Nearly 6 million Americans are living with Alzheimer’s disease (AD) and a staggering 7.7 million are expected to have dementia by 2030. Currently, AD is the sixth leading cause of death with 1 in 10 people age 65 and older experiencing AD, and of those 81 percent being age 75 and older.
AD disproportionately affects minorities and women, with African Americans twice as likely to experience it, Hispanics 1.5 times more likely than whites, and women accounting for two-thirds of those with AD, according to the Alzheimer’s Association and the Centers for Disease Control and Prevention.
AD is a neurodegenerative progressive disease that has a long pre-clinical sequelae thought to last from 10 to 20 years. That timespan is typically followed by a period of mild cognitive impairment (MCI) that lasts between six and 10 years. Finally, the advanced stage occurs during which the person’s health, functional abilities, and care needs worsen sharply over time.
Due to this long trajectory, clinicians caring for older adults have – hopefully – many opportunities to engage older adults and their care partners in dementia screening and detection.
The earlier, the better
Recent research has shown that many patients present with MCI, which can be caused by AD, and has an annual progression rate to AD of 8-15 percent per year.
Early screening, detection, and treatment of both MCI and AD are essential for providing timely access to care that can potentially slow the progression of dementia, provide people with AD and their caregivers time to plan for safe and high-quality care, and put measures in place to optimize health outcomes and protect functional capacity.
The Health Resources & Services Administration’s (HRSA) “Training Curriculum for AD and Related Dementias,” as well as additional research, report that multidomain lifestyle interventions, including nutrition, exercise, cognitive training, and management of vascular-related factors, have improved cognitive performance in healthy older adults and hold promise for those with MCI.
In addition to existing therapies to slow the progression of AD, disease modifying therapies (DMTs) are the next hope for AD. While no DMTs are currently available, several are in clinical trials.
Clinicians must arm themselves with the knowledge and tools to effectively screen, diagnose, and treat MCI and AD at the earliest stages. Once DMTs become available, there will be a tremendous need for dementia specialist clinicians who can effectively screen and identify older adults for whom these therapies would be appropriate.