Dementia is a huge public health challenge, and the situation is expected to get even worse in the coming decades. New research predicts that by 2060, around a million US adults will develop dementia every year. In 2020, the figure was 514,000, highlighting the growing need for preventative measures and care strategies to protect this vulnerable patient population.
“Dementia” is an umbrella term for a set of symptoms including memory loss and other problems with thinking and problem-solving. The most common cause of dementia is Alzheimer’s disease, but there are several others, including vascular dementia and frontotemporal dementia.
Dementia symptoms start with mild changes that gradually get worse over time. Early symptoms can include things like forgetting appointments, struggling to keep track of your keys and wallet, and difficulties planning and organizing. When these types of signs first appear, it’s referred to as mild cognitive impairment (MCI). MCI often progresses to a form of dementia, but this can look very different for each person.
Although there are some rare cases of dementia in young people – and even childhood forms of the condition exist – most of the time it is older adults who are affected. Public health experts and clinicians have been warning about the increasing incidence of dementia with the aging populations in many countries around the world, and this new analysis from the US paints quite a concerning picture for the future.
“Our results suggest that the current lifetime risk of dementia may be substantially higher than previously thought,” the authors write in their paper.
They used over 15,000 health records covering the period between 1987 and 2020, from Black and white adults aged over 55. None of the participants had a diagnosis of dementia at age 55. Over an average follow-up period of 23 years, they calculated that at 55 years old, these participants had a lifetime dementia risk of 42 percent, with most of the eventual diagnoses coming after 75 years of age.
Delving deeper, the researchers found that the risk increased incrementally over time: 0-4 percent from age 55 to 75; 4-20 percent from age 75 to 85; and 20-42 percent from age 85-95.
There were also some demographic differences. Women were found to have a higher lifetime risk of dementia than men, at 48 percent vs 35 percent. Black participants had a 44 percent overall lifetime risk, compared with 41 percent for white participants.
“Racial disparities in dementia may reflect the cumulative effects of structural racism and inequality throughout the life course,” the authors posit, citing examples like poorer access to education in early life and limited healthcare access later on.
There are also some genetic factors that can strongly affect someone’s individual risk of developing dementia. The one highlighted in this study involves a gene called APOE ε4. It’s been well established previously that inheriting this particular gene variant – and inheriting two copies of it, especially – increases the risk of developing Alzheimer’s disease. The authors of this study found the lifetime dementia risk for people with two copies of APOE ε4 was 59 percent, compared with 48 percent with one copy and 39 percent with no copies.
The authors do highlight several potential limitations of the study, such as the fact that the findings might not necessarily generalize to the entire US population. They also say it’s possible that their figures may still be an underestimate, although they took steps to verify the diagnoses of dementia using a number of different types of records.
Overall, the forecast for the future is that the burden of dementia is set to increase even further, and the authors say there’s an urgent need for more research into how the condition may be prevented. Some avenues that are already being explored include dietary changes, exercise, and environmental factors.
“Approximately 1 million US adults will develop dementia annually by 2060,” the authors conclude. “Policies that enhance prevention and healthy aging are urgent public health priorities for reducing the substantial and growing burden of dementia.”
The study is published in Nature Medicine.
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