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2013 年阿尔茨海默病事实和数据。

2013 Alzheimer's disease facts and figures.

出版信息

Alzheimers Dement. 2013 Mar;9(2):208-45. doi: 10.1016/j.jalz.2013.02.003.

Abstract

This report provides information to increase understanding of the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality rates, health expenditures and costs of care, and effect on caregivers and society in general. It also explores the roles and unique challenges of long-distance caregivers, as well as interventions that target those challenges. An estimated 5.2 million Americans have AD. Approximately 200,000 people younger than 65 years with AD comprise the younger onset AD population; 5 million comprise the older onset AD population. Throughout the coming decades, the baby boom generation is projected to add about 10 million to the total number of people in the United States with AD. Today, someone in America develops AD every 68 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, or nearly a million new cases per year, and the total estimated prevalence is expected to be 13.8 million. AD is the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age 65 years or older. Between 2000 and 2010, the proportion of deaths resulting from heart disease, stroke, and prostate cancer decreased 16%, 23%, and 8%, respectively, whereas the proportion resulting from AD increased 68%. The number of deaths from AD as determined by official death certificates (83,494 in 2010) likely underrepresents the number of AD-related deaths in the United States. A projected 450,000 older Americans with AD will die in 2013, and a large proportion will die as a result of complications of AD. In 2012, more than 15 million family members and other unpaid caregivers provided an estimated 17.5 billion hours of care to people with AD and other dementias, a contribution valued at more than $216 billion. Medicare payments for services to beneficiaries age 65 years and older with AD and other dementias are three times as great as payments for beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2013 for health care, long-term care, and hospice services for people age 65 years and older with dementia are expected to be $203 billion (not including the contributions of unpaid caregivers). An estimated 2.3 million caregivers of people with AD and other dementias live at least 1 hour away from the care recipient. These "long-distance caregivers" face unique challenges, including difficulty in assessing the care recipient's true health condition and needs, high rates of family disagreement regarding caregiving decisions, and high out-of-pocket expenses for costs related to caregiving. Out-of-pocket costs for long-distance caregivers are almost twice as high as for local caregivers.

摘要

本报告提供了有关阿尔茨海默病(AD)对公众健康影响的信息,包括发病率和患病率、死亡率、卫生支出和护理费用,以及对护理人员和整个社会的影响。它还探讨了远程护理人员的角色和独特挑战,以及针对这些挑战的干预措施。据估计,美国有 520 万人患有 AD。大约 20 万名年龄在 65 岁以下的 AD 患者构成了年轻发病 AD 人群;500 万构成了老年发病 AD 人群。在未来几十年,婴儿潮一代预计将使美国 AD 总人数增加约 1000 万。现在,美国每 68 秒就有一人患上 AD。到 2050 年,预计每 33 秒就会出现一例新的 AD 病例,即每年新增病例近 100 万例,预计总患病率将达到 1380 万例。AD 是美国第六大死因,也是美国 65 岁及以上人群的第五大死因。在 2000 年至 2010 年间,心脏病、中风和前列腺癌导致的死亡比例分别下降了 16%、23%和 8%,而 AD 导致的死亡比例则上升了 68%。官方死亡证明(2010 年为 83494 人)确定的 AD 死亡人数可能低估了美国的 AD 相关死亡人数。预计 2013 年将有 45 万患有 AD 的美国老年人死亡,其中大部分将死于 AD 的并发症。2012 年,超过 1500 万家庭成员和其他无薪护理人员为患有 AD 和其他痴呆症的人提供了估计 175 亿小时的护理,价值超过 2160 亿美元。医疗保险向 65 岁及以上患有 AD 和其他痴呆症的受益人支付的服务费用是向没有这些疾病的受益人的三倍,而医疗补助支付的费用则是 19 倍。预计 2013 年,65 岁及以上患有痴呆症的人用于医疗保健、长期护理和临终关怀的总支出将达到 2030 亿美元(不包括无薪护理人员的贡献)。估计有 230 万 AD 和其他痴呆症患者的护理人员与护理接受者的距离至少为 1 小时。这些“远程护理人员”面临着独特的挑战,包括难以评估护理接受者的真实健康状况和需求、家庭在护理决策方面存在很大分歧,以及与护理相关的自付费用很高。远程护理人员的自付费用几乎是本地护理人员的两倍。

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