Of all the health issues we face as we get older, the threat of developing dementia could feel like it’s the most inevitable. Unfortunately, research published earlier this year reinforced this grim outlook for the future, forecasting a doubling of people diagnosed with cognitive decline by the year 2060 to 42 percent of the population aged 55 and older. But despite the frightening figures, scientists are now pushing back on some of these findings, with some saying that the prediction of a serious surge in dementia might not be entirely inevitable.
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The latest warning raised serious concerns about the future of dementia.
The latest response comes just months after foreboding research was published in the journal Nature Medicine. The study used data from roughly 16,000 participants collected between 1987 and 2020. Researchers found that two in five Americans could be afflicted with cognitive decline by the time they start approaching their 60s, and they warned that the number would likely rise to 50 percent once people passed their 75th birthday.
The prediction was exceptionally high for Black patients who are carriers of the APOE4 gene—considered to be one of the most significant known risk factors for dementia—with a 45 to 60 percent chance of developing cognitive decline. Overall, the split risk of dementia for men and women was found to be 35 and 48 percent, respectively, although researchers explained that women’s longer average lifespans likely accounted for the steep increase.
The scientists said their findings made the case that there should be as much emphasis placed on preventative lifestyle changes and treatments for brain health as there currently is for cardiovascular health.
"The pending population boom in dementia cases poses significant challenges for health policymakers, in particular, who must refocus their efforts on strategies to minimize the severity of dementia cases, as well as plans to provide more health care services for those with dementia," Josef Coresh, MD, PhD, one of the study’s authors and founding director of the Optimal Aging Institute at NYU Langone, said in a press release.
Some experts disagree with the warnings, though.
While the study garnered plenty of attention in the wake of its release, not everyone in the scientific community is quite as pessimistic about the future. In a commentary published in The Journal of the American Medical Association (JAMA) on March 12, experts argued that "the expected tsunami of dementia" may not be threatening to crash into the U.S. population after all.
Actuary Eric Stallard, co-director of the Biodemography of Aging Research Unit at Duke University, doesn’t believe the prediction that case rates will rise nearly as high as the original study predicted in the coming decades.
"The notion that the number of people with dementia will double over the next 25, 30 or 35 years due to the aging of baby boomers is widespread, it’s pervasive—and it’s wrong," he told The New York Times.
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Data shows that dementia rates have been dropping.
In the counterargument posted by Stallard and a group of researchers, the team points to data collected in recent years. They analyzed information collected in three large population studies, including the National Long Term Care Survey from 1984 to 2004, the U.S. Health and Retirement Study from 2002 through 2012, and the National Health and Aging Trends Study from 2011 to 2021. Altogether, the research included data from hundreds of thousands of individuals.
In each instance, the group found that dementia diagnosis rates have actually been on a steady decline, dropping by at least two-thirds over the past four decades, per AlzForum. If anything, the team’s revised numbers instead suggest there might only be a 25 percent increase over the next 25 years.
"If your risks are lower than your parents’ risks and this trend continues, you won’t see the doubling or tripling of dementia that’s been projected," Murali Doraiswamy, MD, a professor of psychiatry and medicine at Duke University and one of the authors of the dissenting study, told The Times.
The ultimate outcome will still depend on what action is taken.
The drastic reduction of the prediction also drew praise from some others in the field. Jennifer Weuve, MPH, an associate professor at Boston University’s School of Public Health, replied to a post on AlzForum, saying, "The authors convey a message of hope."
However, there may still be other points to consider. Doraiswamy concedes that increased testing or a wider definition of cognitive decline in the future could still cause a spike in dementia diagnoses, as could a prolonged life expectancy.
Still, other variables could also derail progress. Changes in access to healthcare that help address and mitigate contributing factors to dementia, such as obesity, hypertension, and cholesterol levels, could make it harder for patients to take preventative steps, Gill Livingston, MD, a psychiatrist at University College London, told The Times. Continued success could even be threatened by regulatory changes that increase air pollution or limit access to effective yet costly new medications.
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The Takeaway:
Months after a bombshell study predicted a drastic increase in dementia cases to 42 percent of Americans aged 55 and older by the year 2050, researchers are pushing back with a bit of good news. Their recent commentary points out that data collected over the last 40 years shows a sustained drop in cognitive decline diagnoses.
According to their calculations, the worst-case scenario might see cases only rise about 25 percent in the next quarter decade, driven mostly by the increasing elderly population. But while some other scientists lauded the improved forecast, others pointed out that any progress could be imperiled if populations don’t have access to healthcare or preventative treatments.
"None of this is inevitable," Livingston told The Times. "It depends on what we do."
