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CDC: US Alzheimer’s disease burden expected to increase 178% by 2060
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The burden of Alzheimer’s disease and related dementias in the U.S. will nearly double by 2060, according to a CDC press release.
The announcement coincided with CDC research based on U.S. Census projections and CMS percentages of Medicare Fee-for-Service beneficiaries aged at least 65 years that was recently published in Alzheimer’s & Dementia.
Besides the overall U.S. burden, which has been updated over time, researchers predicted Alzheimer’s disease and related dementias by race and ethnicity by 2060 for the first time.
Among the findings:
- In 2014, the overall burden of Alzheimer’s disease and related dementias was 5 million people, or 1.6% of the population, and was expected to grow 178% to 13.9 million, or 3.3% of the population, in 2060.
- In 2014, black adults aged at least 65 years had the highest prevalence of Alzheimer’s disease and related dementias (13.8%), followed by Hispanics (12.2%) and non-Hispanic whites (10.3%).
- In 2060, the number of Hispanic adults with Alzheimer’s disease and related dementias was expected to climb to 3.2 million; CDC estimated there will be 2.2 million black adults with Alzheimer’s disease or related dementia.
“We have assumed that the prevalence estimates in 2014 will be constant over time. Given the heterogeneity in research results, some have argued that the evidence is not strong enough to deduce a trend different than a stable age-specific prevalence,” Kevin A. Matthews, PhD, of the CDC’s division of population health, and colleagues wrote.
“These findings may also be complicated by the temporal changes in dementia diagnosis thresholds and recording practices and shifts in survey methods, among other factors,” they added.
CDC has data and early assessment and diagnosis tools on its website for those affected by Alzheimer’s disease and related dementias, the release stated. – by Janel Miller
Disclosure: Healio Family Medicine could not confirm relevant financial disclosures at the time of publication.
Perspective
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Douglas Scharre, MD
Unfortunately, the findings by Matthews and colleagues are not surprising and serve as a reminder that the medical community needs to be watchful of the symptoms for Alzheimer’s disease and related dementias.
It’s important to remember that the current medications we have for these conditions work better when the first signs of cognitive decline appear, rather than when the patient is further along in their cognitive decline. Hopefully this report will encourage primary care physicians to be watchful and screen for cognitive decline their patients during their annual wellness visit at 65 years of age. Even if the patient shows no signs of cognitive decline, the screening should still occur so that a good baseline for the patient can be established.
There are many screening tools available. One is the SAGE (Self-Administered Gerocognitive Exam) that I developed that asks the patient to draw pictures, identify objects and other tasks that can indicate the signs of cognitive decline. This free tool can be done by the patient and the results brought to an appointment for the PCPs for evaluation. PCPs not wanting to use the SAGE test can also use the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) or any of the other clinically validated cognitive assessments available. The important thing is that some kind of cognitive screening be performed.
PCPs should also encourage patients to bring family members to appointments, since the patient’s relatives may be more likely to see the signs of cognitive decline than the patient him- or herself.
For more information:
The Ohio State University Wexner Medical Center. https://wexnermedical.osu.edu/brain-spine-neuro/memory-disorders/sage. SAGE: A Test to Detect Signs of Alzheimer's and Dementia. Accessed Sept. 21, 2018.
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Keith Fargo, PhD
These findings by the CDC are troubling, but expected and indicative of the large, growing problem in our society. We know our population, particularly the large baby boomer population is aging, so unfortunately, we do expect more and more people in the coming years with Alzheimer’s disease and related dementias.
Perhaps even more troubling, the medical system is not prepared to handle this growing problem of patients with Alzheimer’s disease and related dementias. By way of comparison, if you look at someone who is diagnosed with cancer, there are many specialists and other medical professionals trained to help that person. That is not really the case right now with Alzheimer’s disease and related dementias. Most of these latter patients are treated by their primary care physicians and there is a lack of resources for PCPs to treat this large and growing number of people.
The CDC report suggests it would behoove the primary care community to get ready for the wave of Alzheimer’s disease and related dementia that is coming and seek out guidance to care for patients. Earlier this year, we published dementia care recommendations, and at the recent Alzheimer’s Association International Conference, we presented clinical practice guidelines related to diagnosing Alzheimer’s disease and related dementias.
The primary care community also may not be aware of the large number of clinical trials out there that seek to further the understanding of Alzheimer’s disease and related dementias. To improve this understanding, the Alzheimer’s Association created the free website TrialMatch, which PCPs can either share with their patients, or even enter their patient’s information themselves, and the website returns a customized list of trials in the area and how to get in touch with trial organizers.
There are resources for PCPs available to help with this coming wave. We know PCPs have so many pulls on their time, so we hope the primary care community will take advantage of these tools.
For more information:
Alzheimer’s Association. https://www.alz.org/professionals/professional-providers/dementia_care_practice_recommendations. Dementia Care Practice Recommendations. Accessed Sept. 20, 2018.
Alzheimer’s Association. https://www.alz.org/aaic/releases_2018/AAIC18-Sun-clinical-practice-guidelines.asp. Clinical Practice Guidelines. Accessed Sept. 20, 2018.
Alzheimer’s Association. https://www.alz.org/trialmatch.org. TrialMatch. Accessed Sept. 20, 2018.
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