Nearly Half Think They Will Get Dementia

Americans overestimate their chances of developing dementia, according to an AARP survey. Nearly half (48 percent) of adults aged 40 or older say it is somewhat/very/extremely likely that they will get dementia as they get older. In fact, only 14 percent of people aged 71 or older have dementia. 

The widespread sense of impending doom may be due to the fact that most know someone now or in the past who has/had dementia. The 51 percent majority of adults aged 40 or older say they currently have or had in the past a close friend or relative with dementia. Not surprisingly, the percentage who have/had a close friend or relative with dementia rises with age...

Percent of adults aged 40-plus who have/had a close friend or relative with dementia

Aged 40 to 49: 42%

Aged 50 to 59: 50%

Aged 60 to 69: 55%

Aged 70-plus: 58%

Source: AARP, 2021 AARP Survey on the Perceptions Related to a Dementia Diagnosis: Adults Aged 40-Plus

Dementia: the 3rd Leading Cause of Death?

Dementia is a major cause of death. We know that. The government's mortality reports show Alzheimer's disease to be the 6th leading cause of death in the United States. In 2017, Alzheimer's disease killed 121,000 Americans.

But Alzheimer's disease accounts for only a portion of dementia deaths. A much larger 262,000 people died of dementia in 2017, according to a report by the National Center for Health Statistics. If all types of dementias were considered a single cause of death (as they are in some countries), then dementia would be the third leading cause of death in the United States, following heart disease and cancer.

The NCHS report provides a detailed look at dementia deaths by type. Alzheimer's disease is most common, accounting for 46 percent of dementia deaths in 2017. Vascular dementia deaths are another 6 percent, and other types or unspecified dementias account for the rest. Regardless of the type, all dementias have one thing in common—they are debilitating for the individual and devastating for the family. One table in the report reveals the debilitation and devastation: place of death. Most dementia deaths occur in a nursing home, long-term care facility, or hospice. In other words, most patients and families are unable to deal with the consequences of dementia on their own or at home. Among all deaths in the U.S., just 27 percent occur in a nursing home, long-term care facility, or hospice. Among dementia deaths, the figure is 60 percent.

Source: National Center for Health Statistics, Mortality Data, Dementia Mortality in the United States, 2000–2017

Are You Having Trouble Remembering Things?

"During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse?" This question was posed to Americans aged 45 or older in the 2015–16 surveys of the Behavioral Risk Factor Surveillance System.

A substantial 11 percent of people aged 45 or older answered "yes" to the question. They are experiencing what is called "subjective cognitive decline," reports the CDC. Subjective cognitive decline (SCD) can be a symptom of early-stage dementia. Among those who said they were experiencing SCD, the 51 percent majority also reported functional limitations due to their cognitive problems.

Interestingly, the percentage who reported SCD does not vary all that much by age, ranging from 10 percent among 45-to-54-year-olds to 14 percent among people aged 75 or older. By race and Hispanic origin, American Indians are most likely to report SCD (20 percent) and Asians least likely (7 percent). Education has a big impact on the prevalence of SCD, with 18 percent of high school dropouts reporting SCD versus 7 percent of people with a bachelor's degree. By state, the percentage with SCD is highest in Nevada (16.3 percent) and lowest in South Dakota (6.0 percent).

Source: CDC, Subjective Cognitive Decline among Adults Aged ≥ 45 Years—United States, 2015–2016

Dementia Risk for Men and Women

What is the risk of developing dementia among healthy 70-year-olds? A study published in Demography, determined the probability using data from the nationally representative and longitudinal Aging, Demographics, and Memory Study—a subsample of the Health and Retirement Study. Among 70-year-olds born in 1920, men had a 27 percent chance of developing dementia before death. Among their female counterparts, the probability was an even higher 35 percent.

But there's more. The probability of developing dementia is increasing as mortality rates at older ages decline, allowing more time for dementia to develop. In the 1940 birth cohort, men aged 70 had a 31 percent chance of developing dementia before death, and women 37 percent. For this cohort, the average 70-year-old man could expect to live 1.1 years with dementia, and the average woman 2.0 years.

"These estimates imply a larger need for individuals and families to plan for a life stage with dementia," concludes the study.

Source: Demography, Volume 54, Issue 5, Risk of Developing Dementia at Older Ages in the United States

Retirees with Dementia: Who Has Help with Finances?

How many retirees with mild cognitive impairment or dementia have someone to help them with their finances? That's the question posed by a Center for Retirement Research study. The question is critical, the researchers say, because studies show that 18 percent of people with mild cognitive impairment and 80 percent of those with dementia need help with their finances.

Analyzing data from the Health and Retirement Study, the researchers determined first the percentage of retirees aged 70 or older with mild cognitive impairment or dementia, then examined how many had potential helpers. Mild cognitive impairment is more common than dementia, affecting 33 percent of 70-to-74-year-olds and rising with age to 45 percent of people aged 85 or older. Dementia affects 2.7 percent of 70-to-74-year-olds and rises with age to 26.5 percent of those aged 85 or older.

"Fortunately, most individuals do have some help," the researchers find. Among those with mild cognitive impairment, 85 percent have available assistance. Among those with dementia, the figure is an even higher 95 percent. The types of helpers range from a non-impaired spouse or caregiving child to nursing home care. Those least likely to have help are what the researchers call "isolated"—defined as not having a non-impaired spouse and not having children within 10 miles. Others who are less likely to have help are high school dropouts and non-whites.

Source: Center for Retirement Research, Are Many Retirees with Dementia Lacking Help?

How Many Have Dementia?

Half of nursing home residents have Alzheimer's or dementia, according to a government report on long-term care. But most people with dementia live in their community. Overall, 10 percent of Medicare beneficiaries aged 65 or older who are not living in a nursing home have dementia. Here are the percentages by age...

Percent with dementia*
Aged 65 to 69: 3.6%
Aged 70 to 74: 4.8%
Aged 75 to 79: 9.9%
Aged 80 to 84: 15.3%
Aged 85 to 89: 24.0%
Aged 90-plus: 36.2%

* Among non-nursing home population
Source: Federal Interagency Forum on Aging-Related Statistics, Older Americans 2016: Key Indicators of Well-Being