A new report estimates 6.9 million older Americans are living with Alzheimer’s disease in 2024, an increase of about 200,000 cases of the mind-robbing disease from 2023 and “a significant public health crisis,” according to an expert.
Another 5 million to 7 million adults have mild cognitive impairment, a set of early changes to memory and thinking linked to Alzheimer’s, according to an Alzheimer’s Association’s annual facts and figures report released Wednesday.
The report also highlights good news. Other studies indicate that dementia rates have declined over the past 25 years as more adults are achieving higher levels of education, staying active and exercising, reducing their blood pressure, avoiding cigarettes and staying socially engaged.
Adults face a higher risk of Alzheimer’s and other types of dementia as they age, and the number of Americans 65 and older is projected to swell from 58 million in 2022 to 82 million in 2050. In just six years, the youngest baby boomers will be 65.
The nation’s aging population will create profound economic and social challenges. The annual cost of caring for people with Alzheimer’s or other types of dementia will be $360 billion in 2024, up $15 billion from a year ago, the report said.
Medicare and Medicaid will cover the bulk of that, spending $231 billion this year to care for people with Alzheimer’s and dementia. Public and private spending to take care of Alzheimer’s and dementia patients will skyrocket to nearly $1 trillion in 2050, the report projects.
“Our population is aging, so we really need to address these issues,” said Sam Fazio, the Alzheimer Association’s senior director of quality care and psychosocial research. “Alzheimer’s disease remains a significant public health crisis.”
Lifestyle changes reduce risk
Other Alzheimer’s experts not involved with the report said more Americans are taking steps to reduce their risk for Alzheimer’s or dementia.
Research suggests up to 40% of dementia cases can be prevented through lifestyle changes, said Dr. Keith Vossel, a neurologist and director of the Mary S. Easton Center for Alzheimer’s Research and Care at the University of California, Los Angeles.
Vossel said people who exercise regularly, do not smoke and achieve higher levels of education tend to have lower risk. Reducing blood pressure in midlife, in particular, is linked to lower risk, he said.
Paying close attention to elevated blood pressure is especially important, Vossel said. “We know that lowering blood pressure among people with elevated blood pressure in middle life can lower risk of dementia or (mild cognitive impairment) later on.”
Caregivers spend 31 hours a week on Alzheimer’s, dementia patients
Families and other caregivers take on an array of tasks, scheduling appointments and feeding and caring for people with Alzheimer’s or dementia. The report said 11.5 million relatives and caregivers provided more than 18 million hours of unpaid care last year.
That amounted to a full-time job for caregivers who spent an average of nearly 31 hours a week caring for a person with Alzheimer’s or dementia.
In July, the Centers for Medicare & Medicaid Services will launch an initiative to improve the quality of life for people with dementia, allowing them to remain at home and reduce the strain on unpaid caregivers. The model, called Guiding an Improved Dementia Experience, will coordinate care and provide a 24/7 support line. Families also can access care navigators who can connect patients and caregivers to services and support. Doctors and clinics who participate will receive a monthly per-patient fee from Medicare.
Fazio said access to navigators is crucial because the report showed that families live through a great deal of stress and that workers in the field believe the health care system is not equipped to help people living with dementia. President Joe Biden recently expanded a similar navigator plan for cancer patients in which private health insurers will cover such services.
Families “really want help and need help to navigate the system,” Fazio said.
New drugs, old target
Of the eight drugs approved for Alzheimer’s patients, only two attempt to attack the disease and slow memory and cognitive decline. Biogen has discontinued one of those drugs, aducanumab, sold under the brand Aduhelm. The Food and Drug Administration approved the drug despite mixed clinical trial results. Biogen also faced withering criticism when it launched Aduhelm, initially priced at $56,000 a year.
In January 2023, Eisai won FDA approval for its amyloid beta-busting drug, lecanemab. Sold under the brand name Leqembi, the drug is intended for patients in the early stages of the disease, the population studied in clinical trials.
The Alzheimer’s Association report notes that the benefits of lecanemab “in the short term may be imperceptible” because it’s designed to slow the disease, not reverse cognitive decline. The report said the long-term results of the drug are not clear.
Earlier this month, the FDA delayed action for Eli Lilly’s drug donanemab, the drug manufacturer said. The FDA expects to convene an advisory committee to discuss the treatment.
Clinical trials of all three amyloid-removing drugs have side effects visible on brain scans, such as brain swelling and bleeding. Some patients don’t notice symptoms. Others have experienced headaches, dizziness, nausea, confusion and vision changes.
Though drugmakers largely have focused on drugs to target and clear amyloid from the brains of Alzheimer’s patients, the report says, other studies are examining different methods of attacking the disease. Other potential drugs are being studied to limit the accumulation of tau protein, inflammation, altered cell metabolism and damage from toxic oxygen molecules, the report said.
Ken Alltucker is on Twitter at @kalltucker, or can be emailed at alltuck@usatoday.com.
