March 27, 2019 - According to the Alzheimer’s Association 2019 Alzheimer’s Disease Facts and Figures report, despite a strong belief among seniors and primary care physicians that brief cognitive assessments are important, only half of seniors are being assessed for thinking and memory issues, and much fewer receive routine assessments. These findings were the focus of the Alzheimer’s Association’s Facts and Figures, an annual report on the disease’s prevalence, incidence, cost of care, and its impact on caregivers. (Full report: alz.org/facts.)
A brief cognitive assessment is a short evaluation for cognitive impairment performed by a health care provider that can take several forms — including asking a patient about cognitive concerns or using short verbal or written tests that can be administered easily in the clinical setting. An evaluation of cognitive function is a required component of the Medicare Annual Wellness Visit, but findings from the report show that only 1 in 3 seniors are aware these visits should include this assessment.
The report also found, however, that among both seniors and primary care physicians there is widespread understanding of the benefits of early detection of cognitive decline and the importance of brief cognitive assessments. In fact, 82 percent of seniors believe it is important to have their thinking and memory checked, and nearly all primary care physicians (94 percent) consider it important to assess all patients age 65 and older for cognitive impairment.
"Early detection of cognitive impairment is so important, offering numerous medical, social and emotional benefits to individuals and their families,” says Cheryl Kanetsky, LSW, MBA, executive director of the Alzheimer’s Association Greater East Ohio Area Chapter. “If you're going in for your Medicare Annual Wellness Visit, initiate that conversation with your doctor. Ask for a brief cognitive assessment."
The report found that just 1 in 7 seniors (16 percent) say they receive regular cognitive assessments for memory or thinking issues during routine health checkups, compared with blood pressure (91 percent), cholesterol (83 percent), vaccinations (80 percent), hearing or vision (73 percent), diabetes (66 percent) and cancer (61 percent).
The Facts and Figures report also reveals a troubling disconnect between seniors and primary care physicians regarding who they believe is responsible for initiating these assessments and reticence from seniors in discussing their concerns.
The survey found that while half of all seniors (51 percent) are aware of changes in their cognitive abilities — including changes in their ability to think, understand or remember — only 4 in 10 (40 percent) have ever discussed these concerns with a health care provider, and fewer than 1 in 7 seniors (15 percent) report having ever brought up cognitive concerns on their own.
"Seniors expect their physician to recommend cognitive assessment, but that's not happening - physicians wait for patients to bring it up, so it's not being discussed. Initiate that conversation with your physician and take control of your own health," adds Kanetsky. "It’s normal to feel nervous about undergoing a cognitive assessment, our local family service coordinators can provide you with a checklist to prepare for your visit with questions to ask your doctor."
The Alzheimer’s Association Greater East Ohio Area Chapter provides free care and support to those living with Alzheimer’s and their families and caregivers. The Alzheimer’s Association 24/7 Helpline (800.272.3900) or website (alz.org/eastohio) is often an entry point for families seeking caregiver support groups, and education programs on reducing caregiver stress and being a better caregiver. The chapter also provides early stage social engagement opportunities, ongoing local support for caregivers with the Side by Side: Successfully Managing Dementia Care program.
Updated Alzheimer’s Statistics
The Alzheimer’s Association Facts and Figures report also provides a look at the latest national and local statistics and information on Alzheimer’s prevalence, incidence, mortality and morbidity, costs of care and caregiving.
Prevalence, Incidence and Mortality
- An estimated 5.8 million Americans of all ages are living with Alzheimer’s dementia in 2019, including 200,000 under the age of 65.
- Of the estimated 5.8 million Americans living with Alzheimer’s dementia in 2019, 220,000 are Ohio residents.
- By 2025 — just six years from now — the number of people age 65 and older with Alzheimer’s dementia is estimated to reach 7.1 million — an increase of 27 percent from the 5.6 million age 65 and older affected in 2019. Here in Ohio, the estimated number of individuals with Alzheimer’s will be 250,000.
- Barring the development of medical breakthroughs, the number of people age 65 and older with Alzheimer’s dementia may nearly triple from 5.6 million to 13.8 million by 2050.
- Two-thirds of Americans over age 65 with Alzheimer’s dementia (3.5 million) are women.
- Alzheimer’s is the sixth-leading cause of death in the U.S., and it is the fifth-leading cause of death for those age 65 and older. In Ohio, 5,117 died from Alzheimer’s in 2017, the most recent figure available.
Cost of Care
- Total national cost of caring for those with Alzheimer’s and other dementias is estimated at $290 billion (not including unpaid caregiving) in 2019, of which $195 billion is the cost to Medicare and Medicaid; out-of-pocket costs represent $63 billion of the total payments, while other costs total $32 billion.
- In Ohio, the report estimated total Medicaid costs for Americans with dementia age 65 and older is $2.45 billion for 2019. In the next six years, that figure is expected to increase 18.5 percent.
- Total payments for health care, long-term care and hospice care for people with Alzheimer’s and other dementias are projected to increase to more than $1.1 trillion in 2050 (in 2019 dollars).
- In 2018, the lifetime cost of care was greater for those with dementia than those without ($350,174 versus $192,575, respectively).
Caregiving
- More than 16 million Americans provide unpaid care for people with Alzheimer’s or other dementias.
- In Ohio, there are 603,000 caregivers. In 2018, these caregivers provided 687 million total hours of unpaid care, valued at $8.68 billion.
- Approximately two-thirds of caregivers are women, and one-third of dementia caregivers are daughters.
- Forty-one percent of caregivers have a household income of $50,000 or less.
- It is estimated that the U.S. has approximately half the number of certified geriatricians than it currently needs, and only 9 percent of nurse practitioners report having special expertise in gerontological care.
Alzheimer's Association
The Alzheimer's Association leads the way to end Alzheimer's and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia.™ For more information, visit www.alz.org or call the 24/7 Helpline at 800.272.3900.