The number of Americans living with Alzheimer’s disease or other dementias will double to nearly 13 million over the next 20 years, according to the new Milken Institute report “Reducing the Cost and Risk of Dementia: Recommendations to Improve Brain Health and Decrease Disparities.”
Milken Institute research estimates that by 2020, roughly 4.7 million women in the US will have dementia, accounting for nearly two-thirds of all people living with the condition.
The number of both women and men living with dementia is projected to nearly double by 2040, with the number of women projected to rise to 8.5 million, and the number of men expected to reach 4.5 million (up from 2.6 million in 2020), according to the report, which was released at the 2019 Milken Institute Future of Health Summit in Washington, D.C.
Over the next 20 years, the economic burden of dementia will exceed $2 trillion, with women shouldering more than 80 percent of the cumulative costs.
“Longer lifespans are perhaps one of the greatest success stories of our modern public health system,” explains Nora Super, lead author of the report and senior director of the Milken Institute Center for the Future of Aging.
“But along with this success comes one of our greatest challenges. Our risk of developing dementia doubles every five years after we turn 65; by age 85, nearly one in three of us will have the disease.”
“With no cure in sight, we must double down on efforts to reduce the cost and risk of dementia,” she added.
“Emerging evidence shows that despite family history and personal genetics, lifestyle changes such as diet, exercise, and better sleep can improve health at all ages.”
In collaboration with partners such as UsAgainstAlzheimer’s, AARP and Bank of America, Super and her co-authors, Rajiv Ahuja and Kevin Proff, have developed detailed recommendations and goals for policymakers, businesses, and communities to improve brain health, reduce disparities, and ultimately change the trajectory of this devastating disease.
1) Promote strategies to maintain and improve brain health for all ages, genders, and across diverse populations
2) Increase access to cognitive testing and early diagnosis
3) Increase opportunities for diverse participation in research and prioritize funding to address health disparities
4) Build a dementia-capable workforce across the care continuum
5) Establish services and policies that promote supportive communities and workplaces for people with dementia and their caregivers
“As this important new report shows, dementia is one of the greatest public health challenges of our time,” said Sarah Lenz Lock, SVP, Policy & Brain Health at AARP.
“It also demonstrates that we have the power to create change, whether by helping consumers maintain and improve their brain health, advancing research on the causes and treatment of dementia, or supporting caregivers who bear so much of the burden of this disease. We at AARP look forward to working with the Milken Institute and other key partners to achieve these goals.”
Women caregivers are more likely to be impacted financially and leave their jobs or miss work to care for a family member. The image is in the public domain.
“Brain health broadens the fight against Alzheimer’s to include everyone and is the key to defeating stigma, increasing early detection, speeding up research — and ending this disease,” said Jill Lesser, a founding board member of UsAgainstAlzheimer’s. “This new look by the Milken Institute offers important recommendations and actions to help move us to an optimal system of brain health care in this country.”
Among the breakthrough findings, new data have “unveiled key discoveries about the differences between men’s and women’s brains, and how they age. Moreover, women typically take on greater caregiver responsibilities than men. Women caregivers are more likely to be impacted financially and leave their jobs or miss work to care for a family member.
And research demonstrates that spousal caregivers may be at a higher risk of cognitive impairment or dementia than non-caregivers.”
“With this research, the Milken Institute has taken an important step to better understand the impacts of dementia on diverse populations,” said Lorna Sabbia, Head of Retirement and Personal Wealth Solutions, Bank of America.
“This study, together with our own research on life stages, women, health and wellness, plays a critically important role in our efforts to educate and provide guidance to individuals and families throughout their financial lives.”
Dementia directly influences the quality of life of a person suffering from this chronic illness. The caregivers or carers of dementia people provide critical support to them but are subject to negative health outcomes because of burden and stress.
The intervention of mobile health (mHealth) has become a fast-growing assistive technology (AT) in therapeutic treatment of individuals with chronic illness.
The purpose of this comprehensive study is to identify, appraise, and synthesize the existing evidence on the use of mHealth applications (apps) as a healthcare resource for people with dementia and their caregivers.
A review of both peer-reviewed and full-text literature was undertaken across five (05) electronic databases for checking the articles published during the last five years (between 2014 and 2018).
Out of 6195 searches yielded articles, 17 were quantified according to inclusion and exclusion criteria. The included studies distinguish between five categories, viz.,
(1) cognitive training and daily living,
(3) health and safety monitoring,
(4) leisure and socialization, and
Furthermore, two most popular commercial app stores, i.e., Google Play Store and Apple App Store, were searched for finding mHealth based dementia apps for PwD and their caregivers. Initial search generated 356 apps with thirty-five (35) meeting the defined inclusion and exclusion criteria.
After shortlisting of mobile applications, it is observed that these existing apps generally addressed different dementia specific aspects overlying with the identified categories in research articles. The comprehensive study concluded that mobile health apps appear as feasible AT intervention for PwD and their carers irrespective of limited available research, but these apps have potential to provide different resources and strategies to help this community.
Dementia is considered as one of the most challenging conditions in older people that affects not only the people with this chronic illness but also their nonprofessional or informal caregivers. It is a complex syndrome with progressive decline in cognitive functioning such as thinking, remembering, and reasoning .
National Institute on Aging (NIA) stated that dementia is a brain disorder that disturbs the cognitive and behavioural abilities to such an extent that it hinders a person’s daily living activities . A study  based on the Delphi consensus technique estimated the global prevalence of dementia.
This report stated that approximately 24.3 million people suffered from dementia in the year 2001 and this number is expected to double in every 20 years, i.e., 42.3 million PwD in 2020 and 81.1 million in 2040. Prince et al.  also projected the risks of rise in dementia cases from 65.7 million to 115.4 million in the duration of 2030 to 2050.
The current and future estimated ratio of PwD in developing countries (low-and-middle-income countries (LMIC)) is greater than in developed countries (high-income countries (HIC)).
Approximately 58% of the total PwD cases in 2010 were from developing countries (LMIC) and were estimated to upsurge to 70% in 2050.
Although many health organizations approved different kinds of medications for the treatment of mild to moderate dementia disease, still these medicines do not cure, reverse, or tackle the underlying root problem causing dementia.
Additionally, dementia treatment consumes a large number of resources and money . The treatment cost increases with the severity of dementia . Moreover, PwD need care as per their severity level and the majority of which is provided by their family members who are usually inexpert for this demanding role.
Family members are commonly considered as the main source of providing physical, emotional, social, and financial support, due to which they encounter different challenges like anxiety, depression, hopelessness, and poor quality of life .
Therefore, in the absence of a cure and limited care skills of caregivers, more advanced strategies need to be developed to maximize the quality of life and promote the independence of high need and high-cost dementia patients .
In this context, the assistance of technology offers much potential and can improve the quality of life of people with dementia and their informal caregivers . Recent initiatives in smart devices (i.e., smartphones, portable workstations, tablets, etc.) have made mobile applications a promising source for engaging people in healthcare , particularly PwD with high healthcare needs [11, 12].
Mobile Health, aka mHealth, is the provision of a healthcare facility to people by using a mobile device. Approximately over 50,000 medicine related applications are available for mobile devices and the majority of these applications are free .
Researches [14–20] indicated that PwD can use touchscreen devices easily, and this technology is able to provide a wide range of benefits to them and their caregivers. It makes a valuable opportunity for developers to deliver a meaningful app by adding engaging activities for such people to live their life more independently.
The aim of this paper is to provide a comprehensive review of existing research that supports the evidence of using mHealth applications in dementia healthcare. The research paper is organized as follows: next section provides the background research on dementia and the role of assistive technology in dementia healthcare.
Then, the underlying methodology of the research is presented and followed by the existing research studies about mHealth apps used for dementia healthcare. Afterwards, currently available smartphone apps in Android and iOS markets were listed. The paper closes with the conclusion.
Geoffrey Baum – Milken Institute
The image is in the public domain.
Original Research: The findings will be presented at Milken Institute Future of Health Summit.