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 Alzheimer’s Stats Look Alarming, But No Need to Panic

According to a new report from the Centers for Disease Control & Prevention (CDC), Alzheimer’s disease mortality increased significantly in 41 states and the District of Columbia from 1999 to 2014. However, as the headlines scream, “Death from Alzheimer’s on the Rise,” Allen Power, MD, an internist, geriatrician, and author of “Dementia Beyond Drugs: Changing the Culture of Care,” says that there is some good news behind the numbers.

The report’s authors studied state-level and county-level death certificate data from the National Vital Statistics System from 1999 to 2014. They found that 93,541 Alzheimer’s deaths occurred in the United States in 2014, a 54.5 percent increase compared with the deaths from the illness in 1999. However, when breaking down the numbers, says Power, a different picture emerges.

“There is a huge increase in deaths attributed to Alzheimer’s from 1999 to 2005. But from 2006 to 2014, the increase actually is minimal.” There likely are many factors accounting for the skyrocketing rate of deaths from Alzheimer’s between 1999 and 2005 and the lesser rise in later years, he says.

“Much has happened over the years in terms of how death certificates are written. It is likely that the visibility of and our focus on recognizing dementia has increased so much that deaths previously attributed to something else increasingly are recognized as being directly related to Alzheimer’s disease,” Power says.

Diagnostic tools have improved, so more accurate diagnoses of Alzheimer’s have been made in that 15-year period, he says.

“Several durable studies in recent years have indicated that the incidence of new cases of Alzheimer’s disease is decreasing significantly, so the data in the CDC report don’t square with those reports,” he says. However, having most of the increased deaths in the first five years of the study might also be related to an older cohort of people who had lived with Alzheimer’s for several years prior to the onset of the study.

The CDC report suggests huge increases in minority deaths from Alzheimer’s disease between 1999 and 2014—99 percent for African Americans, 151 percent for Asian/Pacific Islanders, and 107 percent for Hispanics. Power suggests that these statistics also raise some questions. For instance, he wonders if there has previously been more of a racial disparity in access to health care. He also speculates that as a growing number of people obtain health care insurance under the Affordable Care Act, more patients may be seeing physicians and receiving Alzheimer’s disease diagnoses.

The CDC report notes that most Alzheimer’s-related deaths occurred in a skilled nursing center or long term care facility, and the percentage of Alzheimer’s patients dying in a medical facility such as a hospital declined from 14.7 percent in 1999 to 6.6 percent in 2014. At the same time, the percentage who died at home increased from 13.9 percent in 1999 to 24.9 percent in 2014.

While the authors suggest that more people with Alzheimer’s dying at home means a greater burden on caregivers, Power suggests that it also means more people likely are having end-of-life discussions, completing advance directives, and having their wishes to die at home honored. He notes that this also backs the need for more support for caregivers, including education, respite care options, better home care financing, and case management to lessen their burden.

Power says that as people with Alzheimer’s are living longer, new ways to positively engage and empower them must be found. This, in turn, may also help slow their decline and maximize their quality of life. “We need health care policies that address these issues,” Power says.

While this report suggests a need to recommit research, resources, and policy efforts to addressing Alzheimer’s disease prevention, treatment, and care, Power urges providers not to be misled by the numbers. “Take a deep breath. The statistics shouldn’t change our efforts to keep our patients with Alzheimer’s disease as healthy, functional, and meaningfully engaged as possible.”

The CDC report on Alzheimer’s disease deaths is available at

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