Dementia: The Growing Crisis in West Virginia

Executive Summary
Overview of Dementia
Types of Dementia
Prevalence of Dementia
Cost of Dementia
Risk Factors for Dementia
Prevention of Dementia
Diagnosis of Dementia
Treatment of Dementia
Diagnosis in Hospital Records
Dementia Mortality
Dementia Research

Hospitalization Rates by County of Residence

Mortality Rates by Type of Dementia and Gender

Dementia Mortality by County of Residence

Credits and Acknowledgements

Executive Summary

General Facts

● Dementia occurs when there is a disruption of the communication among brain cells, or neurons, through cell death or isolation. Alzheimer’s disease (AD) is the most frequently diagnosed form of irreversible dementia, accounting for 50% to 70% of all cases. Vascular dementia accounts for about 10% to 15% of all cases.

● As many as seven million people in the United States suffer from some form of dementia. It is estimated that 4.5 million people suffer from AD.

● The estimated economic costs of AD in the United States total at least $100 billion annually. It is considered the third most expensive disease to treat.

● The greatest risk factor for AD is age; it is estimated that nearly 50% of people over the age of 85 are at risk for developing the disease. Women are more likely than men to develop AD, as are people with a family history of the illness. Other risk factors for AD include Down’s syndrome, low educational achievement, learning disabilities, head injury in early life, coronary artery bypass surgery, and brain inflammation. Strokes are the greatest risk factor for vascular dementia.

● Researchers have growing evidence that certain measures can be taken to postpone the onset of dementia, including intellectually challenging activities, physical activity, and a low-fat, low-calorie diet that includes fish. Other possible preventive measures being researched include the use of NSAIDS, lithium, and antioxidants and vitamins C and E.

● There are currently no cures for AD or vascular dementia. However, there are a few medications that have been shown to slow progression and lessen symptoms: donepezil (Aricept), rivastigmine (Exelon), galantamine (Reminyl), tacrine (Cognex), and memantine (Namenda).

West Virginia Statistics

An estimated 40,000 individuals in West Virginia had AD in 2000. By 2025, this number is expected to increase to 50,000.

Evidence is mounting thatboth AD and vascular dementia are subject to the same risk factors as cardiovascular disease, including cigarette smoking, high cholesterol, hypertension, physical inactivity, poor nutrition, and diabetes. In 2003, West Virginia adults reported significantly higher prevalences of these risk factors than adults in the nation as a whole.

Approximately 5% of all hospital discharges both nationally and statewide in 2001 had dementia as either a principal or secondary diagnosis.

● West Virginia’s total rate of hospitalizations with a diagnosis of dementia in 2001 was 74.3 per 10,000 population, compared with a U.S. rate of 58.2. The state rate of hospitalizations with a diagnosis of Alzheimer’s disease was 68% higher than the national rate, 22.8 hospitalizations per 10,000 population vs. 13.6.

● In 2002, AD alone was the eighth leading cause of death in both the state and the nation.

● Mortality rates for dementia as the underlying (or principal) cause of death have risen markedly in West Virginia over the past two decades due to several factors, including an enhanced awareness of AD and other dementias, earlier diagnosis of the illnesses, and an aging population.

● When 2001 multiple-cause-of-death data were examined, the results showed that the state mortality rate for dementia as the underlying cause of death was 10% higher than the national rate (35.5 deaths per 100,000 population vs. 32.3). The state rate for mortality from dementia as an any-listed cause of death was 38% higher than the national rate (106.2 deaths per 100,000 population vs. 77.2).

Hard Copy Published February 2005