A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012
Open accessAbstract
Importance: The aging of the US population is expected to lead to a large increase in the number of adults with dementia, but some recent studies in the United States and other high-income countries suggest that the age-specific risk of dementia may have declined over the past 25 years. Clarifying current and future population trends in dementia prevalence and risk has important implications for patients, families, and government programs. Objective: To compare the prevalence of dementia in the United States in 2000 and 2012. Design, Setting, and Participants: We used data from the Health and Retirement Study (HRS), a nationally representative, population-based longitudinal survey of individuals in the United States 65 years or older from the 2000 (n = 10 546) and 2012 (n = 10 511) waves of the HRS. Main Outcomes and Measures: Dementia was identified in each year using HRS cognitive measures and validated methods for classifying self-respondents, as well as those represented by a proxy. Logistic regression was used to identify socioeconomic and health variables associated with change in dementia prevalence between 2000 and 2012. Results: The study cohorts had an average age of 75.0 years (95% CI, 74.8-75.2 years) in 2000 and 74.8 years (95% CI, 74.5-75.1 years) in 2012 (P = .24); 58.4% (95% CI, 57.3%-59.4%) of the 2000 cohort was female compared with 56.3% (95% CI, 55.5%-57.0%) of the 2012 cohort (P < .001). Dementia prevalence among those 65 years or older decreased from 11.6% (95% CI, 10.7%-12.7%) in 2000 to 8.8% (95% CI, 8.2%-9.4%) (8.6% with age- and sex-standardization) in 2012 (P < .001). More years of education was associated with a lower risk for dementia, and average years of education increased significantly (from 11.8 years [95% CI, 11.6-11.9 years] to 12.7 years [95% CI, 12.6-12.9 years]; P < .001) between 2000 and 2012. The decline in dementia prevalence occurred even though there was a significant age- and sex-adjusted increase between years in the cardiovascular risk profile (eg, prevalence of hypertension, diabetes, and obesity) among older US adults. Conclusions and Relevance: The prevalence of dementia in the United States declined significantly between 2000 and 2012. An increase in educational attainment was associated with some of the decline in dementia prevalence, but the full set of social, behavioral, and medical factors contributing to the decline is still uncertain. Continued monitoring of trends in dementia incidence and prevalence will be important for better gauging the full future societal impact of dementia as the number of older adults increases in the decades ahead.
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Evidence supports that greater educational attainment over time in the United States, with gains more substantial for women than men, has led to decreased risk for dementia.
“evidence supports that greater educational attainment over time in the United States -the gains in which have been more substantial for women than men -has led to decreased risk for dementia.276”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [276]
The Results and Discussion report that educational attainment rose among US adults aged 65 or older between 2000 and 2012 and that increased education accounted for some of the decline in dementia risk. The paper does not report that education gains were greater for women than men, and it qualifies education’s contribution rather than establishing that it caused the decline. (LLM, conf=0.88)
Experimental — accuracy not yet measuredGreater educational attainment over time in the United States - the gains in which have been more substantial for women than men - has led to decreased risk for dementia.
“but evidence supports that greater educational attainment over time in the United States — the gains in which have been more substantial for women than men — has led to decreased risk for dementia.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [302]
The Discussion reports that education increased among older US adults between 2000 and 2012 and accounted for some of the decreased dementia risk. The Introduction says rising education levels may have contributed to the decline, so the claim's causal wording is stronger than the paper's evidence. The passages do not establish that educational gains were greater for women than for men. Page numbers were not provided in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDeclines in dementia risk have been attributed to increasing levels of education and improved control of cardiovascular risk factors.
“Declinen dementia risk have been attributed to increasing levels of education and improved control of cardiovascular risk factors.”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [276]
Declines in dementia risk have been attributed to increasing levels of education and improved control of cardiovascular risk factors.
“Declines in dementia risk have been attributed to increasing levels of education and improved control of cardiovascular risk factors.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [302]
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- Authors
- Langa, K. M., Larson, E. B., Crimmins, E. M., Faul, J. D., Levine, D. A., Kabeto, M. U., & Weir, D. R.
- Affiliations
- University of Michigan (US)
- University of Washington (US)
- University of Southern California (US)
- Corresponding author
- Langa, Kenneth M.
- ORCID
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2017-01-01
- Volume
- 177
- Issue
- 1
- Pages
- 51
- ISSN
- 2168-6106 (ISSN-L)
- PMC
- PMC5195883
- OpenAlex
- W2557663540
- Cited by
- 910
- References
- 31
- Citations by year
- 2026: 52 · 2025: 86 · 2024: 91 · 2023: 143 · 2022: 65 · 2021: 99 · 2020: 89 · 2019: 99 · 2018: 98 · 2017: 83 · 2016: 3 · 2013: 1
- FWCI
- 82.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (P30AG053760, U19AG010483, P30AG017265, U01AG009740, P30AG024824, K23AG040278)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- dementia prevalence, temporal trends, older adults, years of schooling, socioeconomic status, cognitive decline, dementia risk factors, population aging, Health and Retirement Study, cognitive assessment, United States, high-income countries, dementia epidemiology, health policy implications, caregiver burden
- MeSH terms
- Aged, Dementia, Female, Humans, Male, Risk Factors, United States, Prevalence
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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