As America ages, the number of people diagnosed with dementia is expected to double every year, reaching more than 1 million diagnoses a year by 2060. That translates to about 42% of those over age 55, per a study out this week in the journal Nature Medicine.
Baby boomers — born between 1946 and 1964 — will be a driving force of the growth. In 2020, there were 73 million boomers, per the U.S. Census Bureau, and the youngest of them had just turned 60.
According to CNN, “By 2040, all baby boomers will be at least 75 years old, an age after which dementia diagnoses were found to increase substantially. Only about 17% of cases were diagnosed before age 75, according to the new research, with an average age of 81.”
“If you start at age 55 and go forward until your 95th birthday, there are two options: You die before dementia, or you get to dementia before death,” Josef Coresh, founding director of the Optimal Aging Institute at the New York University Grossman School of Medicine, told The Washington Post. He added that from age 55 to 75, “the risk of developing dementia is only about 4%. That increases substantially over the next two decades, particularly after people’s 85th birthdays.”
Racial differences
Black Americans are expected to be especially hard hit, based on the study’s findings of racial differences in diagnosis. Their numbers may triple by 2060.
Per the study, “Racial disparities in dementia may reflect the cumulative effects of structural racism and inequality throughout the life course. For instance, poor access to education and nutrition may contribute to earlier differences in cognitive reserve, and socioeconomic disparities and limited access to care may lead to a higher burden of vascular risk factors at midlife.”
Dementia is progressive, marked by memory failure, difficulty concentrating and decline in judgment. Besides aging, the researchers, led by a team at NYU Langone Health, in a news release cite genetics and medical issues like high blood pressure and diabetes, as well as poor diets, lack of exercise and mental health challenges.
It is a diagnosis that has been plagued by underestimates linked to unreliable documentation in health records and on death certificates, little surveillance at the early stages of dementia and inadequate reporting of cases involving members of racial minority groups, who are especially at risk, the researchers said.
About the study
Data for the study comes from the ongoing Atherosclerosis Risk in Communities Neurocognitive Study, which has looked at the vascular health and cognition of nearly 16,000 participants over time, starting in 1987. It includes a large cohort of Black participants, a group that’s been underrepresented in research and that is especially vulnerable in terms of cognition and heart health.
The overall 42% risk includes a 35% risk for men and 48% risk for women. Female risk is higher because women live longer on average and have more time to develop disease associated with aging.
Per the release, “The new results also showed a higher risk among Black adults and in those who carried a variant of the APOE4 gene (between 45% and 60%), which codes for a protein that carries cholesterol and other lipids in the bloodstream. Having a certain version of APOE4 is thought to be the single biggest genetic risk factor in developing late-onset Alzheimer’s disease."
The study also found that the lifetime risk of dementia increases to more than 505 among those who live to age 75.
Some good news
But this and other research suggest strongly that steps that help prevent heart disease, like controlling blood pressure and preventing diabetes, lower the risk and can slow cognitive decline.
There are other steps, as well, including making sure that hearing loss is treated, since that’s a risk factor for dementia, but just a third of Americans who have hearing loss use hearing aids. The researchers suggest monitoring hearing and advocate for government help covering the costs for those who cannot afford it. Many insurance companies and even traditional Medicare do not cover the cost of hearing aids, though dementia itself is a very expensive disease.
Exercise and diet play a role in preventing dementing illnesses like Alzheimer’s disease, as does treating sleeping disorders like sleep apnea, experts say. And the more people challenge their brains, the more neural connections they may be able to form to delay the onset of symptoms.