Post on 21-Apr-2015
INCLUDES A SPECIAL REPORT ON
EARLY DETECTION AND DIAGNOSIS
2011 Alzheimer’s Disease Facts and Figures2012
ALZHEIMER’S DISEASE FACTS AND FIGURES
Includes a Special Report on People with Alzheimer’s Disease and Other Dementias Who Live Alone
ONE IN EIGHT OLDER AMERICANS HAS ALZHEIMER’S DISEASE. ALZHEIMER’S DISEASE IS THE SIXTH-LEADING CAUSE OF DEATH IN THE UNITED STATES. OVER 15 MILLION AMERICANS PROVIDE UNPAID CARE FOR A PERSON WITH ALZHEIMER’S OR OTHER DEMENTIAS. PAYMENTS FOR CARE ARE ESTIMATED TO BE $200 BILLION IN 2012.
Alzheimer’s Association, 2012 Alzheimer’s Disease Facts and Figures, Alzheimer’s & Dementia, Volume 8, Issue 2
2012 Alzheimer’s Disease Facts and Figures provides a statistical resource for U.S. data related to Alzheimer’s disease, the most common type of dementia, as well as other dementias. Background and context for interpretation of the data are contained in the Overview. This information includes definitions of the types of dementia and a summary of current knowledge about Alzheimer’s disease. Additional sections address prevalence, mortality, caregiving and use and costs of care and services. The Special Report focuses on the challenges of people with Alzheimer’s disease and other dementias who live alone.
ABOUT THIS REPORT
1 2012 Alzheimer’s Disease Facts and Figures
Specific information in this year’s Alzheimer’s Disease Facts and Figures includes:
2 Contents 2012 Alzheimer’s Disease Facts and Figures
Overview of Alzheimer’s Disease
Alzheimer’s Disease 7
Prevalence
Mortality
Caregiving
Contents
2012 Alzheimer’s Disease Facts and Figures Contents
Use and Costs of Health Care, Long-Term Care and Hospice
Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone
Appendices
ALZHEIMER’S DISEASE IS THE MOST COMMON TYPE OF DEMENTIA.
OVERVIEW OF ALZHEIMER’S DISEASE
“Dementia” is an umbrella term describing a variety of diseases and conditions that develop when nerve cells in the brain die or no longer function normally. The death or malfunction of these nerve cells, called neurons, causes changes in one’s memory, behavior and ability to think clearly. In Alzheimer’s disease, these brain changes eventually impair an individual’s ability to carry out such basic bodily functions as walking and swallowing. Alzheimer’s disease is ultimately fatal.
Dementia: Definition and Specific Types
Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition (DSM-IV).(1) To meet DSM-IV
and in at
2012 Alzheimer’s Disease Facts and Figures Overview of Alzheimer’s Disease
1: Common Types of Dementia and Their Typical Characteristics
Type of Dementia Characteristics
Alzheimer’s disease
Vascular dementia
1 (continued): Common Types of Dementia and Their Typical Characteristics
Type of Dementia Characteristics
Overview of Alzheimer’s Disease 2012 Alzheimer’s Disease Facts and Figures
Dementia with Lewy bodies (DLB)
Mixed dementia Parkinson’s disease
Frontotemporal lobar degeneration (FTLD)
Creutzfeldt-Jakob disease
Normal pressure hydrocephalus
7
Alzheimer’s Disease
Symptoms of Alzheimer’s Disease
Diagnosis of Alzheimer’s Disease
2012 Alzheimer’s Disease Facts and Figures Overview of Alzheimer’s Disease
8
It is important to note that these are
recommended criteria and guidelines.
More research is needed, especially
biomarker research, before the new
criteria and guidelines can be used in
clinical settings, such as in a doctor’s
office.
Differences Between the Original and New Criteria
The Three Stages of Alzheimer’s Disease Proposed by the New Criteria and Guidelines for the Diagnosis of Alzheimer’s Disease
due to Alzheimer’s disease and dementia
criteria, dementia due to Alzheimer’s
Preclinical Alzheimer’s disease
A MODERN DIAGNOSIS OF ALZHEIMER’S DISEASE: PROPOSED NEW CRITERIA AND GUIDELINES
In 2011, the National Institute on Aging (NIA) and the Alzheimer’s Association recommended new diagnostic criteria and guidelines for Alzheimer’s disease.(7-10)
Overview of Alzheimer’s Disease 2012 Alzheimer’s Disease Facts and Figures
diagnostic criteria that doctors can use
MCI due to Alzheimer’s disease
them enough concern to contact their
Further
Dementia due to Alzheimer’s
disease
Biomarker Tests
2012 Alzheimer’s Disease Facts and Figures Overview of Alzheimer’s Disease
10
Causes of Alzheimer’s Disease
continuum, neuronal damage and death is so
outside
inside
memories, thoughts, sensations, emotions,
Risk Factors for Alzheimer’s Disease
Overview of Alzheimer’s Disease 2012 Alzheimer’s Disease Facts and Figures
2012 Alzheimer’s Disease Facts and Figures Overview of Alzheimer’s Disease 11
Family History
(20)
Apolipoprotein E-!4 (APOE-!4) !
!!2, ! !
!
!2 or !
!
Mild Cognitive Impairment (MCI)
suggest that in some
Cardiovascular Disease Risk Factors
modifiable
Social Engagement and Diet
12
Head Trauma and Traumatic Brain Injury (TBI)
!
!
Additional research is
Treatment of Alzheimer’s Disease
Overview of Alzheimer’s Disease 2012 Alzheimer’s Disease Facts and Figures
PREVALENCE
One in eight older Americans has Alzheimer’s disease.
MILLIONS OF AMERICANS HAVE ALZHEIMER’S DISEASE AND OTHER DEMENTIAS.
Prevalence of Alzheimer’s Disease and Other Dementias
and 200,000
A2
Prevalence of Alzheimer’s Disease and Other Dementias in Women and Men
Prevalence 2012 Alzheimer’s Disease Facts and Figures
Alzheimer’s disease or any dementia
are not
Prevalence of Alzheimer’s Disease and Other Dementias by Years of Education
Prevalence of Alzheimer’s Disease and Other Dementias in Older Whites, African-Americans and Hispanics
(70)
(71) Instead, health conditions such as
socioeconomic characteristics in these communities
Although rates
2012 Alzheimer’s Disease Facts and Figures Prevalence
Prevalence 2012 Alzheimer’s Disease Facts and Figures
Incidence and Lifetime Risk of Alzheimer’s Disease
existing
new
(77)
A7
A7
(78), A8
1: Proportion of People Age 65 and Older with Alzheimer’s Disease and Other Dementias, by Race/Ethnicity, Washington Heights-Inwood Columbia Aging Project, 2006
70
20
10
0
9.12.9 7.5
10.9
19.9
27.930.2
58.662.9
17 2012 Alzheimer’s Disease Facts and Figures Prevalence
Estimates of the Number of People with Alzheimer’s Disease, by State
A10 The
(78)
20
10
0
2: Framingham Estimated Lifetime Risks for Alzheimer’s by Age and Sex
9.1%9.1%
17.2%17.2%
10.2%
18.5%
12.1%
20.3%
18 Prevalence 2012 Alzheimer’s Disease Facts and Figures
Looking to the Future
(80)
AK
AL
ARAZ
CA CO
CT
DC
DE
FL
GAHI
IA
ID
IL IN
KSKY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
(81)
A11
3: Projected Changes Between 2000 and 2025 in Alzheimer’s Prevalence by State
2012 Alzheimer’s Disease Facts and Figures Prevalence
(80) This
(80)
(80)
18
12
10
8
2
0
(in millions)
4: Projected Numbers of People Age 65 and Over in the U.S. Population with Alzheimer’s Disease Using the U.S. Census Bureau Estimates of Population Growth*
4.5
5.7
13.2
5.1
7.7
11.0
20 Prevalence 2012 Alzheimer’s Disease Facts and Figures
Percentage Change in Alzheimer’s (Compared with 2000)
Projected Total Numbers (in 1,000s)
with Alzheimer’s
2: Projections by State for Total Numbers of Americans Age 65 and Older with Alzheimer’s
State 2000 2010 2025 2010 2025
21
Percentage Change in Alzheimer’s (Compared with 2000)
Projected Total Numbers (in 1,000s)
with Alzheimer’s
2 (continued)
State 2000 2010 2025 2010 2025
2012 Alzheimer’s Disease Facts and Figures Prevalence
MORTALITY
ALZHEIMER’S DISEASE IS THE SIXTH-LEADING CAUSE OF DEATH IN THE UNITED STATES.
Alzheimer’s disease is the fifth-leading cause of death for those age 65 and older.(82)
5 6
2012 Alzheimer’s Disease Facts and Figures Mortality
(82)
Thus,
Deaths from Alzheimer’s Disease
(82, 87)
with dementia
and death from
(87) (82)
70
20
10
0
Cause
5: Percentage Changes in Selected Causes of Death (All Ages) Between 2000 and 2008
disease cancer cancer disease
-3%
-20%
-8%-13%
-29%
+ 66%
Mortality 2012 Alzheimer’s Disease Facts and Figures
(82)
State Number of Deaths Rate
3: Number of Deaths and Annual Mortality Rate (per 100,000) Due to Alzheimer’s Disease, by State, 2008
State Number of Deaths Rate
U.S. Total 82,435 27.1
2012 Alzheimer’s Disease Facts and Figures Mortality
(82)
State-by-State Deaths from Alzheimer’s Disease
(82) The
Death Rates by Age
(82) This large
Duration of Illness from Diagnosis to Death
4: U.S. Alzheimer’s Death Rates (per 100,000) by Age, 2000, 2002, 2004, 2006 and 2008
Age 2000 2002 2004 2006 2008
Rate* 17.6 20.4 22.5 24.2 27.1
CAREGIVING
OVER 15 MILLION AMERICANS PROVIDE UNPAID CARE FOR A PERSON WITH ALZHEIMER’S OR OTHER DEMENTIAS.
Eighty percent of care provided at home is delivered by family caregivers.
80%
27
Unpaid Caregivers
A12
Who are the Caregivers?
(100) The
Alzheimer’s disease or other dementias and other (101)
(102)
2012 Alzheimer’s Disease Facts and Figures Caregiving
Under 35: 10%
35–44: 11%
45–54: 23%
55–64: 33%
65–84: 21%
85 and older: 2%
6: Ages of Alzheimer’s and Other Dementia Caregivers, 2010
28
They
(102)
(102) and
(102)
Care Provided by Ethnic Communities
(102)
(101) and
(102)
Caregiving Tasks
Caregiving 2012 Alzheimer’s Disease Facts and Figures
the disease:
2012 Alzheimer’s Disease Facts and Figures Caregiving
7: Proportion of Caregivers of People with Alzheimer’s and Other Dementias vs. Caregivers of Other Older People Who Provide Help with Specific Activities of Daily Living, United States, 2009
20
10
0
(102)
54%
42%40%
31% 32%
26%
31%
23%
31%
16%
31%
14%
(102)
(102)
Caregiving 2012 Alzheimer’s Disease Facts and Figures
20
10
0
32%
28%
43%
33%
23%
34%
4%2%
8: Proportion of Alzheimer’s and Dementia Caregivers vs. Caregivers of Other Older People by Duration of Caregiving, United States, 2009
(102)
Duration –
Duration of Caregiving
(102)
Hours of Unpaid Care and Economic Value of Caregiving
the estimated
2012 Alzheimer’s Disease Facts and Figures Caregiving
9: Proportion of Alzheimer’s and Dementia Caregivers Who Report High or Very High Emotional and Physical Stress Due to Caregiving
80
20
0
61%
39%43%
57%
Impact of Caregiving
(110)
Caregiver Emotional Well-Being
(101)
Caregiving 2012 Alzheimer’s Disease Facts and Figures
Had to go in
100
80
20
0
65%
10: Effect of Caregiving on Work: Caregiver Work-Related Changes
20%13% 11% 11% 10% 8%9% 9%
Had to turn
Chose early retirement
dismissal
(102)
Caregiver Physical Health
General Health and Risk for Chronic Disease
Dementia
greatest (101)
(117)
(118)
Physiological Changes
reduced immune (122) and increased
coronary heart disease
2012 Alzheimer’s Disease Facts and Figures Caregiving
Health Care Utilization
Mortality
(127)
Caregiver Employment
Interventions that May Improve Caregiver Outcomes
These
and delaying
Paid Caregivers
Caregiving 2012 Alzheimer’s Disease Facts and Figures
2012 Alzheimer’s Disease Facts and Figures Caregiving
5: Types and Focus of Caregiver Interventions
Type of Intervention Description
Psychoeducational
Supportive
Psychotherapy
Multicomponent
Caregiving 2012 Alzheimer’s Disease Facts and Figures
Number of Alzheimer’s/ Hours of Value of Higher Health Care State Dementia Caregivers Unpaid Care Unpaid Care Costs of CaregiversA16
6: Number of Alzheimer’s and Dementia Caregivers, Hours of Unpaid Care, Economic Value of the Care and Higher Health Care Costs of Caregivers, by State, 2011*
2012 Alzheimer’s Disease Facts and Figures Caregiving
6 (continued)
Number of Alzheimer’s/ Hours of Value of Higher Health Care State Dementia Caregivers Unpaid Care Unpaid Care Costs of CaregiversA16
U.S. Totals 15,248,740 17,365,265,478 $210,467,017,597 $8,652,903,101
USE AND COSTS OF HEALTH CARE, LONG-TERM CARE AND HOSPICE
PAYMENTS FOR CARE FOR 2012 ARE ESTIMATED TO BE $200 BILLION.
As the number of people with Alzheimer’s disease and other dementias grows, aggregate payments for their care will increase dramatically.
A17
2011 dollars,A18
Total Payments for Health Care, Long-Term Care and Hospice
Disease and Overall Community-Dwelling Residential Facility Other Dementias
Beneficiaries with Alzheimer’s Disease Beneficiaries and Other Dementias by Place of Residence without Alzheimer’s
Total* $43,847 $25,804 $69,066 $13,879
7: Average Annual Per-Person Payments for Health Care and Long-Term Care Services, Medicare Beneficiaries Age 65 and Older, with and without Alzheimer’s Disease and Other Dementias and By Place of Residence, 2008 Medicare Current Beneficiary Survey, 2011 Dollars
2012 Alzheimer’s Disease Facts and Figures Use and Costs of Health Care, Long-Term Care and Hospice
Payment Source
A17
Use and Costs of Health Care Services
Use and Costs of Health Care, Long-Term Care and Hospice 2012 Alzheimer’s Disease Facts and Figures
Total cost: $200 Billion (B)
A17
Medicare $104.5 B, 52%
Medicaid $35.5 B, 18%
Out-of-pocket $33.8 B, 17%
Other $26.2 B, 13%
11: Aggregate Costs of Care by Payer for Americans Age 65 and Older with Alzheimer‘s Disease and Other Dementias, 2012*
9%
6% 5%
20
10
0
trauma disease disease status change
26%
17%
12: Reasons for Hospitalization of People with Alzheimer’s Disease: Percentage of Hospitalized People by Admitting Diagnosis*
also
Use of Health Care Services
Hospital.
The most
Skilled nursing facility.
Home health care.
disease and other dementias had at least one home
2012 Alzheimer’s Disease Facts and Figures Use and Costs of Health Care, Long-Term Care and Hospice
Costs of Health Care Services
8: Average Annual Per-Person Payments, from All Sources, for Health Care Services Provided to Medicare Beneficiaries Age 65 and Older with and without Alzheimer’s Disease and Other Dementias, 2008 Medicare Current Beneficiary Survey, 2011 Dollars Beneficiaries with Beneficiaries without Alzheimer’s Alzheimer’s Disease and Disease and Other Dementias Other Dementias
Use and Costs of Health Care, Long-Term Care and Hospice 2012 Alzheimer’s Disease Facts and Figures
9: Specific Coexisting Medical Conditions Among Medicare Beneficiaries Age 65 and Older with Alzheimer’s Disease and Other Dementias, 2009
Percentage of People with Alzheimer’s Disease and Other Dementias Who Also Had Coexisting Condition Coexisting Medical Condition
13: Hospital Stays per 1,000 Beneficiaries Age 65 and Older with Specified Coexisting Medical Conditions, with and without Alzheimer’s Disease and Other Dementias, 2009
Condition
1,042
801
1,002948
998
753
897
592
876
656
835
474
776
477
1,200
1,000
800
200
0
Impact of Coexisting Medical Conditions on Use and Costs of Health Care Services
Alzheimer’s and other dementias also had coronary
2012 Alzheimer’s Disease Facts and Figures Use and Costs of Health Care, Long-Term Care and Hospice
Average per-Person Medicare Payment
Total Skilled Medicare Hospital Physician Nursing Home Hospice Payments Care Care Facility Care Health Care Care
Selected Medical Condition by Alzheimer’s Disease/Dementia (AD/D) Status
10: Average Annual Per-Person Payments by Type of Service and Coexisting Medical Condition for Medicare Beneficiaries Age 65 and Older, with and without Alzheimer’s Disease and Other Dementias, 2009, in 2011 Dollars*
Coronary heart disease
$25,389
15,748
Diabetes
24,776
13,695
Congestive heart failure
24,331
27,946
Chronic kidney disease
29,952
23,045
Chronic obstructive pulmonary disease
27,543
18,851
Stroke
25,843
18,554
Cancer
23,782
15,564
Medical Condition by Alzheimer’s Disease/Dementia (AD/D) Status
Home care.
Adult day center services.
Nursing home care
Alzheimer’s special care unit.
Use and Costs of Health Care, Long-Term Care and Hospice 2012 Alzheimer’s Disease Facts and Figures
Use and Costs of Long-Term Care Services
(78)
day
),
Use of Long-Term Care Services by Setting
2012 Alzheimer’s Disease Facts and Figures Use and Costs of Health Care, Long-Term Care and Hospice
11: Cognitive Impairment in Nursing Home Residents, by State, 2009
Percentage of Residents at Each Stage of Cognitive Impairment**
None Very Mild/Mild Moderate/SevereState Total Nursing Home Residents*
Use and Costs of Health Care, Long-Term Care and Hospice 2012 Alzheimer’s Disease Facts and Figures
11 (continued): Cognitive Impairment in Nursing Home Residents, by State, 2009
U.S. Total 3,279,669 32 27 41
Percentage of Residents at Each Stage of Cognitive Impairment**
None Very Mild/Mild Moderate/SevereState Total Nursing Home Residents*
Affordability of Long-Term Care Services
Long-Term Care Insurance
Medicaid Costs
2012 Alzheimer’s Disease Facts and Figures Use and Costs of Health Care, Long-Term Care and Hospice
Costs of Long-Term Care Services
Home care
Adult day centers
Alzheimer’s disease and other dementias, and
Assisted living.
Nursing homes.
Out-of-Pocket Costs for Health Care and Long-Term Care Services
A17
The
As noted earlier,
Use and Costs of Health Care, Long-Term Care and Hospice 2012 Alzheimer’s Disease Facts and Figures
A17
dementias are nursing home residents, and the rest
Among nursing home
2012 Alzheimer’s Disease Facts and Figures Use and Costs of Health Care, Long-Term Care and Hospice
Use and Costs of Hospice Care
An
Projections for the Future
A17
SPECIAL REPORT
PEOPLE WITH ALZHEIMER’S DISEASE AND OTHER DEMENTIAS WHO LIVE ALONE.
At least 800,000 Americans with Alzheimer’s disease live alone.
How Many People in the United States with Alzheimer’s Disease and Other Dementias Live Alone?
Older Americans Living Alone
A20
20
10
0
16.2%
27.7%
19.6%
42.3%
30.2%
56.3%
14: Percentage of Men and Women Age 65 or Older in the United States Who Live Alone
2012 Alzheimer’s Disease Facts and Figures Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone
Living Alone with Dementia
Medicare Current Beneficiary Survey
Aging, Demographics, and Memory Study
disease and other dementias is the Aging,
Other Studies
(102) As
Summary
2012 Alzheimer’s Disease Facts and Figures Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone 2012 Alzheimer’s Disease Facts and Figures
Racial and Geographic Disparities
(170) Among all
These
Typical Characteristics of People with Alzheimer’s Disease and Other Dementias Who Live Alone
Risks Encountered by People with Alzheimer’s Disease and Other Dementias Who Live Alone
(180)
(181)
2012 Alzheimer’s Disease Facts and Figures Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone
Delayed or Missed Diagnosis2011 Alzheimer’s Disease Facts and
Figures,
As discussed in 2011 Alzheimer’s Disease Facts and
Figures
delayed or missed diagnosis include:
Nursing Home Placement
(187)
(111, 188)
2012 Alzheimer’s Disease Facts and Figures Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone 2012 Alzheimer’s Disease Facts and Figures
Self-Neglect
Falls, Wandering, Emergencies and Fatal Injuries
(200)
Psychiatric Symptoms
(201) and increased (111)
This issue
Social Isolation and Loneliness
(207)
(207)
2012 Alzheimer’s Disease Facts and Figures Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone
Caregiving for People with Dementia Who Live Alone
and
Unmet Needs of People with Alzheimer’s Disease and Other Dementias Who Live Alone
needs include:
distress and health issues, such as eyesight and
Health Care Utilization
2012 Alzheimer’s Disease Facts and Figures Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone 2012 Alzheimer’s Disease Facts and Figures
In-Home Support Services
(181)
(187, 218)
Conclusion
Total** 25,389 25,943 -2%
12: Average Per-Person Payments for Health Care Services, Medicare Beneficiaries Age 65 and Older with a Reported Diagnosis of Dementia and Who Live in the Community, by Living Situation, 2008 Current Beneficiary Survey, 2011 Dollars
Beneficiaries Who Beneficiaries Who Alone/Live with Live Alone Live with Someone Else Someone Else)
Percentage Average Costs Per Person Difference (Live
Type of Health Care Service
2012 Alzheimer’s Disease Facts and Figures Special Report: People with Alzheimer’s Disease and Other Dementias Who Live Alone
Appendices 2012 Alzheimer’s Disease Facts and Figures
disease:
disease:
:
Institute on Aging and the Alzheimer’s Association, researchers
End Notes
disease:
other dementias:
2012 Alzheimer’s Disease Facts and Figures Appendices
These
Alzheimer’s and other dementias:
This
Appendices 2012 Alzheimer’s Disease Facts and Figures
A12
A12
These
These data come
2012 Alzheimer’s Disease Facts and Figures
The
2012 Alzheimer’s Disease Facts and Figures Appendices
References
Appendices 2012 Alzheimer’s Disease Facts and Figures
2012 Alzheimer’s Disease Facts and Figures Appendices
Appendices 2012 Alzheimer’s Disease Facts and Figures
2012 Alzheimer’s Disease Facts and Figures Appendices
Appendices 2012 Alzheimer’s Disease Facts and Figures
2012 Alzheimer’s Disease Facts and Figures Appendices
2012 Alzheimer’s Disease Facts and Figures.
The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer’s care, support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health.
Our vision is a world without Alzheimer’s disease.®
Alzheimer’s Association National Office 225 N. Michigan Ave., Fl. 17 Chicago, IL 60601-7633
Alzheimer’s Association Public Policy Office 1212 New York Ave., N.W., Suite 800 Washington, DC 20005-6105
800.272.3900alz.org
©2012 Alzheimer’s Association. All rights reserved.This is an official publication of the Alzheimer’s Association but may be distributed by unaffiliated organizations and individuals. Such distribution does not constitute an endorsement of these parties or their activities by the Alzheimer’s Association.
®