Dementia Treatment

According to current estimates, more than five million people in the United States have Alzheimer’s disease, the most common type of dementia. Under the current trajectory, more than 13.8 million additional baby boomers are expected to develop dementia by 2050. Despite considerable effort by researchers, there are currently no drugs or medical procedures for preventing or curing dementia. 

A 2015 AARP policy survey revealed that virtually all members recognize dementia as a serious problem. The survey also reported that 85 percent have known someone with dementia, yet misconceptions abound. Older adults want to know about their mental functioning. Health care providers are the first line of defense for individuals who notice a decline in cognitive health. But few health care providers discuss dementia with their patients or assess mental functioning during the Medicare Annual Wellness Visit. Nearly half of members mistakenly believe that dementia is a mental illness, and 41 percent think dementia is part of the normal process of aging. 

The human, societal, and financial costs of dementia are all very high. They include health care costs, negative impacts on individuals and their families and friends, and adverse effects on the workforce. It is estimated that the average per-person Medicare spending for people age 65 and older with dementia is three times higher than for seniors without dementia. Medicaid payments are 19 times higher. And research projects that the cost of caring for those with Alzheimer’s will make up 24.2 percent of Medicare’s spending by 2040. Dementia impacts not only the patient but also their family and friends. In 2015, the direct annual cost of caring for those with dementia was estimated at $226 billion. It is expected to reach over $1.1 trillion a year by 2050. People caring for family or friends with dementia had $9.7 billion in additional health care costs of their own due to the physical and emotional toll of caregiving. 

People with dementia make up substantial proportions of all older individuals served in medical, residential, and home and community settings. On average, about one-quarter of all older hospital patients are people with dementia. Almost 65 percent of nursing home residents have moderate to severe cognitive impairment. Most people prefer to receive services in their homes or the community whenever possible. However, many communities are not equipped to meet the needs of individuals with dementia and the families who provide the care. This has enormous implications on quality of life, both for individuals living with dementia and for their families. 

Of additional concern are the racial and ethnic disparities that exist in dementia diagnosis and care. For instance, Black Americans and Hispanic/Latino communities have substantially higher incidence rates of dementia than whites. As the nation ages and more racially and ethnically diverse generations reach older adulthood, racial and ethnic diversity among people with dementia will increase. The need to develop person- and family-centered care to accommodate such diversity will grow. This is important because certain racial and ethnic groups use care differently. They face different risks of suffering from Alzheimer’s disease, have different chances of receiving a diagnosis, and experience different attitudes and levels of support from caregivers.