Health officials predict 'tsunami' of new dementia cases

Nov. 24--The number of Americans living with dementia will double to nearly 13 million over the next 20 years, according to a recently released report from the Milken Institute.

The "Reducing the Cost and Risk of Dementia: Recommendations to Improve Brain Health and Decrease Disparities" report estimates the number of Americans suffering dementia will double by 2040.

Women are expected to bear a disproportionate burden in that increase, increasing to 8.5 million, compared to 4.5 million men.

Economic costs associated with dementia are predicted in the report to exceed $2 trillion over the next 20 years, with women shouldering more than 80% of the cumulative costs.

"Longer lifespans are perhaps one of the greatest success stories of our modern public health system," said Nora Super, lead author of the report and senior director of the Milken Institute Center for the Future of Aging. "But along with this success comes one of our greatest challenges. Our risk of developing dementia doubles every five years after we turn 65; by age 85, nearly one in three of us will have the disease."

Nicolette Casula, community outreach coordinator for Alzheimer's Association Oklahoma Chapter, said the health care system in Oklahoma is "in no way ready" for that kind of increase in the number of dementia patients.

"That is across the board, in Oklahoma and nationwide," Casula said. "We all need to prepare. It's not just health care systems. This is something that affects all of us. More people are diagnosed every day."

Alzheimer's Association works to educate the public and health care providers about dementia and its care -- there currently is no cure. Casula said that effort remains hindered by public stigma surrounding the disease.

"There is a general shortage of understanding," Casula said, "and there is a bit of stigma surrounding even having that conversation."

About 100 people turn 65 in Oklahoma each day, according to Alzheimer's Association figures.

Erin Powell, family outreach coordinator with Alzheimer's Association Oklahoma, said many of those Oklahomans and their families remain uneducated about and unprepared for dementia, in part because overtaxed health care systems don't provide one-on-one counseling about the disease.

"Even when there's a diagnosis, physicians just don't have the time to sit with them and describe the next steps and what's going to happen," Powell said. "Unfortunately, a lot of times they end up doling out what is currently a death sentence, and don't have time to connect the families with help."

Powell said the Alzheimer's Association works to fill that gap, and connect families with support and services.

Those services will continue to be stretched thin, Powell said, as more "Baby Boomers" age into the high-risk age for dementia.

Powell agreed with the Milken report numbers, and said long-term care availability, health care costs and physical burdens on caregivers will become increasingly problematic in the foreseeable future.

"We have a compounding problem here, because dementia affects so many people, and because of how much care they need," Powell said.

The greatest need, she said, is to provide better education and support to unpaid caregivers -- usually family members of the person diagnosed with dementia.

Mark Fried, president and CEO Alzheimer's Association Oklahoma Chapter, said resources in the state may be overwhelmed by 2025, as the number of Oklahomans with Alzheimer's and other dementias increases from 65,000, currently, to a predicted 74,000 in five years.

"We know things are tight and stressed right now, with the number we have at this time," Fried said. "As more of the Baby Boomers get older, with age being the number one risk, we understand the tsunami we're facing, and that's going to pick up speed in the next couple of decades."

Fried said health care officials and legislators are aware of that impending "tsunami." But, he said, "it's escalating so quickly ... it does make it difficult to come up with something that's going to be 100% effective."

The Legislature formed a task force 10 years ago to focus on Alzheimer's disease in the state, and Fried said legislators are doing a good job of working toward enacting that group's 23 recommendations, which focus on caregiver education, public awareness, and improving care standards for health care providers and adult protective services.

Another work group was formed in about 2015, Fried said, and that group is continuing "study and conversation."

"There's been some encouraging movement on those recommendations in the new levels of dementia-specific training for people in dementia care," Fried said. He pointed specifically to Senate Bill 435, passed in the last session, which increases training standards for adult protective services workers.

"The state Legislature has been proactive the last couple of sessions to address these issues and make sure aging issues are on the forefront," Fried said.

Dealing with the increase in the number of dementia patients will be a complex issue, Fried said, involving health care costs, long term care availability and funding, and an increasingly aging population. But, ultimately, Fried said, addressing all of those issues needs to start with both physicians and the general public spending more time on dementia education.

"If dementia education becomes a priority within the health care systems across the state, you're talking about a better quality of care for people with dementia, wherever they happen to be," Fried said.

Nora Super, lead author of the Milken report, also advised the general public to take some basic steps toward reducing their dementia risk.

"Emerging evidence shows that despite family history and personal genetics, lifestyle changes such as diet, exercise and better sleep can improve health at all ages," Super said.

To view the full Milken report, visit https://milkeninstitute.org. For more information on Alzheimer's and dementia, visit https://www.alz.org, or call their 24-hour help line at (800) 272-3900.

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