2012 alzheimer's disease facts and figures

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


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)


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


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


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


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


(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


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:


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)


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


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)


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


Health Care Utilization

Mortality

(127)

Caregiver Employment

Interventions that May Improve Caregiver Outcomes

These

and delaying

Paid Caregivers



5: Types and Focus of Caregiver Interventions

Type of Intervention Description

Psychoeducational

Supportive

Psychotherapy

Multicomponent


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*


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


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


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


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 Long-Term Care Services

(78)

day

),

Use of Long-Term Care Services by Setting


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*


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


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,


A17

dementias are nursing home residents, and the rest

Among nursing home


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)


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)


Self-Neglect

Falls, Wandering, Emergencies and Fatal Injuries

(200)

Psychiatric Symptoms

(201) and increased (111)

This issue

Social Isolation and Loneliness

(207)

(207)


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


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


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


A12

A12

These

These data come

2012 Alzheimer’s Disease Facts and Figures

The


References


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.

®

2012 alzheimer's disease facts and figures

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