Isnt Dementia Part Of Normal Aging
No, many older adults live their entire lives without developing dementia. Normal aging may include weakening muscles and bones, stiffening of arteries and vessels, and some age-related memory changes that may show as:
- Occasionally misplacing car keys
- Struggling to find a word but remembering it later
- Forgetting the name of an acquaintance
- Forgetting the most recent events
Normally, knowledge and experiences built over years, old memories, and language would stay intact.
What To Do If A Loved One Is Suspicious Of Having Dementia
- Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
- Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
- Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.
A Costly And Growing National Crisis
- In 2021, the total national cost of caring for people living with Alzheimers and other dementias is projected to reach $355 billion. This number does not include the estimated $257 billion price of unpaid caregiving.
- Medicare and Medicaid are expected to cover $239 billion, or 67%, of the total health care and long-term care payments for people with Alzheimers or other dementias. Out-of-pocket spending is expected to be $76 billion, or 22% of total payments.
Source: Alzheimers Associations 2021 Facts & Figures Report
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Prevalence Of Dementia In India
The Global Burden of Disease Study estimated that, in 2016, 3.74 million people in South Asia had dementia, including 2.93 million people from India , whereas an estimated 4.02 million people had dementia in the USA . The estimate for the USA was based on several large, epidemiological studies however, the estimate for India was extrapolated from the sparse available data. Thus, rigorous, large-scale epidemiological studies on dementia prevalence in India are still required. Dementia research in India also poses unique challenges such as the need to adapt cognitive tests to the sociocultural context, while taking into account the fact that large sections of population have low levels of literacy. Although some cognitive tests, such as the Addenbrookes Cognitive Examination , have been translated and adapted to Indian languages, the relevance of such tests among illiterate populations is a matter for debate. A neurocognitive test battery called the Indian Council of Medical ResearchNeurocognitive Tool Box was developed in India for use among literate and illiterate individuals.
Fig. 2: Varying prevalence of dementia according to geographical location in India.
This figure shows the prevalence of dementia in different geographical locations in India. Also provided is the age range of the population studied and the year of publication.
Dementia In The United States
United States dementia statistics indicate that over the last two to three decades, U.S. dementia rates are dropping. The rate of dementia in the United States changed from 11.6% to 8.8% between 2000 and 2012, and the decline rate is estimated to be between 1% to 2.6%. Although there has been a decline in dementia rates, growth in the elderly population is expected due to an increase in life expectancy and because of baby boomers reaching old age. As a result, the number of people suffering from dementia in the United States is expected to rise from 5.8 million to 13.8 million by 2050.
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What Is Already Known On This Topic
The World Alzheimer Report 2009 includes the most recent available epidemiologic studies on nationwide dementia prevalence. However, it does so as a meta-analysis combining results of studies derived from a variety of settings, most of them urban samples. The estimates hence have the limitations of the underlying study data. Reviews and meta-analyses that combined the results of prevalence estimations, have concluded that the different prevalence results across studies are largely explained by the difference in definitions of dementia used. Yet, the consistency of prevalence found internationally lends credence to the validity of the World Alzheimer Report estimates, and they currently are our most agreed upon estimate. Our observed national prevalence based on claims evidence of diagnosis in the USA aligns with what would be expected based on the estimated rate.
What Are The Signs And Symptoms Of Dementia
Because dementia is a general term, its symptoms can vary widely from person to person. People with dementia have problems with:
- Reasoning, judgment, and problem solving
- Visual perception beyond typical age-related changes in vision
Signs that may point to dementia include:
- Getting lost in a familiar neighborhood
- Using unusual words to refer to familiar objects
- Forgetting the name of a close family member or friend
- Forgetting old memories
- Not being able to complete tasks independently
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Data And Study Sample
We used data from the 2000 and 2012 waves of the HRS. The HRS is a biennial, survey of US adults that started in 1992 and collects a wide-range of data on health, cognition, family, employment, and wealth.16 The HRS follows respondents longitudinally until death, and new cohorts have been enrolled at different times since the 1992 baseline interviews in order to maintain population representativeness as the study sample has aged.16 As a result, 4,008 individuals in our analysis were included in both the 2000 and 2012 cohorts, while 6,538 were included only in 2000 and 6,503 only in 2012.
Our study sample included all HRS participants aged 65 or older, living in the community or in nursing homes in 2000 and 2012. There were 10,546 respondents in 2000 and 10,516 respondents in 2012, after excluding 165 and 218 respondents from the 2000 and 2012 samples, respectively, due to missing data for one or more covariates used in the analysis. If a respondent is unable or unwilling to participate in the survey, the HRS attempts to identify a proxy respondent to complete the survey for them. There were 1,317 respondents represented by a proxy in 2000 and 860 in 2012. The response rate for the full HRS sample was 88% in 2000 and 89% in 2012.17
Informed consent to participate in the HRS is obtained from all respondents. The HRS has been approved by the Health Sciences and Behavioral Sciences IRB at the University of Michigan.
Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of biological ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of cognitive decline and dementia by being physically active, not smoking, avoiding harmful use of alcohol,controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, social isolation, low educational attainment, cognitive inactivity and air pollution.
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Dementia Incidence Declined Every Decade For Past Thirty Years
For immediate release: August 14, 2020
Boston, MAOver the past 30 years, the incidence of dementia has declined an average of 13% every decade in people of European ancestry living in the U.S. or Europe, according to a study led by researchers at Harvard T.H. Chan School of Public Health. Using this trend, the researchers estimate that 15 million fewer people could develop dementia by 2040 in high-income countries than if the incidence of the disease remained steady.
As the populations of the U.S. and Europe age and life expectancy increases, the prevalence of dementia and Alzheimers disease has dramatically increased, due to the larger pool of people in the ages of highest risk, said Lori Chibnik, assistant professor in the Department of Epidemiology at Harvard Chan School. However, our analysis shows that the incidence, or rate of new cases, has been declining, translating into fewer new dementia and Alzheimers disease cases than what we would have expected.
The study was published in the August 3, 2020 issue of Neurology.
Currently, 47 million people worldwide live with dementia. Due to the rapidly aging population, the number of people living with the disease is expected to triple over the next 30 years, as is the expected socioeconomic burden associated with dementia.
Previous analyses suggested a decline in incidence over the last 40 years, but most studied smaller populations.
Funding for the study is listed at the end of the article.
Nicole Rura
The Role Of Vascular Dysfunction
Future dementia research in India should also focus on understanding the interplay between cerebrovascular dysfunction, amyloid accumulation and hyperphosphorylation of tau, all of which contribute to cognitive dysfunction in older individuals,,. However, in our experience, performing PET imaging of A and phosphorylated tau in India can be challenging owing to limited availability of PET ligands. Therefore, the potential use of peripheral blood biomarkers such as, A140, A142, p-tau, total tau and neurofilament light chain, should be examined. Some international studies into the associations between cerebrovascular disease and neurodegenerative diseases have been performed using animal models,. Nevertheless, in our opinion, the substantial increase in the prevalence of vascular risk factors, the complex sociocultural milieu and exposure to pollutants means that India should be a specific focus of such research.
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Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . Dementia may also develop after a stroke or in the context of certain infections such as HIV, harmful use of alcohol, repetitivephysical injuries to the brain or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
What Are The Most Common Types Of Dementia
- Alzheimers disease. This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimers disease increases the risk of developing it by 10 to 30 percent.
- Vascular dementia. About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.
- Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations .
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Q: Has Alzheimers Become More Prevalent In Recent Years
A: Since its discovery in 1906,Alzheimers diseaseA degenerative brain disease and the most common form of dementia.1 has become increasingly prevalent among adults in the United States. Today, the CDC estimates that 5.4 million people in the US have Alzheimers disease.69 Meanwhile, a report from the Alzheimers Association estimates that 6.5 million adults over the age of 65 have AD in the United States and reports that each year, 100,000 people develop AD.70 Some studies estimate that by 2050, 14 million people will have AD.71, 72, 73 Because research methods to identify and diagnose AD is improving, Alzheimers disease most likely will continually become more prevalent in the future.
Alzheimers diseaseA degenerative brain disease and the most common form of dementia.1 is currently the sixth-leading cause of death in the United States and is the fifth-leading cause of death for those ages 65 and older,74 killing more than breast cancer and prostate cancer combined each year.75 By 2040, approximately one in five Americans will be age 65 or older, rising from one in eight in 2000.76 Current projections estimate that in 2050, 1.6 million people in the US could die due to AD, a number that is nearly triple the number of recorded AD deaths in 2010.77, 78
Q: How Does This Issue Look Today
A: There is still room for improvement in the care and resources provided for Alzheimers patients and their caregivers, as well as the efficiency with which healthcare professionals detect and diagnose thediseaseA condition that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.11. Currently, outside of research settings, many individuals who should be diagnosed with Alzheimers diseaseA degenerative brain disease and the most common form of dementia.1 are not getting the diagnosis they needbeing underdiagnosed, misdiagnosed, or undiagnosed because physicians avoid prematurely diagnosing Alzheimers disease without a full diagnostic workup.86 In 2016, there was one geriatrician for every 1,924 Americans age 65 or older in need of care.87 Far from the recommended ratio of 1 geriatrician per 3 or 4 patients, this 2016 figure indicates that the United States health system does not have enough trained geriatric healthcare professionals to meet the need of the increasing prevalence of Alzheimers disease in America.88, 89
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Dementia Statistics Us & Worldwide Stats
You may personally know someone thats affected by dementia, perhaps you have been diagnosed and are currently living with a related condition. Although this diagnosis can be frightening, its important to understand that youre not alone. Across America alone, millions of individuals and their family members suffer from varying conditions which yield symptoms of dementia.
In fact, 7.7 million new cases are diagnosed every year, with 47.5 million people living with dementia worldwide. Based on the high number of individuals affected, dementia is one of the leading cause of dependency and mental impairment among the elderly population.
Q: What Is Alzheimers And How Does It Relate To Dementia
A:Alzheimers diseaseA degenerative brain disease and the most common form of dementia.1 is a neurodegenerative diseaseA condition that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.11 that targets specific brain regions related to memory and executive function. For instance, AD damages the hippocampus and the nearby entorhinal cortex, both involved in forming and storing memories.24 AD also targets the frontal lobe, an area responsible for judgment and behavior, and areas of the cerebral cortex responsible for language, reasoning, and behavior.25 Although AD damages critical brain areas, thediseaseA condition that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.11 does not directly kill an individual. Instead, complications from the decline in brain function lead to death. Some examples of these complications include vascular changes, infections, injuries from falls, and malnutrition.26, 27
Photo by Robina Weermeijer on Unsplash
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High Mortality And Morbidity Rate
The prevalence of Alzheimers in the US leads to an increase inmorbidityThe condition of ill health or disease.15 and mortality rates because AD and other dementias directly lead to life-threatening medical complications. This process is known as theAlzheimers diseaseA degenerative brain disease and the most common form of dementia.1 continuum, where the degenerative changes made to the brain as a result of Alzheimers disease cause problems with memory and eventually lead to physical disability.153, 154 The AD continuum begins with the phase of preclinical Alzheimers, which manifests no symptoms, and continues until the individual has severe Alzheimers disease, where the patient needs around-the-clock care to complete tasks involved in daily livinga process spanning an average of 48 years.155, 156 An individual with Alzheimers may experience complications such as immobility, malnutrition, and swallowing disordersAn abnormal physical or mental condition.12. Alzheimers may also compromise an individuals immune system response, leading to conditions like pneumonia, which is commonly identified as the immediate cause of death among older Americans withdementiaA usually progressive condition marked by the development of multiple cognitive deficits such as memory impairment, aphasia, and the inability to plan and initiate complex behavior.10.157
Photo by Muskan Anand
Risk Factors Associated With Dementia
In the present study, the risk factors associated with dementia included demographic, socioeconomic, and health factors and lifestyle, including leisure activities and dietary patterns. We found differences in the numbers and types of risk factors associated with dementia between the younger age group and the older age group . The younger group had more risk factors, including demographic, socioeconomic , and health factors and lifestyle, such as intellectual and recreational activities. Meanwhile, living in rural areas and lifestyles such as less fruit intake were the only risk factors in the older group.
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Characteristics Of The Study Sample
Table 1 shows the characteristics of the 2000 and 2012 study cohorts . Compared to the 2000 cohort, the 2012 cohort had a significantly larger proportion of those who were aged 85 or older, but the average age for the full cohort was similar across the two years. The 2012 cohort had significantly more years of education individuals with fewer than 12 years of education comprised 32.6% of the sample in 2000, but only 20.6% in 2012 . On average, individuals in the 2012 cohort had nearly 1 more year of education, compared to those in the 2000 cohort . There was a greater disparity in household net worth in 2012 , with a greater proportion of the 2012 cohort in both the lowest and highest wealth quartiles .
The 2012 cohort had significantly higher rates of self-reported cardiovascular risk factors, including obesity , diabetes , and hypertension . The prevalence of heart disease increased from 29.1% to 31.8% between 2000 and 2012 , but the prevalence of stroke did not change significantly. There was a small decline between 2000 and 2012 in the proportion of individuals with 1 or more IADL limitations, but this change was not significant . The proportion of the sample living in a nursing home at the time of their HRS interview declined from 4.4% in 2000 to 2.8% in 2012 , and the weighted and standardized proportion of the HRS sample represented by a proxy respondent declined from 12.1% in 2000 to 6.6% in 2012 .