ST. GEORGE — While Alzheimer’s disease is the only leading disease without prevention or a cure, both the medical community and the general population struggle with understanding it.
That’s the finding of the 2022 Alzheimer’s Disease Facts and Figures report issued by the Alzheimer’s Association.
“There is a dire shortage of qualified dementia care specialists in this country,” said Ronnie Daniel, executive director of the Alzheimer’s Association of Utah. “This creates a barrier to a timely and accurate diagnosis, and a lack of diagnosis means a delay in treatments, care delivery and supportive services.”
The report states that more than half (55%) of primary care physicians surveyed say there aren’t enough dementia care specialists in their communities. In rural areas, that jumps to 71%.
Utah currently has 25 certified geriatricians, according to a news release from the national Alzheimer’s Association office. To serve the population age 65 and older with dementia in the year 2050, it is estimated that Utah will need 114 geriatricians. To meet the medical needs of all Utahns age 65 and older – estimated at 30% of the population – the state would need 341 geriatricians.
Nationally, the U.S. has 5,170 geriatricians but will need 15,417 to serve the dementia population in 2050 and 46,252 to provide services to all people age 65 and older.
Yet while one study found that 85% of people diagnosed with dementia are first diagnosed by a non-specialist physician, nearly 40% of PCPs reported “only sometimes or never” being comfortable personally making a diagnosis for Alzheimer’s or other dementias.
According to the National Center for Health Workforce Analysis, there already was a shortage of geriatricians in 2013, with a projected increase in demand by 2025 that was not expected to be met. Similarly, a study of the current and future U.S. neurology workforce projected a 19% shortage of neurologists by 2025. Looking ahead to 2050, the situation gets worse.
The Facts and Figures report includes a special section on “More than Normal Aging: Understanding Mild Cognitive Impairment (MCI),” which includes two national surveys that examine patients’ and PCP’s awareness and understanding of MCI.
According to the news release, MCI is characterized by subtle changes in memory and thinking. It is sometimes confused with normal aging, but it is not part of the typical aging process. A variety of factors can cause MCI, so it is viewed as a broad set of symptoms. This can make the diagnosis of MCI challenging for affected individuals and physicians.
The reason that MCI is of concern is that between 12% and 18% of people age 60 or older are living with the condition. Studies estimate that 10% to 15% of individuals with MCI go on to develop dementia each year and about one-third of people with MCI develop dementia due to Alzheimer’s disease within five years.
The most notable finds of the surveys are:
- MCI is a mystery – Fewer than 1 in 5 Americans (18%) are familiar with MCI.
- Tell us early – A large majority of Americans (85%) say they would want to know early if they had Alzheimer’s disease, including during the MCI stage (54%) and mild Alzheimer’s disease stage (31%).
- Concerns create hesitation – Nearly 8 in 10 Americans (78%) express concerns about seeing a doctor in the wake of MCI symptoms. Concerns cited most often include receiving an incorrect diagnosis (28%), learning of a serious health problem (27%), receiving unnecessary treatment (26%) and believing symptoms might go away (23%).
- Doctors recommend early diagnosis – The vast majority of PCPs (86%) say that early intervention can slow progression of cognitive decline. When MCI is detected in patients, PCPs most often recommend lifestyle changes (73%), perform laboratory testing for reversible causes of MCI (70%) and/or refer patients to a specialist (53%).
- But many doctors are unclear on next steps – Only 4 in 10 PCPs (40%) say they are familiar (7% very familiar and 33% somewhat familiar) with current biomarker tests to aid in the diagnosis of Alzheimer’s disease, and they refer fewer than 1 in 5 patients (18%) for biomarker testing for Alzheimer’s disease when MCI is detected.
Other key findings in the Facts and Figures Report
- The costs are unsustainable – In 2022, the total national cost of caring for individuals with Alzheimer’s and other dementia is projected to reach $321 billion. In Utah, the Medicaid costs of caring for people with Alzheimer’s are estimated at $185 million. By 2025, these local costs are projected to increase 27% to $235 million.
- More Americans are living with the disease – An estimated 6.5 million Americans age 65 and older have Alzheimer’s dementia in 2021, including 35,000 in Utah.
- Alzheimer’s is a leading cause of death – Deaths due to Alzheimer’s have increased an alarming 145% since 2000. In Utah in 2019, there were 980 deaths.
- Many family and friends are serving as Alzheimer’s caregivers – In Utah, 97,000 caregivers provided a total of 119 million hours of unpaid care in 2021 valued at $2 billion.
Click here for the 2022 Alzheimer’s Disease Facts and Figures report.
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