AD is the most common cause of dementia among people age 65 and older. It presents a major health problem for the United States because of its enormous impact on individuals, families, the health care system, and society as a whole. Scientists estimate that up to 4 million people currently suffer with the disease, and the prevalence (the number of people with the disease at any one time) doubles every 5 years beyond age 65. It is also estimated that approximately 360,000 new cases (incidence) will occur each year, though this number will increase as the population ages (Brookmeyer et al., 1998). A number of research groups have examined differences in AD prevalence among racial and ethnic groups, and it appears from some studies that the risk is higher for African Americans and Hispanic Americans than it is for Caucasians, though not all studies provide similar results. These differences are important to study, not only because of the growing percentage of non-Caucasians in the older U.S. population (by the year 2050, the percentage of the population over the age of 85 that is non-Caucasian will have increased from 16 percent to 34 percent), but because the variations in prevalence may reflect different roles of particular genetic and environmental factors in the development of AD.
AD puts a heavy economic burden on society. A recent study estimated that the annual cost of caring for one AD patient is $18,408 for a patient with mild AD, $30,096 for a patient with moderate AD, and $36,132 for a patient with severe AD. The annual national cost of caring for AD patients is estimated to be slightly over $50 billion (Leon et al., 1998).
These numbers gain significance when they are placed against the backdrop of increasing life expectancy and changing demographics in the United States. Since the turn of the century, life expectancies have increased dramatically. More than 34 million people–13 percent of the total population of the United States–are now aged 65 and older. According to the U.S. Bureau of the Census, this percentage will accelerate rapidly beginning in 2011, when the first baby boomers reach age 65, and will reach 18 percent of the total population by the year 2025.
Approximately 4 million Americans are 85 or older, and in most industrialized countries, this age group is one of the fastest growing segments of the population. The Bureau of the Census estimates that this group will number nearly 8.5 million by the year 2030; some experts who study population trends suggest that the number could be even greater. As more and more people live longer, the number of people affected by diseases of aging, including AD, will continue to grow. For example, some studies show that nearly half of all people age 85 and older have some form of dementia.
Slightly more than half of AD patients receive care at home, while the remainder are in many different types of health care institutions. Many spouses, relatives, and friends take care of people with AD. During their years of caregiving, these families and friends experience emotional, physical, and financial stresses. They watch their loved ones become more and more forgetful, frustrated, and confused. Eventually, the person with AD may not even recognize his or her nearest and dearest relatives and friends. Caregivers–most of whom are women–must juggle child care, jobs, and other responsibilities with caring for relatives with AD who cannot function on their own. As the disease runs its course and the abilities of people with AD steadily decline, family members face difficult decisions about the long-term care of their loved ones. Frequently, they have no choice but to place their relative in a nursing home. The numbers of caregivers–and their needs–can be expected to grow significantly as the population ages and as the number of people with AD increases.
National Institutes of Health
National Institute on Aging
1999 PROGRESS REPORT ON ALZHEIMER’S DISEASE