2022 Alzheimer's disease facts and figures
2022 Alzheimer's disease facts and figures
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DOI：
10.1002/alz.12638
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发表时间：
2022-03-14
影响因子：
14
通讯作者：
Hohman, Timothy J.
中科院分区：
文献类型：
--
作者：
Gaugler, Joseph;James, Bryan;Hohman, Timothy J.
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、护理的使用和成本，以及对家庭照顾者、痴呆症劳动力和社会的总体影响。特别报告讨论了消费者和初级保健医生对轻度认知障碍(MCI)的认识、诊断和治疗的观点，包括阿尔茨海默病引起的MCI。据估计，目前有650万65岁及以上的美国人患有阿尔茨海默氏症。除非在预防、减缓或治愈AD的医学突破方面取得进展，否则到2060年，这一数字可能会增长到1380万。官方死亡证明记录了2019年死于AD的121,499人，这是可获得数据的最新年份。2019年，阿尔茨海默病被正式列为美国第六大死因，2020年和2021年，新冠肺炎进入前十大死因行列，阿尔茨海默氏症被正式列为第七大死因。阿尔茨海默氏症仍然是65岁及以上美国人的第五大死因。2000年至2019年，死于中风、心脏病和艾滋病毒的人数下降，而报告的AD死亡人数增加了145%以上。2021年，1100多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160亿小时的护理。这些数字反映出，与十年前相比，照顾者的人数有所减少，而其余每个照顾者提供的照顾量都有所增加。2021年，无偿痴呆症护理价值2716亿美元。然而，它的成本延伸到家庭照顾者情绪困扰和负面身心健康结果的风险增加--这些成本因新冠肺炎而加剧。痴呆症护理人员也受到了新冠肺炎的影响。作为基本护理工作者，一些人选择跳槽以保护自己的健康和家人的健康。然而，这发生在需要更多痴呆症护理劳动力的时候。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人均联邦医疗保险支出几乎是没有这些疾病的受益人的三倍，而医疗补助的支出则是后者的22倍以上。2022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3210亿美元。阿尔茨海默氏症协会最近委托进行的一项调查显示，消费者对MCI的理解存在几个障碍。调查显示，美国人对MCI的认识较低，美国人在注意到MCI症状后不愿去看医生，初级保健医生在诊断MCI方面一直面临挑战。调查结果表明，需要提高对MCI的认识和诊断，特别是在服务不足的社区，并鼓励更多地参与MCI相关的临床试验。
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 family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI awareness and diagnosis, especially in underserved communities, and to encourage greater participation in MCI-related clinical trials.