The Alzheimer's Association has released its annual report, Alzheimer's Disease Facts and Figures, which as usual contains some daunting figures, especially as Baby Boomers age and we hear the latest news story of an unsuccessful drug trial. Here are some of the results:
- 5.8 million Americans have been diagnosed with Alzheimer's disease, which is projected to increase to 14 million by 2050.
- The annual cost of the illness is $290 billion, which is projected to rise to $1 trillion by 2050 (in current dollars). Medicare and Medicaid currently pay $195 billion of this cost.
- More than 16 million Americans provide unpaid care to family members with Alzheimer's or other forms of dementia providing an estimated 18.5 billion hours of care valued at $234 billion.
- Two thirds of Americans with Alzheimer's are women and African Americans get Alzheimer's at twice the rate of white Americans.
- Men have a 10 percent and women a 20 percent lifetime risk of incurring Alzheimer's disease.
Here are some of the figures for Massachusetts:
- 130,000 residents have been diagnosed with Alzheimer's.
- 340,000 people provide care to them, of which 387 million hours are unpaid, totaling $5 billion in value.
- MassHealth costs for Massachusetts residents with dementia are projected to be $1.7 billion this year and to increase by more than 18 percent by 2025.
Flat Numbers, Then a Spike
We've actually been in something of a lull in the growth of the dementia population over the last decade or so, since people in their 80s today were born during the Depression when families were not being formed or were having fewer children. This continued through World War II. Someone born in 1942 would turn 77 this year.
Of course, there was a huge change in fertility after World War II with the Baby Boom beginning in 1946. People born that year will turn 73 this year. In ten years, they will be 83 an age at which the prevalence of Alzheimer's and other forms of dementia increases rapidly.
What Can We Do to Plan?
So, what can we do to prepare both individually and collectively?
Unfortunately, so far there's no cure for Alzheimer's. There is some evidence that aerobic exercise and cognitive stimulation have benefits both for patients with Alzheimer's and people who may get the illness in the future—in other words, everyone. There's much stronger evidence that controlling heart disease through exercise and diet can prevent or delay strokes, both large and small, that can lead to dementia.
Fortunately, we have learned a lot over past decades about how to improve the lives of people with Alzheimer's and to relieve the burden on their caregivers. Nursing homes have been replaced by memory units in assisted living facilities. MassHealth has begun to cover care in assisted living facilities and at home, though the programs and eligibility rules are extremely complicated.
Planning ahead to pay for care you may want in the future can be very important, whether through savings, long-term care insurance, MassHealth planning, or a combination of resources. Equally important is deciding with family members what care you would like and coordinating that care so your needs do not fall unduly on just one or two people. This can be hard to do in advance, because it's all very abstract and everyone's situation changes over time. But once a diagnosis has been made, there's usually still time to plan and the plans can be made based on more knowledge of everyone's situation at that time. Care managers, financial planners, and elder law attorneys can assist in this planning process.