The public health impact of Alzheimer's disease

The Public Health Impact of Alzheimer's Disease Dementia is emerging as a major public health concern.There are few diseases which have such a profound impact on society, patients, and their circle of families and friends as does dementia.While dementia is a common disorder, our knowledge of its etiology, natural history, treatment, and impact is still incomplete.Although we do know that such deterioration of cognitive functioning is distinct from that attributable to the normal aging process and usually develops insidiously, all too often it is dismissed as simply being due to old age.It also has only been within the last decade or two that dementia has emerged from the shadows into the limelight.With this increased attention has come a better understanding of the magnitude of the public health impact of the disease.Because dementia is largely a disease of older age, the demographic changes in the United States have resulted in increasing numbers of people at risk of developing the disease.Never before in our history have so many people lived to be so old.Today more than 50 per cent of the entire US population reaches age 75 and 25 per cent live to age 85.The segment 85 years of age and older is growing fastest and expected to increase by over 80 per cent by the year 2000.1An increasing number of elderly with significant intellectual and functional impairment will accompany this large increase in the "at-risk" population.Although good epidemiologic data from this country are lacking, the prevalence of severe dementia in the over age 65 population ranges from 1.3 to 6.2 per cent with the medium prevalence of 4.15 per cent.The prevalence of dementia in the age group over 85 years may be as high as 20 per cent.2In the United States today, approximately three million persons are moderately affected.Over 56 per cent of the elderly in nursing homes have a diagnosis of chronic mental condition or senility3 which is a significant factor in the admission to nursing homes in over 50 per cent of the cases.These data represent a tenfold increase in the number of people affected since the turn of the century and the number of people with severe dementia is expected to increase 60 per cent by the year 2000.4It is currently estimated that the most common cause of severe intellectual impairment in the elderly is Alzheimer's Disease, accounting for about 50-60 per cent of all cases; multi-infarct or mixed dementia accounts for approximately 20-40 per cent; and the remaining 10 per cent or so includes a variety of rarer types.5 Alzheimer's Disease may lead to death in five to 10 years, decreasing life expectancies by one-half to one-third that of healthy persons of the same age.6Based on these data, some have suggested that dementia is probably the third or fourth leading cause of mortality in the United States, accounting for at least 120,000 adult deaths annually, although it is rarely reported on death certificates.7

Alzheimer's disease · Disease · Environmental health · Journal of Public Health · Pathology · Public health · Public health policy · Dementia and Cognitive Impairment Research · Health, Environment, Cognitive Aging · Medicine · Gerontology · Health Policy

• The economic costs of Alzheimer's disease

  Joel W Hay, R L Ernst et al.•American Journal of Public Health•1987

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• Alzheimer's Disease

  Open Access•Wendy Max, Pam Webber et al.•Journal of Aging and Health•1995

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• Cognitive impairment and hospital use

  Philip G Weiler, James E Lubben et al.•American Journal of Public Health•1991

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• The economic costs of Alzheimer's disease

  Joel W Hay, R L Ernst et al.•American Journal of Public Health•1987

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