AARP Eye Center
In an effort to find “practical solutions” to this country's “most expensive disease,” the Milken Institute today released a comprehensive report on dementia. It suggests ways to help the 13 million men and women who, based on its projections, will be living with the condition in the next 20 years.
Along with addressing the enormous scale of the memory-robbing disease, the authors underscore that its burden is not equally shared among us — both in terms of who gets dementia and who sacrifices to care for those who have it.
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Sarah Lenz Lock, AARP's senior vice president for policy and brain health, wrote the forward to the report and notes that the work “provides a great service by showing the disproportionate burden dementia places on women, African Americans and Hispanics and by showing the economic costs of dementia caregiving.”
The report also recommends solutions — lots of them, including raising awareness of risk-reducing, brain-healthy habits; developing a national prevention and detection strategy in Medicare; and increasing participation in dementia research among diverse groups.
Here's a look at some of the major takeaways on the report in more detail.
Women's higher burden
The report makes a strong case that Alzheimer's disproportionately affects women, from their increased risk of the disease — which, the new thinking goes, isn't entirely explained by the fact that women live longer than men — to their larger caregiving burden.
By the numbers
Along with policy recommendations, the Milken Institute report compiles some useful foundational knowledge on dementia. Here's a quick take, by the numbers.
1. Dementia is not considered a normal part of aging, but age is still the greatest risk factor for dementia. Your risk of developing it doubles every five years after you turn 65. By the time you turn 85, your risk is nearly 1 in 3.
2. Not all cases of dementia are Alzheimer's disease, but Alzheimer's is by far the most common cause of dementia and accounts for 60 to 80 percent of all cases.
3. After receiving a diagnosis of Alzheimer's disease, people live, on average, four to eight years, though some live as long as 20 years.
4. Most — 83 percent — of dementia caregiving in the U.S. is performed by family members, friends or other unpaid caregivers. In 2018, more than 16 million Americans served as caregivers to people with dementia, providing an estimated 18.5 billion hours of unpaid care.
"What we found was that the total economic impact of treating dementia will be $368 billion by 2020, and more than 70 percent of these costs will be to the treatment of women — even though women are less likely than men to be treated for dementia,” notes study coauthor Nora Super, senior director of the Milken Institute Center for the Future of Aging. What's more, the total economic loss to women in terms of things like lost wages and care in nursing homes will be in the trillions. And Super considers that a conservative estimate.
Women, the report explains, not only do the bulk of caregiving, they take on the most challenging tasks (bathing, toileting and dressing included) more often than men do. As the demands of later-stage dementia multiply, women more frequently miss work or quit their jobs, leading to lost wages and benefits amounting to hundreds of thousands of dollars, on average. They also experience higher levels of stress, depression and other adverse health outcomes than their male counterparts.
The report suggests that caregivers could benefit from, for instance, employer-subsidized caregiving leave and changes to how future Social Security benefits are calculated for those with caregiving holes in their work histories. On an individual level, Super notes, women with caregiving burdens need to try to stay in the workforce as long as they possibly can.