Dementia is Everyone’s Concern

As America gets older, so too is there an increase in the number of people living with dementia or other forms of cognitive impairment. They and their loved ones struggle to get them the care they need to remain living at home. The burdens on family and friend caregivers, and the costs of health care, are among the concerns that communities are working to address. 

Estimates vary, but it is believed that more than 7 million people aged 65 or older had dementia in 2020. These estimates vary in part by how we ask about cognitive impairment. For example, an estimated 8% of people aged 65 and older – approximately 4.5 million people – reported that they had cognitive difficulty in 2023, meaning they reported having difficulty remembering, concentrating, or making decisions because of a physical, mental, or emotional problem. Meanwhile, an estimated 12.3% of people age 65 and older reported experiencing cognitive decline in 2022, meaning they reported experiencing confusion or memory loss that was happening more often or getting worse in the past year. As baby boomers age, the total number of people with dementia will rise with more than 9 million Americans projected to be living with dementia by 2030 and nearly 12 million by 2040.¹ 

Because dementia has some of the same risk factors as other chronic health issues, we are also seeing evidence of similar racial disparities. Black individuals with dementia tend to have greater severity that other ethnic groups. Gender is also a risk factor,  with women more likely than men to develop Alzheimer’s disease. This is likely because women tend to live longer than men and the older you are, the more likely you are to have dementia. Research also shows that sexual orientation and gender identity are factors, with LGBT older adults having higher rates of dementia. Socio-economic factors such as lower incomes and lower education levels may in part explain why women and LGBT older adults have higher incidence of dementia.

For people living with dementia, having a caregiver such as a spouse, family or friend who is willing to take on the unpaid support is very important for well-being. Often the caregiving burden falls to another older adult. In 2022, 26% of adults aged 65 and older who were providing care for a family member or friend reported that the person they were caring for had a cognitive impairment. People who live alone with cognitive difficulties – which was the case for many older Americans in 2022 – may be more likely to have unmet needs for care. But caring for someone with cognitive impairment can be very physically, emotionally, and mentally taxing. Caregivers for people with dementia experience high rates of burnout, and are at risk for health problems of their own. Providing unpaid elder care has also been shown to significantly reduce the lifelong earnings of women and makes them more likely to experience poverty as they age.

Some people turn to paid care for people for their loved ones with dementia, who often need round-the-clock care. But this can be a financial impossibility for many as the AARP LTSS Scorecard shows that the cost of in-home help can exceed $40,000 per year, and the price of a memory care assisted living facility can be even more. 

Americans paid $12.2 billion out of pocket for home health care in 2020, 71% of which was for care for people aged 65 and older. Programs such as Medicaid can offer limited home-based care for people with very low incomes, but eligibility requirements for these services often leave out people who have cognitive impairment but no functional impairment. Thus, near poor and low-middle income older adults often have few options for support with dementia care.  

Facing the Future: How Communities and Leaders are Responding to the Dementia Crisis 

When it comes to dementia, Americans have much to worry about. Will I develop it? How will I know? How will I care for my parent, or my spouse, if they develop it? How will my family pay for whatever care is needed? Who can help us prepare for and navigate all the challenges ahead? Leaders from the public and private sectors are coming together in communities across the nation to grapple with these issues and more. To see more data about the dementia challenge, including data about your state, visit our National Aging Readiness dashboard. 

To learn more about policy activity in your state, visit multisectorplanforaging.org.