The Impact of Changes in Population Health and Mortality on Future Prevalence of Alzheimer's Disease and Other Dementias in the United States

Abstract

Objectives: We assessed potential benefits for older Americans of reducing risk factors associated with dementia.

Methods: A dynamic simulation model tracked a national cohort of persons 51 and 52 years of age to project dementia onset and mortality in risk reduction scenarios for diabetes, hypertension, and dementia.

Results: We found reducing incidence of diabetes by 50% did not reduce number of years a person ages 51 or 52 lived with dementia and increased the population ages 65 and older in 2040 with dementia by about 115,000. Eliminating hypertension at middle and older ages increased life expectancy conditional on survival to age 65 by almost 1 year, however, it increased years living with dementia. Innovation in treatments that delay onset of dementia by 2 years increased longevity, reduced years with dementia, and decreased the population ages 65 and older in 2040 with dementia by 2.2 million.

Conclusions: Prevention of chronic disease may generate health and longevity benefits but does not reduce burden of dementia. A focus on treatments that provide even short delays in onset of dementia can have immediate impacts on longevity and quality of life and reduce the number of Americans with dementia over the next decades.

Figure 1.

Prevalence of dementia by age for two definitions of dementia. Note: Health and Retirement Study Waves 2000 to 2012. Dementia definition based on single wave cognitive status, dementia (persistent) based on at least two waves of dementia or low cognitive score.

Figure 2.

Difference in number of Americans ages 85 and 86 with dementia: number under scenario less number under status quo.