In 2022 – the most recent year for which data is available – 4 percent of seniors (adults over 65) received a dementia diagnosis.
Now, it seems things could get a lot worse. New research published in Nature Medicine reveals a startling trend: a dramatic spike in cases over the next four decades. The paper argues that the lifetime risk of dementia after age 55 is now closer to 42 percent, more than double than previous reports.
That’s not all. The new data show that women, Black adults, and those with the APOE ε4 gene face disproportionately higher risks – as high as 45 percent to 60 percent.
This risk, the authors write, translates into an additional half-million cases this year, climbing to as many as a million new cases annually by 2060.
The researchers directly blame the rise in cases on an aging U.S. population. But there’s more to it than that. Other mitigating factors include genetics, skyrocketing diabetes and hypertension rates, widespread obesity, poor diets, an absence of exercise, and undiagnosed (and untreated) mental health issues.
Additionally, the study authors attribute earlier underestimates of dementia risk to unreliable dementia documentation in health records and on death certificates, minimal surveillance of early-stage cases, and the underreporting of cases among minorities.
Methodology
Researchers from the Atherosclerosis Risk in Communities (ARIC) Study analyzed data from more than 15,000 participants to calculate the lifetime risk of developing dementia and determine how those numbers might inform public health policy.
The source data revealed that – between 1987 and 2020 – 3,252 study participants developed dementia. From that, the researchers extrapolated an overall lifetime risk for dementia (among middle-aged Americans) of 42 percent. That translates to an average risk of 35 percent for men and 48 percent for women.
Startling Results
“Our study results forecast a dramatic rise in the burden from dementia in the United States over the coming decades, with one in two Americans expected to experience cognitive difficulties after age 55,” study senior investigator and epidemiologist Josef Coresh, MD, PhD, explained.
Coresh adds that the expected jump in dementia cases can be tied – at least in part – to:
- The progressive decline in brain function that often accompanies middle age.
- That women overall live longer on average than men.
- And that about 58 million Americans have surged past the age of 65.
The researchers also found that the lifetime risk of dementia jumps past 50 percent among anyone who reaches age 75.
“The pending population boom in dementia cases poses significant challenges for health policymakers in particular, who must refocus their efforts on strategies to minimize the severity of dementia cases, as well as plans to provide more healthcare services for those with dementia,” Coresh said.
Dementia’s Growing Burden
Working with these new numbers, the researchers applied U.S. Census data to project the annual rate of new dementia cases. In 2020, about 514,000 Americans developed dementia. By 2060, the authors contend, that will double to at least 1 million cases annually. The most significant growth will hit older seniors – between 75 and 95 years.
Black adults will have it even worse. The researchers expect them to experience a tripling in new dementia cases, compared to a doubling among White adults. This disparity underscores the cumulative impact of social determinants of health, including unequal access to education, healthcare, and nutrition.
Conclusions – And Implications
Today, dementia plagues more than 6 million Americans. It persists as a leading cause of disability and death among seniors. The economic burden is overwhelming – and growing – surging past $600 billion annually.
Addressing this growing crisis requires a multi-pronged approach.
- The authors insist that policymakers must prioritize prevention through lifestyle interventions, such as improving cardiovascular health and promoting hearing rehabilitation. Evidence shows that healthy behaviors and the absence of vascular risk factors can dramatically cut dementia risk. Unfortunately, only 20 percent of American adults meet the recommended health targets.
- Hearing loss among older adults has also been tied to increased risk of dementia. But only a third of them take advantage of hearing aids. To address this, Coresh recommends greater monitoring and testing, and possibly even government assistance programs to support healthy hearing among the elderly, including making hearing aids more widely available and affordable.
- Health policies should encourage efforts among Black communities to improve childhood education and nutrition, which Coresh says can be helpful in staving off cognitive decline later on.
Further Reading
Your Chances of a Dementia Diagnosis Depend on Where You Live
Lack of Purpose in Old Age Could Hasten Dementia
Lancet Commission Identifies 2 New Modifiable Dementia Risk Factors
