Older adults living in the eastern and southeastern regions of the United States are more likely to develop Alzheimer’s disease, according to new data shared at the Alzheimer’s Association International conference.
The Report Provides the first county-level estimates of Alzheimer’s disease prevalence in the United States. Researchers used data from thousands of people who participated in the Chicago Health and Aging Project to estimate demographic risk factors for Alzheimer’s disease — including age, gender and race.
These population estimates suggest that Alzheimer’s rates are highest in Miami-Dade County, Baltimore and the Bronx — where one in 6 seniors has the disease. State-wise, Maryland has the highest incidence, followed by New York and Mississippi.
Experts say the findings could help public health leaders and organizations better support the millions of people living with the disease — and plan for an aging population.
“Having this information is really helpful because I think it adds urgency to the work we’re doing,” said Dr. Halima Amjad, a geriatrician at Johns Hopkins Medicine and chair of the Alzheimer’s Council on Maryland State Government. She is not engaged in studies.
“For dementia, a lot of protection and support — through legislation or programs — often happens at the state and local level, not the national level,” Amjad said. Last year was the first year Maryland’s state budget focused on dementia care, about $3.5 million, he said. “So we need to focus on that by planning at the public health level, supporting that planning with funding, and improving the care and support that’s available.”
Using population-based risk factors to estimate the prevalence of Alzheimer’s disease may better capture the full burden of the disease than can be found in medical records.
“Half, or even more than half, of people living with Alzheimer’s disease and related dementias are actually undiagnosed,” Amjad said. “Why it happens is complicated. Sometimes individuals and families don’t recognize it as dementia. It confuses it with normal aging. And we know doctors don’t always ask about it, so it doesn’t come up until the family brings it up. And doctors can be reluctant to make and share the diagnosis. ”
The risk of Alzheimer’s disease increases significantly with age. According to the report, people aged 75 to 79 are three times more likely to get the disease than those aged 65 to 69, and rates are 15 times higher among those aged 85 and older.
Rates among senior women are about 13% higher than among senior men, and rates among black seniors are 2.5 times higher than among white seniors.
Baltimore Health Department Assistant Commissioner James McGill, who leads the city’s Alzheimer’s program, said the estimates didn’t particularly surprise him.
“This is a majority black city, and the root cause of all of this is decades of segregation in city neighborhoods,” he said. Lack of health care, healthy eating, walkable neighborhoods and greater health disparities have contributed to chronic diseases such as diabetes and high blood pressure, which can increase the risk of Alzheimer’s and related dementias.
“Research indicates that dementia is actually associated with healthy lifestyles, so you have to bring that into the neighborhood,” McGill said. Outreach in those communities can help individuals understand and access the resources available to them to reduce their risk.
“Having data at the community level helps us educate people in those communities and make that case,” he said.