Analysis Says That Aging Veterans at Greater Risk of Alzheimer’s Disease

Published in Wonsocket Call on October 2, 2017

On Monday, October 2, at a press conference USAgainstAlzheimer’s, (UsA2), along with veterans groups, plan to release an issue brief, “Veterans and Alzheimer’s Meeting the Crisis Head on,” with data indicating that many older veterans will face a unique risk factor for Alzheimer’s as a direct result of their military service.

Following the release of this issue brief, on TuesdPbulisheday evening at a reception in room 106 of the Dirksen Senate Office Building, UsA2, a Washington, DC-based Alzheimer’s advocacy group whose mission is to stop Alzheimer’s disease by 2020, will launch VeteransAgainstAlzheimer’s (VA2), a national network of veterans and their families, military leaders, veterans groups, researchers, and clinicians, to focus on raising awareness of the impact of Alzheimer’s and other dementias on active and retired military service members.

Dramatic Increase in Veterans with Alzheimer’s

Forty nine percent of those aging veterans age 65 ((WW2, Korea, Vietnam and even younger veterans, from the Iraq and Afghanistan conflicts in the coming decades), are at greater risk for Alzheimer’s compared to 15 percent of nonveterans over age 65, note the authors of the issue brief. “There is a clear and compelling obligation for greater support to meet the needs of veterans with Alzheimer, they say.

The issue brief pulls together research study findings released by the U.S. Department of Veteran’s Affairs (VA). On study estimates that more than 750,000 older veterans have Alzheimer’s disease and other dementias, another noting that the number of enrollee with Alzheimer’s grew 166 percent from roughly 145,000 in 2004 to 385,000 in 2014.

The “Minority communities are at greater risk for Alzheimer’s and minority veterans are predicted to increase from 23.2 percent of the total veteran population in 2017 to 32.8 percent in 2037, says a VA study.

The issue brief also cites study findings that indicate that older veterans who have suffered a traumatic brain injury (TBI) are 60 percent are more likely to develop dementia, Twenty-two percent of all combat wounds in Afghanistan and Iraq were brain injuries, nearly double the rate seen during Vietnam – increasing these younger veterans’ lifetime Alzheimer’s risk.

Veterans also face a multitude of barriers to effective Alzheimer’s diagnosis and care, including a complex Veteran’s Administration health system, a lack of understanding about available benefits, and a stigma related to brain and mental health, say issue brief authors.

George Vradenburg, UsA2’s Chairman and Co-Founder, sums up the message to Congress and federal and state policy makers in the released issue brief: “We need to understand so much more about why brain injuries sustained in battle put veterans at greater risk for Alzheimer’s. We must encourage veterans to participate in clinical studies to learn about the long-term effects of brain injuries, so we can do everything in our power to mitigate the impact on those who have given so much to this country.”

A Call for Funding…

When former Lt. Gov. Elizabeth Roberts released Rhode’s Alzheimer’s plan in 2013, to guide and coordinate the state’s efforts to care for those with debilitating Alzheimer’s and those who care for them, she called the report a ”living document, ” to be continuing updated as needed. With the 5-year update of the State’s plan being due June 2019, to be submitted to the Rhode Island General Assembly, Lt. Gov. Dan McKee and the Executive Board of the Alzheimer’s disease and related disorders working group, roll up their sleeves to meet that legislative deadline.

McKee and his Alzheimer’s plan working group are now turning to philanthropic organizations, like the Rhode Island Foundation, to fund their efforts to update the State’s Alzheimer’s plan. Yes, it costs money to do this and with the incidence of Alzheimer’s increasing in the Ocean State, lawmakers and state policy makers need an updated plan to provided them with a road map to effectively utilize state resources and dollars to provide care for those afflicted with debilitating cognitive disorder.

In 2013, 24,000 Rhode Islanders were afflicted with Alzheimer’s disease and other cognitive disorders and this number will continue to grow each year. With the state being so small, every Rhode Islander is personally touched, either caring for a family member with the cognitive disorder or knowing someone who is a caregiver or patient.

Funding from the Rhode Island General Assembly and philanthropic organizations are needed to get the ball rolling on the state Alzheimer’s plan. When updating, don’t forget the needs of Rhode Island’s aging veterans.

Founded in 2010, UsAgainstAlzheimer’s has worked to secure the national goal of preventing and effectively treating Alzheimer’s by 2025 and to assist in securing nearly $500 million in additional public funding for Alzheimer’s research over the past few years. The nonprofit’s global efforts has influenced the leaders of the world’s most powerful nations, the G7, to embrace a similar 2025 goal and to call for greater levels of research investment and collaboration to combat Alzheimer’s . Finally, UsAgainstAlzheimer’s works to forge pharmaceutical industry commitments to improve efficiencies for an expedited drug discovery and approval process. For more information click here.

For details on the updating of Rhode Island’s Alzheimer’s Plan, call the office of Lt. Gov. Dan McKee at (401) 222-2371.

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The Growing Incidence of Alzheimer’s

Published in Pawtucket Times on April 26, 2016

While Congress and states are nation grappling with how to put the brakes to one of the largest public health crises in recent times, the escalating Alzheimer’s disease (AD) epidemic, the Chicago-based Alzheimer’s Association releases its annual snap shot detailing statistics on the impact of Alzheimer’s and dementia on caregivers and health care costs..

According to the 2016 Alzheimer’s disease Facts and Figures, released on March 30, 2016, this year nearly 16 million Alzheimer’s caregivers will provide 18 billion hours of unpaid care to 5.4 million afflicted with this devastating disorder. That care had an estimated value of $221.3 billion, says the report.

But that’s not all, this recently released report notes that two out of three people believe that Medicare will help them over costly nursing facility costs. Sorry it won’t. AD also has a direct impact on a caregiver’s pocketbook, too, the researchers found. More than one-third of those surveyed say they were forced by caregiving duties to reduce their hours at work or just quit their job entirely. As a result of these actions their income dropped by $15,000 compared to the previous year. Eleven percent of caregivers were forced to cut back on spending for their children’s education in order to provide support.

The 79 page Alzheimer’s Association report notes that both physical, emotional and financial support required by a person with AD may ultimately deprive family and friend care givers basic necessities, such as food, transportation and medical care. The Facts and Figures report reveals that these caregivers were 28 percent more likely to eat less or go hungry while contributing care to someone with AD, and one-fifth even sacrificed their own medical care by cutting back on doctor visits. Overall, nearly half of the caregivers say they cut back on their own expenses to afford dementia-related care for their family member or friend.

“The devastating emotional and physical effects of caring for a person with Alzheimer’s disease has been well-studied,” said Beth Kallmyer, MSW, Vice President of Constituent Services for the Alzheimer’s Association. “However, this new report shows, for the first time, the enormous personal financial sacrifices that millions of care contributors must make every day. These sacrifices jeopardize the financial security of individuals and families, as well as their access to basic needs and health care.”

This year’s Facts and Figures report found that 13 percent of family or friend caregivers sold personal belongings, such as a car, to help pay for costs related to dementia, while nearly half tapped into savings or retirement funds. On average, caregivers, many of whom do not live with the person they’re caring for, spent more than $5,000 a year of their own money to care for someone with AD; however, amounts varied with many spending tens of thousands of dollars per year.
Incidents of AD is Fast Growing

The Facts and Figures report says that out of the 5.4 million (of all ages) afflicted with AD, an estimated 5.2 million are age 65 and over. Yes, one in nine people having the cognitive disorder. Approximately 200,000, having early onset AD, are under age 65.

Also, the recently released Facts and Figures report warns that we are truly in the midst of an AD epidemic as the baby boomers grow older. By 2050, researchers say that someone in the United States will develop AD every 33 seconds. Without a medical breakthroughs to prevent or cure, the age 65 and over population with AD, the incidence is expected to nearly triple, from 5.2 million to a projected 13.8 million. Some say may be even as high as 16 million. It’s the only disease among the top 10 causes of death in America that cannot be prevented, cured or even slowed. .

Additionally, this year’s Facts and Figure report notes that AD is officially listed as the sixth-leading cause of death in this country. It is the fifth-leading cause of death for people age 65 and older. With the graying of America, AD will become a more common cause of death. At age 70, 61 percent of those with AD are expected to die before the age of 80 compared with 30 percent of people without the cognitive disorder — a rate twice as high, says the report.

The Typical Care Giver

The Facts and Figures report puts the face on a typical caregiver. Approximately two-thirds of caregivers are women, and 34 percent are age 65 or older. Forty one percent have a household income of $50,000 or less.

AD takes a devastating toll on the health of caregivers, says the Facts and Figures report. Nearly 60 percent of those taking care of loved ones with Alzheimer’s and dementia report that their emotional stress being high or very high. About 40 percent suffer from depression. One in five care givers cut back on their own physician visits because of their caregiving responsibilities. And, among caregivers, 74 percent report they are “somewhat” to “very” concerned about maintaining their own health since becoming a caregiver.

A Huge Cost on the Health Care System

The report’s researchers warn that the AD epidemic might just bankrupt the nation’s Medicare program. In 2016, total payments for health care, long-term care and hospice are estimated to be $236 billion for people with Alzheimer’s and other dementias, with just under half of the costs paid by Medicare. Nearly one in every five Medicare dollars is spent on people with Alzheimer’s and other dementias. In 2050, it will be one in every three dollars

Medicare and Medicaid are expected to cover $160 billion, or 68 percent, of the total health care and long-term care payments for people with Alzheimer’s disease and other dementias.

Seeing a huge rise in AD over the last two years, federal and state officials are gearing up to strategize a battle to fight the impending epidemic.

A Call to Action

Yes, the AD epidemic is here, right in Rhode Island. Everyone is personally touched by either caring for a family member with the cognitive disorder or knows someone who is a caregiver or afflicted.

Following the efforts of Congress to create a national strategic plan to address the rapidly escalating AD crisis and to coordinate resources across federal agencies, the Rhode Island General Assembly passed a joint resolution enacted into law to direct the Lt. Governor’s Long Term Care Coordinating Council (LTCCC) to be the vehicle to develop a state plan to address this growing public health crisis in the Ocean State. Ultimately, for over a year former Lt. Governor Elizabeth Roberts along with LTCCC members, former Division of Elderly Affairs Director Catherine Taylor, the state Chapter of the Alzheimer’s Association, universities and health care organizations with the public input gleaned from 8 listening events hammered out the 122 page battle plan with over 30 pages of recommendations.

In 2016, Lt. Governor Daniel J. McKee has picked up the ball and convened a meeting of the Executive Board on Alzheimer’s Disease and Related Disorders, consisting of researchers, advocates, clinicians and caregivers, to begin efforts to implement recommendations from the State’s Alzheimer’s Plan. The group will determine which recommendations are outdated.

With a rising population of Rhode Islander’s with AD, state policy makers must act swiftly and lose no more time in addressing this terrible disease and public health issue.

Calling on Congress to Increase Alzheimer’s Funding

Published in Woonsocket Call on February 21, 2016

Three weeks before President Obama released his Fiscal Year 2017 Budget on February 9,  Senators Susan Collins (R-ME), who chairs the U.S. Select Committee on Aging, and Amy Klobuchar (D-MN) along with seven of their colleagues, called on the Democratic President to increase funding for Alzheimer’s research as part of his last proposed budget request. Senator Sheldon Whitehouse (D-RI), who sits on the Senate Aging Panel, was among the cosigners.

In the bipartisan January 28 correspondence,  the cosigners said, “If nothing is done to change the trajectory of Alzheimer’s, the number of Americans afflicted with the disease is expected to more than triple between 2015 and 2050,” the Senators wrote.  Already our nation’s costliest disease, Alzheimer’s is projected to cost our country more than $1 trillion by 2050… Surely, we can do more for Alzheimer’s given the tremendous human and economic price of this devastating disease.”

Furthermore, cosigners warned that “$2 billion per year in federal funding is needed to meet the goal of preventing or effectively treating Alzheimer’s by 2025.” 

 Aging Groups Express Disappointment

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), says that the Consolidated Appropriations Act, 2016, (P.L.114-113) provided $936 million in FY 2016 (a $350 million or 59.7% increase over FY 2015) for Alzheimer’s disease research at the National Institute on Aging (NIA), the nation’s leading funder of Alzheimer’s disease research.

Richtman expressed disappointment that Obama’s budget proposal did not recommend funding about the FY 2016 level for Alzheimer’s disease and dementia research, it was essentially flat funded.

“Scientists have estimated that spending at least $2 billion a year on research is necessary to accomplish the national Alzheimer’s plan goal of preventing or effectively treating Alzheimer’s disease by 2025,” says Richtman.

According to NCPSSM’s 2016 Legislative Report, “the number of people suffering from Alzheimer’s disease or a related dementia is expected to skyrocket over the next few decades because many people are living longer and the incidence of Alzheimer’s disease increases with age.”

Richtman says “making a significant investment in funding towards finding a cure and appropriate treatments for persons with Alzheimer’s disease and dementias is key to reducing the massive financial drain this disease will impose on the future of the Medicare program, along with the devastating emotional and financial toll exacted on the millions of Alzheimer’s victims and their family members and caregivers.”

The Alzheimer’s Foundation of America (AFA) also expressed disappointment in the proposed $337 million cut in research funding at NIA, contained in Obama’s 2017 Fiscal year budget proposal. “The Administration has been a champion in the fight against Alzheimer’s disease; however, we are disappointed that, in his final budget, the President is retreating,” said CEO and President Charles J. Fuschillo, Jr., of the Alzheimer’s Foundation of America (AFA). “We were hoping President Obama would take the dramatic step necessary to confront the dementia crisis in this country head-on. We will continue to work with Congressional appropriators to ensure we are on the path to a cure,” says Fuschillo, Jr.

Like NCPSSM, Cicilline, Reed, Whitehouse, and many members of congress, the New York-based AFA urged the Administration to build on the historic 60 percent increase in Alzheimer’s research funding that was included in this year’s budget that provided an additional $1 billion in research funding in the upcoming federal budget.  If done, total federal spending would reach almost $ 2 billion, an amount that Alzheimer’s experts say is necessary to finding a cure or meaningful treatment by 2025 (detailed in the National Plan to Address Alzheimer’s Disease.

According to AFA, currently Alzheimer’s disease is the sixth leading cause of death in the United States, with studies indicating it could actually be as high as the third-leading caused.  But this devastating disorder is the only disease in the top 10 for which there is neither a cure nor impactful treatment.  Furthermore, “even with the Fiscal Year 2016 funding increase, funding for Alzheimer’s lags far behind HIV/AIDS, cancer and heart disease.

On the Home Front

Congressman David N. Cicilline, who successfully led the effort in the House to increase funding for Alzheimer’s research by more than 50% last year, sees a need for increased funding a necessity in the Fiscal Year 2017. “Alzheimer’s disease afflicts 22,000 Rhode Islanders and their families each year,” the Democratic congressman representing Congressional District 1.

With Congress poised to begin hammering out next year’s federal budget, Cicilline plans to continue his efforts in the House to fight for an increase federal funding for a treatment and a cure of the devastating disorder.  He urges for Alzheimer’s disease research remain a major funding priority for policymakers at every level of government.

Senator Jack Reed, serving as a member of the Labor-HHS Appropriations Subcommittee, says, “Last year, we successfully included a $350 million boost in new spending for Alzheimer’s research, a 60% increase over the previous year.  Looking ahead to the coming fiscal year, we still have our work cut out for us in this challenging budgetary climate, but I am pushing to secure additional resources to help prevent, treat, and cure Alzheimer’s, as well as for education and outreach.”

“More and more Americans are being impacted by Alzheimer’s disease and we need a serious national commitment to finding cures and treatments.  That means making strategic investments now that will help save lives and future dollars in the long-term,” notes the Senator.

A Call for Action

Experts tell us an impending Alzheimer’s disease epidemic is now upon us. Federal and state officials are scrambling to gear up for battle, developing national and state plans detailing goals to prevent or treat the devastating disease by 2025.

According to the Rhode Island Chapter of the Alzheimer’s Association, an estimated five million Americans over age 65 are afflicted with Alzheimer’s disease in 2013.  The prevalence may well triple, to over 16 million, if research does not identify ways to prevent or treat the cognitive disorder, says the Rhode Island nonprofit.  By 2050, it’s noted that the estimated total cost of care nation-wide for persons with Alzheimer’s disease is expected to reach more than $1 trillion dollars (in today’s dollars), up from $172 billion in 2010.

Congress must not act “penny wise and pound foolish” when it ultimately comes to determining the amount of federal dollars that will be poured into Alzheimer’s research in next year’s fiscal budget.  Less dollars or level funding will only increase state and federal government’s cost of care for Alzheimer’s care in every municipality in the nation.  A total of 469 seats in the Congress (34 Senate seats and all 435 House seats) are up for grabs in the upcoming presidential election in November.  Lawmakers must remember that every voter may be personally touched, either caring for a family member with the cognitive disorder or knowing someone who is a caregiver or patient.  That ultimately becomes a very powerful message to Capitol Hill that it is important to increase the funding to NIA to find the cure.

 

 

The Best Of…Music Reduces Alzheimer’s Patients’ Agitation

         Published August 19, 2002, Pawtucket Times

        After not being home for two years, I traveled to Dallas to visit my family and to celebrate my 88-year old father’s birthday party last week.

        My trip was a bittersweet experience for me as I reconnected with my parents and siblings.  It was great to spend time and catch up with everyone, but I saw firsthand how Alzheimer’s Disease had ravaged, both physically and mentally, my 80-year-old mother, and I saw the impact the disease had on my family.

        My mother, who is in the mid-to-late stage of Alzheimer’s was largely unaware of recent events or even to who I was.

         There was no recognition of my brother or sisters, and many times she did not even recognize my father, who has been her husband for the past 60 years.

         My mother could not tell time on her watch,was not aware of what day it was or even where she lived.

         Moreover, the staff warned me of my frequent mood swings and that she could get agitated very quickly.

         However, some say “music calms the savage beast.”

         That may be true, and it’s most certainly true for victims of Alzheimer’s disease — soothing music can reduce agitation.  While Alzheimer’s robs a person of their memory or cognitive abilities, a timeless tune can reduce agitation and can have calming positive effects on Alzheimer’s patients, too.  This point was driven home to me following my visit to my mother’s 28-bed Alzheimer’s unit at Dallas-base Marriott Brighton Gardens.

         On Friday afternoons, Carrie A. Johns of Blue Rose Entertainment keeps things hopping in the Alzheimer’s unit’s television room with her music therapy program.

        Popping CDs into a compact disc player, Johns plays a continuous string of popular tunes from the early 1900s to the 1960s.  That day, about 20 songs were played, ranging from golden oldies to country and western and Broadway tuns.

       Johns chooses from 8,000 songs in her CD collection, and she often selects songs during her one-and-a-half-hour program that reflect memorable happy periods in the residents’ lives.

       Johns, who raises Arabian horses on a 12-acre ranch in Mabank, Teaxa, has a client list of more than 500 nursing facilities, assisted living facilities and senior centers in the Dallas-Fort Worth metroplex region.

       Swaying, Johns sings the Andrews Sisters’ 1942 hit “The Boogie Woogie Bugle Boy of Company C” into her microphone, residents Rose Grimes, Helen Webb and Francis  Donathan dance up a storm with Ashina Jackson, a personal care assistant, big smiles lighting up all of their faces.

       “It is a joy to make these residents happy when their families are not here,” Jackson tells me.  “I like to see their expressions when they remember the tunes. It’s like I’m going back to their time.”

         To the beat of the 1920s tune “in’t She Sweet,” Activity Director Dave Mandt dances with my mother.

         She belts out the song remembering all the words, not even missing a beat.

          Jane Atobajeun, special care manager, says music helps to calm the residents down.  While residents with Alzheimer’s disease don’t remember recent events — what they ate for lunch, for instance — they will remember songs that were once popular in distant eras, since they can retain long-term memory.

       “Music makes them laugh,” adds Atobajeun, noting that it “touches their very being and also triggers me memories and emotions.”

       According to Atobajeun, throughout the day residents can get frustrated if they can’t remember things.

       But singing makes them very happy because they remember the words.  Dancing can also get the residents up and moving, she adds, noting that even wheelchair-bound residents are assisted to stand and move.

       Throughout the program my father and I traded off dancing with my mother.  Several times, my smiling mother goes up to the microphone, and dances with Johns.

       You guessed it — she automatically knows every word of the song.  When the music ends, I say goodbye to my mother.

       knowing the challenges she faces with Alzheimer’s, I at least know that there is a brief period of pleasure in her life — at least twice a week when she attends the Alzheimer’s unit’s music program.

        Herb Weiss is a Pawtucket-based freelance writer covering aging, health care and medical issues.  This article was published in the August 19, 2002 Pawtucket Times.

Deciphering the Effectiveness of Alzheimer’s Research Findings

           Published July 6, 2012, Pawtucket Times 

          Over a decade my mother was afflicted with the devastating medical disorder, Alzheimer’s Disease. Over the years with this affliction her physician would keep our family updated on the effectiveness of pharmaceutical research on medications that could put the breaks on this devastating disorder, one that would ultimately erase her short and long-term memory, making her husband of sixty years, and adult children virtual strangers to her.

            My family like hundreds of thousands of baby boomers and seniors sought out information from local newspapers, senior publications, national magazines, like Time or Newsweek, to unravel the medical mysteries of Alzheimer’s Disease.  Occasionally, I, like many shoppers at the local grocery store would sneak a peek, reading the National Enquirer while waiting in line looking for a little bit more information on new effective treatments for Alzheimer’s Disease.

Unraveling the Mysteries of Alzheimer’s Disease

            Oftentimes it becomes very confusing for caregivers to determine which profiled treatments are promising ones and which ones are not, due to the diversity of opinions in the research community.  Some articles might detail the effectiveness of taking Vitamin E; while others stress the effectiveness of Gingko, noting how it just might improve your memory.  Others might describe studies that indicate that estrogen replacement therapy is not really an effective treatment for Alzheimer’s Disease for some women.  Or some might even issue a warning to the reader to “not eat off of aluminum plates” because some research findings seem to indicate that an accumulation of heavy metals, such as aluminum, in the brain might cause the devastating disorder of Alzheimer’s.

            Years ago I provided the following helpful tips to readers of my column that might just unravel the mysteries of reported research findings in Alzheimer’s research that are reported by the nation’s media.  These tips are just as true eleven years later.

            Always beware of glitzy headlines. Time limitations keep people from reading every word in articles that appear in their daily, weekly or monthly newspapers.  As a result, may readers just choose to quickly scan the headlines for their information.  Don’t judge an article by its cute headline.  The content of an article is much more balanced than the headline that is composed of catchy words, crafted to draw the reader in.

            Look for authoritative commentary.  You can consider an article to be more credible when it provides multiple quotes on the indications of an Alzheimer’s treatment.  Consider the report to have done a good job if there is an authoritative expert commentary of the significance of the study.  Two likely sources might come from staffers employed by either the National Alzheimer’s Association or the National Institute of health, a major federal government agency that fund’s Alzheimer’s research studies.  One might consider the National Alzheimer’s Association point of view to be less biased and a more reliable opinion than those researchers who have ties to a pharmaceutical company that issued the press release.

            Determine if there are disputes in research findings.  Keep in mind that even if a research study is reported there might be those persons who believe that the study is not well designed or has major research flaws.   On the other hand, the study might just be accepted by the scientific community as a solid study.  However, there might still be serious disagreements about how to interpret the results or how to classify it.  Some researchers might consider it a major study while others would not.  A well-researched article will include the quotes of those who oppose the study.

Seeking out Reliable Expert Sources

            Are you still confused by how to cull articles for tips to learn about safe and effective treatments for Alzheimer’s?  Where do we go from here?  Caregivers should view any article written about new Alzheimer’s treatments as informational in nature.  The article can open the door to the nation’s research community and it now becomes your responsibility to do your homework by seeking out more details about what the research findings indicate.

            If the article describes the results of an actual published research study, obtain the scientific journal with the published study at your local library or search for it on the Internet.   When found carefully read it.  If the findings are reported from a presentation at a conference attempt to track down the researchers for more information.  Finally cruise the Internet and check out the official Websites of the Alzheimer’s Association or the National Institute on Aging, to determine if you can locate more information about a reported new treatment.

            Finally, don’t hesitate to call Donna McGowan, Executive Director of the Alzheimer’s Association – Rhode Island Chapter at 401 421-0008 or email, Donna.McGowan@alz.org, to solicit the organization’s comments on research findings reported by the media. Remember Federal agencies, along with national and state Alzheimer’s organizations monitor research studies and their implications for treatment.

              Herb Weiss is a Pawtucket-based freelance writer who covers aging, health care and medical issues.  His Commentaries are published in two Rhode Island daily’s The Pawtucket Times and Woonsocket Call.