25 Mar 2014

The burden of Alzheimer’s disease falls disproportionately on women, according to the Alzheimer’s Association’s annual Facts and Figures report released on March 19. Women over 65 are twice as likely as men to develop the disease, and make up two-thirds of those who currently have it. In fact, women’s risk of developing Alzheimer’s runs about double that of breast cancer, the Association noted in a press release. Women are also about 2.5 times more likely than men to provide full-time care for someone with Alzheimer’s, and are more likely to have to quit work or cut back on their hours to do so, increasing the financial burden on affected families. Previous studies have estimated the direct medical costs from Alzheimer’s disease at more than $200 billion annually in the United States; adding the costs from unpaid caregiving roughly doubles that figure (see Mar 2012 news story). 

The report comes as other researchers report evidence to support a view long held in the field, namely that Alzheimer's causes more deaths than health records suggest. In many cases, doctors record heart or respiratory failure or other causes on death certificates but not the fatal neurodegeneration that can precipitate such systemic failures (see Dec 2008 news story). In the March 25 Neurology, researchers led by Bryan James at the Rush Alzheimer’s Disease Center, Chicago, reported that over an eight-year period, about one-third of the deaths in a cohort of older adults could be attributed to Alzheimer’s. This data was collected from more than 2,500 participants in the Rush Memory and Aging Project and the Religious Orders Study. By projecting it out to the population at large, the authors estimated that Alzheimer’s could account for more than half a million deaths a year in the United States in people older than 75. This is six times higher than the number of AD deaths reported on death certificates. If correct, this would make AD the third-leading cause of death after heart disease and cancer. The authors note that their cohort may not represent the general population, being better-educated and somewhat healthier overall. Nonetheless, the data suggest that Alzheimer’s deaths are extremely underreported, in agreement with previous studies (see Olichney et al., 1995; Ganguli and Rodriguez, 1999).—Madolyn Bowman Rogers