CNN –
Older people living in the eastern and southeastern regions of the United States are most likely to develop Alzheimer’s disease. That comes from new data announced at the Alzheimer’s Association international conference and published Monday in the organization’s journal.
The report provides the first county-level estimates of Alzheimer’s prevalence in the United States. Researchers used data from thousands of people participating in the Chicago Health and Aging Project to assess demographic risk factors for Alzheimer’s disease — including age, gender and race — and matched them to US state composition.
These demographic estimates suggest that Alzheimer’s rates are highest in Miami-Dade County, Baltimore, and the Bronx — where about one in six seniors has the disease. Maryland has the highest state prevalence, followed by New York and Mississippi.
Experts say the findings could be useful in helping public health leaders and organizations better support the millions living with the disease — and plan for an aging population.
“This information is very helpful because I think it increases the urgency of our work,” said Dr. Halima Amjad, a geriatrician at Johns Hopkins Medicine and Chair of an Alzheimer’s Council in the Maryland state government. She was not involved in the study.
“With dementia, much of the care and support that is provided — through legislation or programs — often occurs at the state and local level, rather than the national level,” Amjad said. Last year marked the first year that Maryland’s state budget earmarked dedicated funds for dementia care, about $3.5 million, she said. “So we need to have that focus, both through planning at the public health level and through the financial underpinning of that planning, to strengthen the care and support available.”
Using demographic risk factors to estimate the prevalence of Alzheimer’s disease can help capture the overall burden of disease better than medical records do.
“Half, or even more than half, of the people who live with Alzheimer’s disease and related dementias actually go undiagnosed,” Amjad said. “Why this happens is complex. Sometimes individuals and families don’t realize it’s dementia. confusing it with normal aging. And we know doctors don’t always ask about it, so it doesn’t come up unless the family brings it up. And doctors may be reluctant to make and share the diagnosis.”
The risk of developing Alzheimer’s increases significantly with age. According to the report, people aged 75 to 79 were about three times more likely to get the disease than people aged 65 to 69, and the rate was about three times higher in people aged 85 and older 15 times higher.
Rates in older women were about 13% higher than older men, and rates in black seniors were about 2.5 times higher than white seniors.
James Macgill, deputy commissioner at the Baltimore Department of Health who heads the city’s Alzheimer’s program, said the estimates weren’t particularly surprising to him.
“This is a black majority city and the root of all of that is really decades of neighborhood segregation,” he said. Lack of access to health care, healthy diets, walkable neighborhoods and greater health inequalities have led to chronic diseases such as diabetes and high blood pressure, which can increase the risk of Alzheimer’s and related dementia.
“Research seems to indicate that dementia is actually becoming increasingly related to healthy lifestyles, so you really have to boil it down to the neighborhood level,” Macgill said. Outreach in these communities can help individuals understand and access the resources available to them to minimize their risk.
“Having data at the community level helps us educate people in those communities and make those arguments,” he said.