Impact of dementia: Health disparities, population trends, care interventions, and economic costs

Abstract

Introduction The dementia experience is not a monolithic phenomenon—and while core elements of dementia are considered universal—people living with dementia experience the disorder differently. Understanding the patterning of Alzheimer's disease and related dementias (ADRD) in the population with regards to incidence, risk factors, impacts on dementia care, and economic costs associated with ADRD can provide clues to target risk and protective factors for all populations as well as addressing health disparities. Methods We discuss information presented at the 2020 National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers, Theme 1: Impact of Dementia. In this article, we describe select population trends, care interventions, and economic impacts, health disparities and implications for future research from the perspective of our diverse panel comprised of academic stakeholders, and persons living with dementia, and care partners. Results Dementia incidence is decreasing yet the advances in population health are uneven. Studies examining the educational, geographic and race/ethnic distribution of ADRD have identified clear disparities. Disparities in health and healthcare may be amplified by significant gaps in the evidence base for pharmacological and non‐pharmacological interventions. The economic costs for persons living with dementia and the value of family care partners' time are high, and may persist into future generations. Conclusions Significant research gaps remain. Ensuring that ADRD healthcare services and long‐term care services and supports are accessible, affordable, and effective for all segments of our population is essential for health equity. Policy‐level interventions are in short supply to redress broad unmet needs and systemic sources of disparities. Whole of society challenges demand research producing whole of society solutions. The urgency, complexity, and scale merit a “whole of government” approach involving collaboration across numerous federal agencies.

Association between ultra-processed food consumption and cognitive performance in US older adults: a cross-sectional analysis of the NHANES 2011–2014

“…The number of people living with dementia is rising as life expectancy increases worldwide. Given the enormous burden that dementia causes to individuals, families, communities, systems of care, and society at large [ 1 ], identification of modifiable risk factors for dementia enables public health measures to prevent or delay the cases of dementia. It has been estimated that 40% of dementia cases could be prevented by controlling 12 modifiable risk factors, which include diet along with physical activity, education, smoking, exposure to air pollution, low social contact, traumatic brain injury, and management of chronic conditions such as diabetes, obesity, depression, hearing impairment, and cardiovascular diseases [ 2 ].…”

Trajectories of cognitive functioning in later life: Disparities by race/ethnicity, educational attainment, sex, and multimorbidity combinations

“…Alzheimer's disease and related dementias (ADRD) affects more than 6 million older adults, and represents extensive costs to individuals, their families, and public programs ( Alzheimer's Association., 2020 ; Hurd et al, 2013 ; Aranda et al, 2021 ). ADRD disproportionately affects minoritized racial and ethnic populations in the United States ( Aranda et al, 2021 ; Jutkowitz et al, 2017 ).…”

“…Alzheimer's disease and related dementias (ADRD) affects more than 6 million older adults, and represents extensive costs to individuals, their families, and public programs ( Alzheimer's Association., 2020 ; Hurd et al, 2013 ; Aranda et al, 2021 ). ADRD disproportionately affects minoritized racial and ethnic populations in the United States ( Aranda et al, 2021 ; Jutkowitz et al, 2017 ). Older Black Americans experience roughly double the incidence, and Latino Americans have 1.5 times the incidence of ADRD observed among older White Americans ( Alzheimer's Association., 2020 ).…”

The positive aspects of caregiving in dementia: A scoping review and bibliometric analysis

“…An estimated 50 million people worldwide are currently living with dementia, and the prevalence of dementia is expected to double in the next 30 years (1). Dementia with progressively cognitive deficits and a variety of neuropsychiatric symptoms leads to disability and care dependence, which emerges as huge demands (e.g., costs and human resources) of long-term care, especially, COVID-19 exacerbates the home-care challenges (2)(3)(4). A majority of people with dementia reside at home and/or with the community and family members play a vital role in dementia care services (5).…”