Dementia is probably the worst effect of aging both for its victims and their families. According to the Alzheimer’s Association, Alzheimer’s is the cause of 60% to 80% of dementia cases in the United States, with the others resulting from vascular dementia, frontotemporal degeneration, Lewy body disease, and the effects of other illnesses, such as Parkinson’s. Often people with dementia suffer from a combination of these illnesses.
While we have learned some methods of staving off dementia, essentially the same steps that promote good physical health — a good diet and exercise — there’s no cure or medicine yet despite billions of dollars spent on research.
Medical Research
It appears that some of that research has been going down the wrong path, seeking to rid the brain of the protein beta-amyloid outside neurons and twisted strands of the protein tau inside neurons associated with Alzheimer’s disease. These may be more of a symptom of Alzheimer’s than a cause, similar to the way coughing and sneezing are symptoms of a cold, not its cause. (Perhaps not the best analogy since cold medicine that treats the coughing and sneezing can certainly make you feel better.)
Yet the first clinical trial showing favorable results from taking anti-amyloid treatment was published in March. It involved people genetically disposed to suffer from Alzheimer’s disease who took the drug for many years beginning either before experiencing any cognitive impairment or just mild cognitive impairment. The question is whether this treatment could be applied on a population-wide basis or perhaps combined with early detection of Alzheimer’s disease. There is also research being conducted to identify biomarkers of Alzheimer’s before individuals start experiencing symptoms.
Research that is now just beginning to receive recognition identifies certain viruses as potentially leading to Alzheimer’s disease. This is the most hopeful indication that I’m aware of that we may be able to take steps to reduce the likelihood of suffering from this disease. Avoid or cure the virus, Alzheimer’s.
Projected Growth of People Suffering from Alzheimer’s Disease
In its annual comprehensive report on the state of Alzheimer’s disease and research to prevent it today, 2025 Alzheimer’s Disease Facts and Figures, the Alzheimer’s Association estimates that there are more than 7 million Americans living with Alzheimer’s dementia today. The number is likely to grow dramatically as the baby boomer generation ages since the likelihood of suffering from Alzheimer’s increases dramatically with age. While just 5% of those between the ages of 65 and 74 suffer from Alzheimer’s dementia, fully a third of those 85 and over do.
Given that the oldest baby boomers will reach age 85 in just seven years, to be followed by some 70 million of their cohort, the Alzheimer’s Association projects that the number of people with the disease will grow from 7.2 million today to 11.2 million in 2040, an increase of 56% over the next 15 years, with the bulk of this increase coming after 2030. They predict only an 18% increase over the next five years.
These numbers also mean that a greater proportion of those with Alzheimer’s and other forms of dementia will be older. The Alzheimer’s Association predicts that the number of Americans aged 85 and over with Alzheimer’s will grow from 2.5 million today to 6.7 million in 2060, almost half of all those with Alzheimer’s.
Who Will the Caregivers Be?
As a result of those with dementia being older on average, they will be less likely to have natural support systems in terms of living and healthy spouses and children available to provide assistance. This lack of family members who can provide assistance will be exacerbated in the future by smaller families. Those who are 85 and older today typically had more children than did baby boomers who, in turn, had more children than those who will be 85 and older in 2060.
In the absence of family caregivers, it’s not at all clear how we will care for those with dementia in the future. The Alzheimer’s Association predicts that we will need 900,000 additional care workers between 2022 and 2032, and that’s before great numbers of baby boomers start experiencing dementia and other ailments for which they will require assistance. (And let’s not get into what an anti-immigration policy will do to the availability of caregivers.)
And the costs will be tremendous. The Alzheimer’s Association estimates that the entire cost of health and long-term care for older adults with dementia is about three times that of those without dementia, approximately $45,000 per year as compared to $15,000 on average. This does not include the costs to families providing care in terms of lost earnings and Social Security benefits, or increased stress.
A Ray of Hope
One interesting and promising statistic in the report has to do with where people with dementia receive care with many more in their own homes rather than in nursing homes. This is measured by where they pass away, with approximately 65% dying in nursing facilities in 2000 as compared with about 40% in 2022. In addition, many fewer are dying in hospitals and many more, though still a small percentage, in hospice facilities.
This is consistent with the response of former Secretary of Health and Human Services for Massachusetts Marylou Sudders to my question of how there will be enough nursing home beds for the growing number of older residents in the future. She said, “I’d like to think that the ability to provide health care for people in the community so that people can maintain their independence for as long as possible and not need an institutional level of care perhaps ever or not until the very end part of life. It’s about building capacity and choice and not being dependent on one model of care.” (You can listen to our discussion here.)