Alzheimer’s and Brain Awareness Month

The Alzheimer’s Association defines Alzheimer’s as a type of dementia that affects memory, thinking, and behavior. It is progressive and worsens over time until it is severe enough to interfere with daily activities, such as bathing, eating, dressing, and other routine tasks.

Alzheimer’s is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60-80% of dementia cases.”

Symptoms are typically mild in the beginning and start in the brain’s learning center. As the disease progresses, the symptoms worsen and broaden, including more severe memory issues, situational confusion, unwarranted suspicion of others (including family and caregivers), profound behavior changes, and eventually difficulty with basic physical functioning, such as swallowing, walking, and talking. Although people under age 65 can suffer from early-onset Alzheimer’s, being older is the most significant risk factor.

The infographic from the Alzheimer’s Association illustrates the prevalence of the disease, its costs, and its challenges. More than seven million Americans are living with Alzheimer’s, and while heart disease deaths (still the number one killer of all Americans) have decreased by two percent, Alzheimer’s deaths have increased by 142 percent (2000-2022).

Population Aging: Important Considerations

In our May blog post on Older Americans Month, we reported that the population of those age 65 and older is at an all-time high, driven by the Boomer generation (1946-1964). This produces a constellation of challenges and opportunities never encountered before in managing our economy, our institutions, and our infrastructure.

The Alzheimer’s Association reports that by 2030, that same age cohort will have significantly increased to an estimated 71 million people representing more than 20 percent of the total population, up from 17 percent in 2022. And the size of this group will continue to grow relative to the younger population, a phenomenon known as population aging, which is being caused by lower fertility rates and increased survival rates.

Growth of the Cohort Age 85+

The same report also points to an important trend on the horizon that could create significant challenges for all:

The number of Americans in their 80s, 90s and beyond is expected to grow dramatically due to population aging. This will lead to an increase in the number and percentage of Americans 85 and older. This age group is expected to comprise 11% of the population age 65 and older in 2025 and 21% of the population age 65 and older in 2050. This will result in an additional 10 million people age 85 and older — individuals at the highest risk for developing Alzheimer’s dementia. In 2025, about 2.5 million people living with Alzheimer’s dementia are expected to be age 85 or older, accounting for 33% of all people with Alzheimer’s dementia.”

Beyond the issues brought about by population aging in general, the potential prevalence of such a sizeable population at risk for Alzheimer’s poses staggering implications, especially for one group.

Women and Alzheimer’s

Nearly 66 percent of caregivers for those with dementia are women. As the Alzheimer’s Association reports:

Over one-third of dementia caregivers in the United States are daughters caring for a parent. It is more common for wives to provide informal care for a husband than vice versa. On average, female caregivers spend more time caregiving than male caregivers. The 2021-2022 Behavioral Risk Factor Surveillance System surveys found that of all dementia caregivers who spend more than 40 hours per week providing care, 70% were women. Two and a half times as many women as men reported living with the person with dementia full time. Of those providing care to someone with dementia for more than five years, 64% were women.”

Women Are More Likely to be Caregivers

Consequently, women tend to experience higher levels of burden and associated symptoms, such as low mood, depression, and health issues versus men. That’s because their greater time spent means they perform more caregiving-related tasks and have more exposure to someone demonstrating the challenging spectrum of emotion/mental, and functional difficulties associated with Alzheimer’s.

In 2024, the nearly 12 million family/caregivers helping people with Alzheimer’s and other dementias provided a whopping 19 billion hours of unpaid help. According to the same report, this translates into almost 31 hours of care per week per caregiver. Based on the average state median wages and the median hourly cost of a home health aide, the estimated value of this care across the country totaled roughly $414 billion in 2024.

These data are powerful insights into the issues affecting women, who, themselves, are more likely to grow older ages, bear higher risk for the disease, and eventually develop it.

Women Are Also More Likely to be Sufferers

As we reported in our post on Older Americans Month, of the 58 million older adults age 65+ (2022), roughly 32 million of them were women compared to 26 million men. More women than men are living to older ages, women make up a greater portion of residency at nursing facilities, and women have a lifetime risk of developing Alzheimer’s that is twice that of men.

According to the Alzheimer’s Association, nearly two-thirds of older Americans with the disease are women. While roughly seven million people have the disease, more than four million are women compared to nearly three million are men. That means that a greater percentage of women (12 percent) than men (10 percent) of those age 65 and older developed the disease.

Women age 65+ will be among the first wave of generations to have worked outside the home in significant numbers and have more formal education then their predecessor generations:

Taken together, these factors highlight important considerations for all Americans and especially for those living with the disease and their caretakers…both more likely to be women. Alzheimer’s is NOT a normal part of aging. There are only two treatments. There is no cure. But there is help.

How PACE Helps those with Alzheimer’s

The Alzheimer’s Association reports that:

The long duration of illness before death contributes significantly to the public health impact of Alzheimer’s disease because much of that time is spent in a state of severe disability and dependence. Alzheimer’s is a very burdensome disease, not only to the individuals with the disease, but also to their families, informal caregivers and communities at large.”

That means that families and caregivers need a strong network of support to help them help their loved ones who suffer from the disease, so they can live a healthy life for as long as possible, ideally in their own communities, before a full-time nursing facility becomes necessary.

The Program of All-inclusive Care for the Elderly (PACE) is an innovative care model that uses an interdisciplinary health care approach to assess the needs of each participant (age 55+) and deliver a comprehensive array of services, all with the goal of keeping seniors healthy and living safely in their own homes.

PACE programs provide seamless, coordinated health care services that improve efficiency and outcomes. It is the only program of its kind that integrates Medicaid and Medicare under a collaborative three-way contract between state agencies and a PACE organization. This fully integrated model of care, with pooled financial resources, allows for greater service flexibility, coordination, and continuity of care.

In its report on PACE Programs as an Alternative to Nursing Homes for Medicaid Beneficiaries, the American Council on Aging says “…PACE has proven especially beneficial for persons with Alzheimer’s disease and related dementias. According to the National PACE Association, almost 50% of program participants have a diagnosis of dementia.” The primary focus of PACE is to prevent or delay nursing facility admission for as long as possible, allowing even those with Alzheimer’s to remain in their own homes/communities.

How Myers and Stauffer Can Help

Myers and Stauffer can help bring a big-picture perspective to PACE program expansion, implementation, and monitoring by aligning PACE with other programs and initiatives. We have extensive multi-state experience with PACE programs, long-term care, rate setting, and managed care – a comprehensive combination that enables us to provide critical insights.

Because of the depth and breadth of our experience and understanding of the PACE service-delivery model, we can apply best practices, spot emerging trends, and accommodate state-specific objectives to guide our work. Our standardized processes incorporate the rigor necessary to generate the defensible results clients need and the meticulous quality they expect, so that they can better serve these individuals.

We also have decades of experience conducting federal compliance reviews and performing quality and/or financial monitoring services that can help safeguard your new or existing PACE program, and those vulnerable individuals they are designed to help. We can help you design a state specific assessment or monitoring program that meets your objectives.

Read our other blog posts, including PACE: Client-Centered and Quality-Focused Project Management, our blog post on PACE and Quality of Life: At the Intersection of Growing Older … Better, and last year’s post on Alzheimer’s and Brain Awareness Month.