Dementia is not a foregone conclusion and needs to be fought on all levels by individuals, communities, healthcare providers and policy makers, according to a new report by AARP and the Global Council on Brain Health.
More than 6 million Americans have Alzheimer’s disease, and that number will more than double to 12.7 million by 2050, according to the Alzheimer’s Association. The risk of developing dementia doubles every five years after age 65, and by age 85 roughly one in three Americans will suffer from dementia, most of them women.
“Cognitive decline is not inevitable,” said Sarah Lenz Lock, senior vice president of policy and brain health at AARP and executive director of the Global Council on Brain Health. “Your brain develops throughout your life. You can grow new brain cells throughout your life even as you age.”
Your brain health is influenced by factors such as physical activity, sleep quality, mental engagement, effective stress management, social engagement and good nutrition, Lock said.
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Lack of access to quality healthcare, discrimination in housing access, a lifetime of racial discrimination, access to information and quality of education all play a role in a person’s brain health, Lock said.
“Over a lifetime, it’s very different for people who face systemic barriers,” Lock said.
For example, Black, Hispanic, Native Americans and Pacific Islanders are all less likely to have insurance coverage than whites, the report said. But even when African-Americans are fully insured, they often receive substandard care, according to the report.
When it comes to dementia care, racial and ethnic minorities, persons with lower socioeconomic status, sexual and gender minorities, and rural populations have a harder time getting quality services, the report said.
Healthcare providers may lack sufficient cultural sensitivity, leading to poor communication and substandard treatment. Racism, ageism and anti-gay views are biases that can undermine treatment and cause doctors to overlook or misdiagnose symptoms, the report said.
While many of these issues require wholesale changes in people’s views and actions, as well as major public policy changes, failing to tackle these problems exacts a huge human toll, Lock said. “Not addressing these issues means huge healthcare costs and a huge waste of human potential,” she said.
In the U.S. alone, the annual cost of dementia in 2020 was estimated at $305 billion and is projected to soar to $1.5 trillion by 2050, Lock said. Overall, impaired brain health may be costing the global economy as much as $8.5 trillion a year in lost productivity, according to the Organization for Economic Cooperation and Development.
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Lock said AARP surveys show that the biggest barriers to positive changes for brain health tend to be individuals’ lack of knowledge of what works and not seeing what other people are doing. So, even talking about positive brain health can help others and providing resources to help people make positive changes will influence others to do the same, she said.
“If we want to improve brain health for all, we have to pay more attention to the needs of those at greatest risk of poor health and address social conditions that stand in the way,” Lock said.
Recommendations in the report for addressing barriers to brain health include:
For individuals: Be an active participant in your healthcare and seek providers you can trust to listen and understand your cultural values. Make healthy choices whenever possible and try to incorporate exercise, healthy nutrition, quality sleep, stress management and social engagement and mental stimulation into your life.
For healthcare providers: Prioritize prevention and establish brain-health screenings in checkups of aging adults and others at risk. Ensure family caregivers have the information they need to provide the most effective care and include them in consultations as appropriate.
For policy makers: Establish public policies and practices to promote greater awareness and early identification of cognitive and mental-health issues, including diverse voices in the policy-making process. Facilitate healthy lifestyles enabling people to proactively promote and sustain their brain health across their lifespans.
For communities: Promote community engagement to raise awareness of brain health and debunk misconceptions. Employers can take the lead in creating incentives to encourage healthy behavior. Include community members in decision making and incorporate diverse perspectives, expertise and feedback in all education, outreach and communications initiatives.
“Age-friendly communities, dwelling affordability, employers helping employees stay cognitively engaged — it’s not that complicated. It’s the will to make this available to everyone,” Lock said.
