Alzheimer’s and other forms of dementia are arguably one of the costliest medical conditions facing America. Few families have sufficient assets or long-term care insurance to cover loved ones who need nursing home care at the end of their life. Long-term care costs vary by region, but nursing home care has a median cost of about $100,000 a year. Two-thirds (63%) of nursing home residents are funded by Medicaid, the federal-state partnership.
Six to seven million Americans suffer from dementia. The conventional wisdom is the numbers are expected to about double by the year 2050. There are around two hundred subtypes of dementia, the risk of which increases with old age. Whereas only 3% of older adults 70-74 have dementia, more than one-in-five age 85 to 89 have dementia. One-third of adults 90 and older are afflicted with memory problems. Women and minorities have a higher likelihood than white males.
The average length of stay in nursing homes is one year, but that is not really a valuable statistic. Nursing homes are also used by patients convalescing after surgeries. About 25% of nursing home residents come and go within three months, but one-in-five will remain five years or more. By some estimates, one-third of seniors today will require two years or more of nursing home care. No matter how you look at it, long term care is a major cost in the United States.
There is a hint of good news, however. Yes, you read that correctly. Dementia is declining. The prevalence of dementia is falling, even as the absolute numbers of dementia cases are rising due to population growth. From The New York Times:
“Dementia is a devastating condition, and it’s very much related to the oldest ages,” said Dr. Josef Coresh, director of the Optimal Aging Institute at NYU Langone Health and the senior author of the study. “The globe is getting older.”
Now the findings are being challenged by other dementia researchers who say that while increases are coming, they will be far smaller than Dr. Coresh and his co-authors predicted.
Using data from about 15,000 Americans over age 55, collected at four research clinics around the country from 1987 through 2020, Dr. Coresh’s team projected a lifetime dementia risk much higher than previous studies had: 42 percent, though most of that risk didn’t emerge until after age 85.
Yet, other research has found your odds of getting dementia are lower than your parents or your grandparents. This is good news for me as both my mother and her mother spent their last years in a nursing home, as did two of my father’s sisters.
But Mr. Stallard estimates that the increase will be more like 10 to 25 percent by 2050. “It will still be a significant challenge for the health system in the U.S.,” he said.
The Duke group relied on its own long-term study of people over age 65, with more than 21,000 respondents in 1984 and about 16,000 in 2004, plus later data from the national Health and Retirement Study and the National Health and Aging Trends Study.
Their analysis found that among 85- to 89-year-olds, for instance, the proportion with dementia was about 23 percent in the cohort born in 1905. In those born 10 years later, the figure had dropped to about 18 percent.
By the time Americans born in 1935 reached their late 80s, about 11 percent had dementia; the projection for those born from 1945 to 1949 is now about 8 percent.
What has led to the reduction in dementia? Researchers attribute the change to higher education levels, better control of high blood pressure and high cholesterol and reduced smoking. Also, hearing aids, lower air pollution, among other things.
Disability free years of life have increased over the past century. Being disability free also pertains to being dementia free. The prevalence of dementia has fallen when controlling for age of onset. More people are making it to the age where dementia is common, however. That boosts dementia levels. Yet, the likelihood of developing dementia has fallen over time.
Read more at NYT: Dementia May Not Always Be the Threat It Is Now. Here’s Why.