voting on the budget. i am worried for our country and families because the budget we are currently debating does massive cuts to medicaid. /by 5.4 billion in missouri alone. these are middle-class families there would be devastated. i also want to echo the statements of the chairman about research. government investment in government investment in medical research has allowed our nation to be a beacon to the world for help medical advancement being a country that is looked to. we are seen we are seen as a leader in the world.

funding the national institutes of health has flattened and suffered of the previous years. i am hopefully amendment i am cosponsoring will be a moment of a moment of bipartisan agreement that we cannot continue to shirk responsibility to advancing medical research. all that said those are problems facing families was the headline of the diagnosis. yesterday yesterday the association released the 2015 fact and figures report half are not even aware of their diagnoses. we cannot go back to the old days. a misguided attempt. not only are many individuals not being alerted, but many

believe mortality rates are higher than projected. studies done by researchers found that alzheimer's is now likely the 3rd leading cause of death in the us following close new line cancer and heart disease. we need to tackle this crisis head-on and provide families such as yours. i like yours. i like forward to hearing the testimony for a panel of witnesses .__reaching treatment by 2025. thank you for your leadership and i want to your leadership and i want to thank you for being here today. >> thank you very much, senator mccaskill. i should correct myself. also a cosponsor of the amendment that we will be offering to the budget. i just want to make sure i corrected the record.

blumenthal from connecticut and senator donnelly from indiana have joined us today i no that they care deeply about this issue. we now turn to the testimony of our panel. i am pleased that joining us today, barbara a well-known supermodel who has graced the cover of fashion magazine. also an accomplished restauranteur the

entertainment executive and has stood by his wife's side every step of the way. sharing their story she and her husband are helping to make a real difference command we thank you. next we will hear from the director of the national institute on aging at the national institutes of health. he represents nih on the hhs secretary federal advisory council on alzheimer's disease research care and services and coordinates the nih research effort under the national plan. we will hear from doctor

ronald peterson whom i mentioned previously the director of the mayo clinic and the study of aging. in 2011 he was appointed the service chair of the advisory committee. the kimberly assembly has been introduced finally it is a great pleasure to welcome to the committee doctor heidi wire meant with us here today for more than ten years served as a geriatric physician of maine medical center and specializes in the challenges that both physicians and caregivers face when caring for

alzheimer's patient. ..

>> >> i am here because i want to make a difference. i don't want anybody else to have to go through this. i am here to rescue to make a difference not just for the 5 million americans who have alzheimer's for their care givers but for future generations who will face that. this has been that is very new to me because i have been healthy for such a long time i did not have anything like this.

but i will fight and do exactly what i can to be better -- better then the person that i even was there are lots of people out there who were feeling the way i unfeeling like this should never have happened to me and there are many problems out here also i feel i am ready to work to do what i have to do to be the best i can be if i have to tell somebody they should not do it they will tell me i do or i don't. but it is important to me and is always health and

wellness that is a big part of my life in helping young people. to day i am excited and happy to be here and thank you very much. i have a lot to do in my future and i will do with the best way i can if i can help people to do it together that is fine. however we do it we just have to do it. >> i want to thank you for having me. and ranking member, to the members of the committee, i love my country i am proud to be an american and a kid from brooklyn and never thought i would have an opportunity to try to make a difference and this is

though one time that i know i can make a difference because i have seen what my wife has gotten through. woman who virtually could do everything sing, dance, look at food and taste it and could get exactly the way from a cookbook television show in commercials and always gave back but now have to wait for people to help her. i reminded of the song that of all people that jay z wrote it is called the paid eight cheapen -- pain ain't

cheap for those who have the disease are those who have to struggle to say i am broken. when you see is someone that you know bluenose that they can't do with their body has told them you realize you have to step out and step up to make a difference. then if we don't do something out 10 or 50 years down the road it as you accurately said with a trillion dollars. what we have for their country is the intellectual

ability. the greatest resource is the two-party system of mandate democracy at work. the greatest resource we have when we have alzheimer's to give the sense of accomplishment we have day modern day social tsunami of alzheimer's. looking at what my wife has gone thorough but i am trying says likely then my caucasian counterparts and looked at the fact within

that community we're getting tested and treated at a later stage so the chances to handle the situation will be more costly than ever the we have invested billions of dollars of heart disease, cancer, but to pay a pittance to alzheimer's. by using the pet scan we can determine that the plaque in the brain if we find out that has happened we can begin the process to take care of ourselves third diet and exercise in holistic practices and through that we can ward off or slow down with government funding and

better intellectual capacity to develop the means and the methods to make a difference. i am here today because i believe in america. 30 years ago if you walked around with the telephone it was on your back. today it is in your hands. i know we can break that gene code that used to take forever with different population groups to bring positive powerful medicines to market. last night i was at the alzheimer's dinner and i saw

1,000 people will although the panel's members is not cheap the last night i saw 18. a group of people from the deep south to the far west from the heartland of america paul saying we're added to pinpoint to push this over. i come here to day unbelievable even big government but could government the how to change the face of the alzheimer's community. i sat at a table with 10 other people and there was a young boy named tither. while they were talking about all the things coming on but the only thing i

could think of is here is a 12 for 13 year-old if i said right now what is the cassette deck? [laughter] what is in a track? , one that young man for when his kids are his age he can look back to say i remember when reconquered alzheimer's in they will say what? we have that within overcapacity to make the difference i want to be a part of there. for the future theiler's of this country. thank you. [applause]

>> chairman collins in the ranking member and members of the committee provided by the research rand nih for the opportunity to be a part of what we are doing. those that give us great hope that it will they to improvements so if we move to the next slide for where we stand with the number of people affected 5.2 million that if we don't change the course with the estimates of

cost already showing also raises the most expensive diseases and conditions reface to increase severalfold. it is imperative that we succeed to change the trajectory. referring to in the j as an indication the way we have insight not possible just a few years ago. these are skiing's that local black men -- a look at amyloid plaque that was only available with the autopsy you see this slide show with relatively little deposits put the next show is the contrast affected with dementia and cognitive changes and with that color

and intensity but the situation is even more complex carries one cognitive lead normal the has accumulations of am elated the brain only gaining insight now to recognize the very early stages potentially before irreversible damage that we can intervene to prevent progression. and i apologize for the difficulty to read it but it is those genetic discoveries. in then would we did not discover new genes and tell the of modern technology but

we're able to identify the tragic family is in the south american country of colombia to identify decades before we know they will have the disease on the bottom left is the gore will scan of an individual if they have sedgy in then to the right those did not inherit the gene to look normal but the bottom right word gene carriers already showing signs decades before symptoms then out there doing studies with prevention with treatments before damage occurs with a new generation of hope. >> just to emphasize their denigrate partnerships with the public and rarely we

monitor the traditions if it is success or not. even as we search for cheers we -- cures we recognize to take care of individuals with diseases and this is an example of a caregiver designed to make life better and those who care for them and the steady -- study that allows people to live that home longer the with the increase of diseases through the virginia and administration to decrease the burden to take on the

most important job of those living with alzheimer's. finally i want to illustrate under the national plan with the new then identified focus we have a spectrum of commitment with the goal to prevent disease by 2025 with goals having to do with care with public awareness and tracking progress through time. and allow forward to addressing questions you may have. >> dr. peter said welcome back. >> thank you chairman. good afternoon chair read, reagan never and distinguished members of the senate special committee on aging. of a play to thank the committee for the opportunity to discuss alzheimer's for this country angeles so the senators for

interesting - - introducing the resolution for funding in 2016 to increase the annual research budget. to sign into law requiring a the secretary of health and human services to generate the first plan for alzheimer's disease as a just finished the recommendations in 2015 in january. to treat him prevent alzheimer's disease by 2025 this is only 10 years away. essentials beecher submitted it includes a recommendation to federal government to

spend $2 million per year it pales in comparison to cancer or hiv/aids or cardiovascular disease with those amounts of deaths per year but the death is escalating alzheimer's disease is incurable with no survivors. in 2013 the united kingdom prime minister use his finally fed to host a summit on demand jedi in preparation we wrote a commentary suggested that member countries consider spending 1% of the annual care budget of research. in 2014 united states spent

220 - - two with a $26 billion if we would spend 1% of that on research we would reach the $2 billion figure recommended by the advisory council. last week in geneva switzerland. in presenting some figures as to the current numbers of individuals but they are projecting to be so what if we delayed the of -- the onset by five years have with those numbers impacted? what if we were able to slow the progression of the disease? but more people with a lesser degree of impairment

with the recent report is projected if the treatment were to be introduced by 2025 it could be delayed by five years that treatment would reduce the number of individuals affected by a 5. 7 million in with medicare and medicaid and family it would save two under $20 billion within the first five years. if the government were to invest 2 million per year they would recoup their investment within the first three years after a treatment became available all of those economic models convergent this point to indicate the savings to the federal government with more than capture the increase of investment in a relatively short period of time with

the effective therapy. the like to commend my colleagues that d.h. just for their work to enact the national alzheimer's plan thus far. has has been accomplished to courtney agencies with capability with respect to alzheimer's disease whoever great deal of work needs to be accomplished since we're not near an overall goal for preventing by 2025 i can say with confidence the research committee is poised to make a significant contribution if funding was available as outlined he and his staff have establish milestones for the execution of the plan now with the alzheimer's accountability actor looking to have good judgment budget to submit to congress our lady extra

ditchers necessary to accomplish the goals set forth in the national plan. we cannot wait until there is a more convenient time to increase funding for this disease projections indicate alzheimer's will bankrupt the health care system as we know it we cannot afford to spend the afore mentioned over $1 trillion per year is projected to care for individuals with alzheimer's the impact on family is is your missive the cost to society is unsustainable we appreciate those constraints the government is operating but our patience and families cannot wait with 10,000 baby boomers turning 65 and a daily basis that will not be resolved by itself we're all placed to make a difference

considering the new report last week we are encouraged something is in the pipeline it is up to those individuals to make difficult decisions with funding for those related disorders going forward. to call on congress to make decisions to alter the course now is what is not a burden to the next generation the national plan has established the blueprint to make this possible and we need your support i appreciate the opportunity to address the committee. thank you. >> and afternoon. on behalf of the

15.7 million caregivers they give for the opportunity to testify today alzheimer's is a devastating new progressive and fatal diseases within 5 million americans are currently living with alzheimer's or other dementia they're your friends, your neighbors some may even be family members business leaders store clerks and construction workers republicans and democrats in dorothea's one of them. i am honored today to share our story and discuss issues facing people with alzheimer's in their care givers.

i noted it has impacted my family the more i hear from other people better going through similar situations. to david mother is living in a skilled nursing facility in misery and am confident she is in the right setting receiving the right care but it was a challenge to their real families out there who never get the care and support they desperately need to face this disease. every year of dividend and i were in denial about the changes in her behavior i would rationalize incident in she did a better job to hide it paul rationalizing in denial came to an abrupt halt when i received a call from a stranger telling me my mother was in the middle of the drive instead was alone in a confused she

slept in her car on the side of st. a long way from home and that marked the beginning of a richard a. with alzheimer's she had three different evaluations they did tests on her ultimately concluded that it was alzheimer's. thereat was as an only child caring for a single mother the world we had shared with stowe lager and add that 38 had a new world that was foreign to me. after her diagnosis we didn't receive much information on what to do next. a friend recommended looking on line for health benefits

of the alzheimer's association which is the first time a light began to shied. a concern about the disease with the diagnosis meant and what the next deaths should be for her care. also how to cope with the emotions i was feeling is important because that was only compounded by the stress of a stowe were. and back pain was so severe the old doctor recommended a make a lifestyle change to reintegrate own health. exercise three times a week and have been eating a healthier diet but the emotional part is very difficult maritime receiver

mother feels like day number one in every single time. when she was diagnosed she was living alone and exhibited other warning signs that raised concerns about her safety. and then the to the senior independent living apartment that provides the social and hospitality alit she was able to live on your own for another four years until the liberal was progress to the point additional care and attention were needed. the next up was my own personal light beer to move my mother to the skilled piercing facility where she currently lives today although she worked for 33

years and retired the selfie pension and though high cost of long-term care exhausted her funds. we needed the medicaid program to afford the long-term care in there very grateful for the assistance. am not the only one that has said difficulty getting help after learning about the alzheimer's diagnosis. after hearing first hand of the gaps in the health care system dealing with this disease far too many physicians are not familiar with how to properly vies patience and care givers after a diagnosis is to find the alzheimer's association it took us to even get basic information what to expect next. ha bill would shift deal as

lost as i fell in there is no treatment of a lever there are many things that can be done to improve the family's ability to cope especially immediately following a diagnosis. that is why deal sidetracked is critically needed to make serve families like mine are provided with care planning services through the next that. i feel blessed in found the resources i needed for rent on will being the answer and i would have felt much less alone in this fight in the beginning until a cure is found u.s. were with the people of the disease and reading the following the

diagnosis. we need care and we need help which is exactly what this act will provide i have had an opportunity to speak with any researchers about the progress that has been paid for the development for a cure. i realize despite progress we still have a very long road to walk for processing advancements in other areas as a result of strong federal unless and research the sea think of an opportunity for ground-breaking treatment for this disease. if i could save millions of families the same heartache alzheimer's is one of the worst i implore all of your colleagues to provide additional funding for alzheimer's research is the

only way we can surely create a world with alzheimer's. fate you for the opportunity to testify and those who are affected by alzheimer's of there is one thing never ask for you to take away from my testaverde then alzheimer's disease not only in packs a diagnosed person with those that love them dearly. thank you very much. >> [applause] >> thank you very much.

oldest media age which we have a few were working aged individuals to care for

older adults in those with dementia as the disease progresses. projections are the 65 and older population is the only population that will grow over the next 10 years. the total population will remain flat at $1.3 billion but we have 37,000 individuals diagnosed with dementia and it is projected to increase by 50 percent up at 53,000 in five years. to been shedding is in an epidemic with dire consequences on our economy, the health system and his family structures if we did not act now to do something. including increased burden on care givers paid and unpaid a lack of state housing, indeed for transportation and health care system that is overburdened and two-thirds

of patients die in nursing homes. we have you were younger people that means a few were formal and informal caregivers to help we are experiencing significant challenges already for hospitalized patients with they can no longer be cared for at home. this results in the rebate at though wrong level of care for them to care of with the chronic to the chip put stress on families as well as the medical community providing care with the tremendous financial burden. it isn't a routine part of clinical training for most providers it is critical of the primary-care system comes prepared to deal with cognitive assessment to

provide resources the family needs to deal with this progressive disease. currently damages of crime and we need to prepare the health care system to provide support was they are diagnosed even as we search for the care. i would like to share a couple of stories i first met mr. and mrs. keller 10 years ago when i diagnosed him with a mild cognitive impairment and sadly it increased to alzheimer's and he had a gradual decline with walking and swallowing and eventually he began having issues with eating is started to develop new media. i began visiting him in his home as it was nearly

impossible to make it to the office. he had support from his wife and unpaid care givers and other families but eventually be called hospice if he died in his apartment with the support of his wife and family. i've got to know his wife while she was very active and involved in the senior community so every night significant anxiety in required treatment of her own. after her husband passed away didn't see her for one year the end she appeared as a new patient she had developed memory loss. she'll longer had a spouse who could help the children cannot provide support she continued to live independently with support and eventually needed to do transfer to assisted level and the transition to not go

well she fell and had a head injury and with delirium continues to decline they tried to plan financially for their deeds but the private care givers are expensive in the muddy preannounced she is now a nursing home. the children feel guilty they cannot provide the same support for the rather than allow the father to die at home with their resources are not there. we need more flexibility for caregiver support an alternative options for housing with individuals with dementia. the id in this case we could have had the outcome provides other scenarios to share their reading of time so thank you for taking the time to hearing where story then it for the support of care givers and individuals with dementia now to have

alternative housing options and ultimately the increase of funding to identify ways of the prevention and care of this devastating disease. faq. >> the key for your rooftree testimony. when we were talking informally before the hearing, you talked about a public-service announcement that you had made. could you share with everyone what you did to try to expand awareness with participation in clinical trials? >> yes. we are affiliated with the braid health registry and put that dennis is cats people to participate with

the information to be considered for drug trials. one of the maid impediments with more research toward drugs is we don't have enough people to participate so they can be considered for the drug trials with the tuskegee experiment they said have help -- happened in the past. with the african americans but you need to have of a diverse pool of different backgrounds of women than men in this parade health

registry registers so they could be considered for the drug trial. we wanted to break down the stigma that going to try villages and the tuskegee experiment all over again. there are so many taboos be want to beecher and let people know we have to do this to find the right medicine. >> faq for doing that. >> one of the great things about that is it increases the overall purchase a patient by 6 percent within the minority community that people saw a dead because they were not aware they needed that diversity of the gene pool spitzer

particularly since african-americans are more likely to get all severs i think you being dealt there has helped to increase awareness. thank you for that. >> i started to visit research center is a unit talking about the wonderful work at the mayo clinic and i spent an hour and at the massachusetts general talking to the alzheimer's researchers there. ibis say and i want to share that i see great promise and hope long the horizon. one of your charts talk about the imaging that was possible that wasn't a few years ago the cattle maybe

diagnosed in the third parade autopsy though we can show the beta amyloid plaques did we learn that massachusetts general there is an antibody given with the employee is developed and know-how affective that is but there's so much exciting research going on i cannot wait to go to pennsylvania or other research centers. but the problem is with only $600 million you cannot possibly fund all of those exciting research applications did you give us

an idea of those projects federal there? >> with their proposed a research far in excess that'd save very real way buyer looking at the success rate that we're able to find in a rage of 11 or 12% it is easily said twice that's the amount are considered as an absolutely outstanding. even at that level with the

research we have proposed there is great room for that more should demand could with the ability to recruit did initiate new areas as a dividend to look forward to. >> but a love of natural% has doubled that number senator? >> and also disproportionately affects more women than men and more african-americans and caucasians? let's talk about the reality of medicaid.

lynn is investing in the research the other is that care can be given. relived in the state with they refuse to expand medicaid or draw down those dollars and the budget we are debating cuts by another $400 billion. i am not sure people realize the percentage of nursing home patients that are suffering from alzheimer's and need help from medicaid. what would you have done? there are stereotypes uttered not fair like your mother working 33 years. she had a pension and a plan and then it got alzheimer's.

then having to access medicaid services for long-term care. what would you have done if they were not available? if there was a block oriented in the money was gone because it was october what would you have had to do? >> senator, i don't know. , was not familiar with the medicaid process until we were thrown into this world there have been many nights understanding the cost of long-term care in in those realities because now you face the financial fight package to have an extraordinary price tag then the emotional and physical to go through.

and initially just understanding that cost there were many nights i was very scared because she does have the attention but we don't have the resources to pay 5000 + 8000 a month with a long-term care facility. if we were going to be denied i did not know. all these years, and to make too much or too little will i be denied? the very disheartening part for me is when the other is a very proud woman and worked 33 years and for the federal government and is

very proud of it sometimes her mind is still says she has to go to work but all those years of work were taken by the disease and not push forward through the inheritance. but the disease is exhausting everything it is heartbreaking. i don't know but that has been my fear. thank god for medicaid and at the same time we have never needed for anything. as a middle-class family i have never bend in the position to have the indeed

but i am grateful for that. >> i hope you into the advocates carry that message because toothache that stereotype is hardly a the program people are comfortable ; those that the debtor those who have not worked hard. nothing could be further from the truth particularly with long-term care in this country it seems not funding research is done because it will cost us money and i hope he will continue to tear advocate. >> i apologize for my delay gsa tried to cover a baking hearing but i wanted to be

here. alzheimer's forces people to watch helplessly as their loved ones slip away but the high cost also stretches to the breaking point. tool under $26 billion caring for people with alzheimer's in by the year 2050 the yearly cost is more than 1.1 trillion for gore is the director of national whole the institute testified he said if we could prevent or delay the onset we could save billions of dollars if it is the matter to choose research now or pay out in a big way later on. clearly congress is choosing to pay out later. it has reduced the

purchasing power of the nih by 25% last year is spent only $562 billion on alzheimer's disease research that is two tenths of 1% of what it costs last year. dr., mccain tell us briefly how the support for funding effect did your colleagues were variants research on all sabres? direct debit is the case it isn't limited by a great idea is put in the earlier comment even if one looks at that outstanding of that we can help it is the concern to find traces much even

with those ideas proposed adding greater speed. and double the we would be able to recruit with a more innovative approach civic soviet funding half or fewer of those afternoons? bamako those proposals currently submitted, yes. >> could you add to that? >> another ramification is the fact with reduction of federal funding is also investigators going into the field will cripple us. so theseus struggling for funding and research setting they say however i going to

survive? i am afraid we're turning off the younger generation and other investigators. >> so the high-cost right now? every single member of congress said they support more medical research but it takes a mighty and congress has done absolutely nothing to get more readily into the agency. that house republican budget willard releasing plans last week people say they support funding but what it actually does is lower the caps there already crushing research agencies making it likely agencies would see a cut and do these plans for gore earlier this year i

introduced a bill to increase funding by $6 billion per year. that isn't enough but it is a start we could do without raising taxes or cutting programs or cutting vital research without adding one dime to the deficit. i hope my colleagues who are serious about finding will join me in the effort or bring other ideas to the table. talk is cheap. we have an opportunity to make a real difference opportunity to save billions of dollars, the necessary health the long term care and keith with those more precious time. we will miss that opportunity unless congress steps up to fund the nih. [applause]

>> they give for holding this hearing to give us the opportunity to interface with so many people they you for your investment of your time in the energy. all offices are filled with your enthusiasm in real-life stories a cannot think of anyone here on the panel who has not been impacted personally by alzheimer's or parkinson's to watch the challenge as my grandfather passed away in 2001 to seize the challenges that she faced but also those who are a support system. if you are blessed with the

opportunity to care for someone with alzheimer's please raise your hand. god bless you. it is a maze saying the impact the disease has on the family and loved ones. such a powerful witness that people talk about loved ones and their commitment to make sure the research and resources are available for others whose baby impacted as well. a thank you for your energy and enthusiasm. dr., they keep for your expertise sand contribution. it is an opportunity for me to talk about the success in south carolina with the

hospital system that has invested a lot of time looking for those resources to make progress received within $12 million in grants to care for hundreds of alzheimer's patients since 2006 the net worth has been doing great work on this issue in conjunction with other hospitals prepare there is still so much work to be done but i hear optimism those that believe they can do amazing things with the right resources. so what does progress look-alike over the next 10 years and are we meet -- meeting milestones and updating appropriately so researchers are working on the most critical projects?

can you point to specific achievements that has advanced the science on this issue? >> thank you for your comments. there is well justified about the potential for progress as they have more insight into cellular mechanisms behind the disease. with the planning in place the intensified project on a regular basis with the senate held last month convened record of the with the experts to help us do rebates -- updates and what we need to accomplish your by your to translate into success that is the objective. with the accomplishments as noted for the record we seem

progress to identify early stages long before the appearance of symptoms giving mci opportunity to intervene in understand if they're working by tracking bio markers long before we would identify progression and you're also committed to important works of quality of life. the research proposals are enormously gratifying than and coupled with that is the nervous disappointment and paid an english of those applications we are not able to support. we are making progress but the pace is limited by what they can support.

>> levy ( with the question. on the budget committee i was unable to be here for the whole hearing but could he be more specific about the prospects for a cure and no call today you are and viable passes someone on doctor like me can get a sense of how much confidence we can have? >> that is an excellent question but i think there is enough exciting research this is the complex diseases

digest single cell but that involves networks and we are somewhat encouraged by last week when of the drugs under investigation in the early phase one indicated there may be a path for word as far as those plaques were reduced in the patients improved clinically very early phase one study is now moving forward with phase three but it is this type of discovery that will lead to more than one hit in the relatively near future to say when it is difficult but i am encouraged we are of the press of this of handling this disease one way or another.

>> we don't know yet exactly what are the octant -- optimal targets with that integrated approach from all the brilliant winds that can convert john the question. giving those most rigorous trials to recognize it is important to maintain early public you for a molecular in genetic targeted to build those in to the next candidates for intervention we may have short-term success but if we couple that that goes deeper into a deeper for better approaches into the future. >> is inspiring to hear that but my colleagues and