2020 Alzheimer's disease facts and figures
2020 Alzheimer's disease facts and figures
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DOI：
10.1002/alz.12068
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发表时间：
2020-03-01
影响因子：
14
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中科院分区：
文献类型：
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本文描述了阿尔茨海默病(AD)对公众健康的影响，包括发病率和患病率、死亡率和发病率、护理的使用和费用，以及对照顾者和社会的总体影响。特别报告讨论了满足美国越来越多的阿尔茨海默氏症患者的护理需求的未来挑战，特别强调初级保健。到本世纪中叶，65岁及以上的美国阿尔茨海默氏症患者人数可能增长到1380万。这与目前65岁及以上的美国阿尔茨海默氏症患者估计为580万人相比，大幅增加。官方死亡证明记录显示，2018年有122,019人死于AD，这是可获得数据的最新年份，使阿尔茨海默氏症成为美国第六大死因和65岁及以上美国人的第五大死因。2000年至2018年间，中风、艾滋病毒和心脏病导致的死亡人数下降，而阿尔茨海默氏症的报告死亡人数增加了146.2%。2019年，超过1600万家庭成员和其他无偿照顾者为阿尔茨海默氏症或其他痴呆症患者提供了约186亿小时的护理。这种护理价值近2440亿美元，但其成本延伸到家庭照顾者情绪困扰和负面心理和身体健康结果的风险增加。为65岁及以上患有阿尔茨海默病或其他痴呆症的受益人提供的服务的平均人均联邦医疗保险付款是没有这些情况的受益人的三倍多，医疗补助付款是前者的23倍以上。2020年，为65岁及以上痴呆症患者提供的医疗保健、长期护理和临终关怀服务的总支出估计为3050亿美元。随着患有阿尔茨海默氏症的美国人口的增加，照顾这些人口的负担也增加了。这些挑战因缺乏痴呆症护理专家而加剧，这给初级保健医生(PCP)提供痴呆症患者护理的负担越来越大。许多PCP感到准备不足，培训不足，无法有效地处理痴呆症护理责任。本报告包括在面临初级保健方面的专家短缺和培训挑战的情况下如何最大限度地提高保健质量的建议。
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the future challenges of meeting care demands for the growing number of people living with Alzheimer's dementia in the United States with a particular emphasis on primary care. By mid-century, the number of Americans age 65 and older with Alzheimer's dementia may grow to 13.8 million. This represents a steep increase from the estimated 5.8 million Americans age 65 and older who have Alzheimer's dementia today. Official death certificates recorded 122,019 deaths from AD in 2018, the latest year for which data are available, making Alzheimer's the sixth leading cause of death in the United States and the fifth leading cause of death among Americans age 65 and older. Between 2000 and 2018, deaths resulting from stroke, HIV and heart disease decreased, whereas reported deaths from Alzheimer's increased 146.2%. In 2019, more than 16 million family members and other unpaid caregivers provided an estimated 18.6 billion hours of care to people with Alzheimer's or other dementias. This care is valued at nearly $244 billion, but its costs extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2020 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $305 billion. As the population of Americans living with Alzheimer's dementia increases, the burden of caring for that population also increases. These challenges are exacerbated by a shortage of dementia care specialists, which places an increasing burden on primary care physicians (PCPs) to provide care for people living with dementia. Many PCPs feel underprepared and inadequately trained to handle dementia care responsibilities effectively. This report includes recommendations for maximizing quality care in the face of the shortage of specialists and training challenges in primary care.