A new study reveals a concerning increase in projected dementia cases in the United States. The lifetime risk of developing dementia after age 55 is estimated at 42%, with Black adults experiencing a more pronounced rise in cases.
The number of US adults who will develop dementia each year is projected to increase from approximately 514,000 in 2020 to about 1 million in 2060, new research shows. In addition, the lifetime risk of developing dementia after age 55 is estimated at 42%. The research showed that the relative growth in dementia cases is particularly pronounced for Black adults. These new findings researchers say, “highlight the urgent need for policies that enhance healthy aging, with a focus on health equity.
” “The aging of the population means that the increased burden of cognitive decline and dementia, particularly among the oldest age group, is going to be significant, and we need to be prepared for it,” study investigator Josef Coresh, MD, PhD, director of the Optimal Aging Institute at NYU Grossman School of Medicine, New York City, told. He added that dementia may be preventable through such strategies as controlling vascular risk factors, treating sleep disorders, detecting and correcting hearing loss, managing mood disorders, and improving access to social support. Over the past century, the US population has aged substantially, resulting in a rise in late-life diseases. Once an uncommon condition, dementia now affects more than 6 million Americans. The lifetime risk for dementia is a critical public health measure that can be used to raise awareness, enhance patient engagement in prevention, and inform policymaking, the investigators noted. The often-cited Framingham Heart Study estimates that 11%-14% of men and 19%-23% of women will develop dementia during their lifetime. But, as Coresh noted, these estimates were based on a predominantly White, relatively affluent, and well educated cohort, as well as limited means of determining dementia cases. In contrast, this new study is based on a more diverse cohort and used more rigorous methodology, Coresh said. “It’s capturing the latest decade of risk, from age 85 to 95 years,” which is important because people are living longer, he added. The report analyzed data collected from 1987 to 2020 from 15,043 participants in the Atherosclerosis Risk in Communities (ARIC) study. Drawn from four US communities, these individuals were all dementia-free of dementia at age 55. One of the study sites was Jackson, Mississippi, where Black individuals comprise 82% of the population. Black individuals accounted for 26.9% of the total study population, 55.1% of participants were women, and 30.8% carried at least one copy of the apolipoprotein E (Over the past three decades, study participants underwent clinical examinations, including cognitive testing, laboratory testing, and both in-person and telephone interviews. In addition to interviews, the ARIC study uses review of hospital records and death certificates to determine dementia, with cases adjudicated by a committee assisted by a computer algorithm. At age 55, researchers estimated the lifetime risk for dementia (up to age 95) to be 42% (95% CI, 41-43). The cumulative incidence of dementia remained relatively low between 55 and 75 years of age (3.9%) but rose significantly beyond that. The lifetime risk for dementia was higher in women (48%; 95% CI, 46-50) vs men (35%; 95% CI, 33-36) and in Black individuals (44%; 95% CI, 41-46) vs White individuals (41%; 95% CI, 40-43). Additionally, Black individuals experienced an earlier median age of dementia onset (79 years) compared with White individuals (82 years). “By age 75, the risk is 3% in our White participants and 7% in our Black participants, so the racial difference is expressed early, and it stays to age 85 and then sort of closes and becomes smaller by age 95,” said Coresh. The racial disparity in dementia risk may reflect the impact of structural racism and socioeconomic inequality, including limited access to quality education and nutrition, said Coresh. Additionally, it could be influenced by poorer access to healthcare and a higher prevalence of vascular risk factors, such as hypertension and diabetes, he added. “People who were born in the South a long time ago may not have had the same opportunities as people in other areas and of other races and ethnicities.” epsilon 4 allele had a higher lifetime risk for dementia (59%; 95% CI, 53-65) compared with those with one copy (48%; 95% CI, 45-50) and those with no copies (39%; 95% CI, 37-40). Dementia also occurred earlier in epsilon 4 carriers (median age, 79 years in those with two copies, 81 years in those with one copy, and 82 years in those with no copies). Applying the lifetime risk estimates to US Census population projections, the researchers predict the annual number of incident dementia cases will increase from about 514,000 in 2020 to 1 million in 2060. The number of individuals who will develop dementia each year is expected to nearly double among White individuals and triple among their Black counterpart
DEMENTIA RISK POPULATION RACIAL DISPARITY PREVENTION
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