Alzheimer's by the Numbers

Two numbers on a page: 7.2 million Americans living with Alzheimer’s disease. 11.5 million providing their unpaid care.

Behind every digit is a kitchen table. A husband learning to cook at seventy-three because his wife no longer remembers how. A daughter driving four hours each weekend to check on a father who insists nothing is wrong. A woman in a memory care unit who lights up when her granddaughter visits, though she cannot recall her name.

Statistics flatten these realities into abstraction. But understanding the scale of what we face, and how unevenly the weight is distributed, is essential to understanding why the system fails so many families and what it would take to change it.

This is a data portrait of Alzheimer’s disease as it actually exists in America. The numbers are current as of 2025. They will get worse before they get better.

Scale and Trajectory

The United States crossed a threshold this year: more than seven million people sixty-five and older are now living with Alzheimer’s dementia. This is the first time that number has exceeded seven million. Three-quarters of them are seventy-five or older.

One in nine Americans over sixty-five has Alzheimer’s. Among those eighty-five and older, the ratio climbs to one in three. Approximately 200,000 people under sixty-five are living with younger-onset Alzheimer’s, a form of the disease that strikes during working years and often goes unrecognized for far too long.

Without medical breakthroughs that prevent or substantially slow the disease, projections show 13.8 million Americans with Alzheimer’s by 2060. The demographic arithmetic is unforgiving: the baby boom generation is entering the age range of highest risk, and the number of people reaching their eighties and nineties continues to grow.

Alzheimer’s is now the seventh-leading cause of death in the United States. Deaths from the disease have increased 145 percent since 2000, even as deaths from heart disease and stroke have declined. This is not because Alzheimer’s has become more deadly. It is because more people are living long enough to develop it, and because death certificates are finally recording it more accurately.

Globally, approximately 55 million people are living with dementia, with Alzheimer’s accounting for 60 to 70 percent of cases. The World Health Organization projects 139 million by 2050. The crisis is worldwide, but the resources to address it are not evenly distributed.

Who Gets Alzheimer’s

The disease does not strike randomly. It follows the fault lines of American inequality.

Almost two-thirds of Americans with Alzheimer’s are women. Longevity explains part of this: women live longer, and age is the greatest risk factor. But longevity does not explain all of it. Research is investigating hormonal factors, particularly the role of estrogen decline after menopause; genetic factors, including how the APOE ε4 risk allele may affect women differently than men; and social factors, including the cumulative stress of caregiving roles that women disproportionately carry across their lifetimes.

Racial disparities are stark. Black Americans are roughly twice as likely to develop Alzheimer’s as white Americans. Hispanic Americans are approximately 1.5 times as likely. These are not purely genetic differences. They reflect lifetimes of unequal exposure to cardiovascular risk factors like hypertension and diabetes, chronic stress from discrimination, environmental exposures including air pollution and lead, and unequal access to healthcare, education, and economic opportunity. The biology of Alzheimer’s is entangled with the sociology of American life.

The APOE ε4 gene variant is the strongest known genetic risk factor for late-onset Alzheimer’s. Carrying one copy increases risk; carrying two copies increases it substantially. But genetic risk is not destiny, and the same gene variant appears to confer different levels of risk in different populations, suggesting that environment and gene expression interact in ways researchers are still working to understand.

The Lancet Commission on dementia prevention identified fourteen modifiable risk factors that collectively may account for up to 45 percent of dementia cases worldwide. The list includes hearing loss, lower educational attainment, hypertension, obesity, physical inactivity, diabetes, excessive alcohol consumption, depression, social isolation, air pollution, traumatic brain injury, smoking, vision loss, and high LDL cholesterol. These are not factors that individuals can simply choose to change. Many of them reflect structural conditions: where you grew up, what schools were available, what jobs were open to you, what your neighborhood air quality was, whether you could afford a hearing aid.

Perhaps the most troubling number in the landscape is this one: up to three-quarters of people with Alzheimer’s symptoms remain undiagnosed. The gap is widest in communities of color and in rural areas, where access to specialists is limited and where cognitive changes may be attributed to normal aging until they become impossible to ignore.

The Care Economy

For every person living with Alzheimer’s, there is at least one person providing care. Usually more than one. And that care is overwhelmingly unpaid.

In 2024, 11.5 million Americans provided unpaid care to someone with Alzheimer’s or another dementia. They provided 19 billion hours of care, valued at more than $413 billion. This is the invisible economy that keeps the formal healthcare system from collapsing under the weight of dementia care.

Sixty percent of these caregivers are employed. Of those, 57 percent have had to modify their work schedules to accommodate caregiving. Sixteen percent have taken a leave of absence. Eight percent have turned down a promotion. Six percent have left the workforce entirely. The career and earnings impact falls disproportionately on women, who provide the majority of dementia care and who are more likely to reduce work hours or exit the labor force as caregiving demands intensify.

The health toll on caregivers is severe enough to warrant its own installment in this series. For now, the summary: caregivers of people with dementia have higher rates of depression, anxiety, and chronic stress than their peers. They have elevated cardiovascular risk. Their immune function is measurably suppressed. Some research suggests that the chronic stress of dementia caregiving may accelerate the caregiver’s own cognitive aging. This is the cruelest arithmetic in the Alzheimer’s landscape: caring for someone with the disease may increase your own risk of developing it.

The professional care workforce is also strained. Fifty-five percent of primary care physicians report that there are not enough dementia care specialists in their area. The projected shortfall of direct care workers, the aides and attendants who provide hands-on care in homes and facilities, is expected to reach one million by 2031. The people we are counting on to provide care are not there in sufficient numbers, and the pipeline to train them is inadequate.

The Money

Alzheimer’s is the most expensive disease in America.

Total care costs are projected to reach $384 billion in 2025. Medicare and Medicaid cover approximately $246 billion of that. Out-of-pocket costs borne by families total $97 billion. By 2050, the total is projected to approach one trillion dollars annually.

The lifetime cost of care for a person with dementia averages $405,262. Families bear 70 percent of that burden, through out-of-pocket payments for care, lost wages from reduced work hours, and the economic value of unpaid care they provide themselves.

Medicaid, the safety net program for low-income Americans, spends 22 times more on beneficiaries with dementia than on those without. This is because Medicaid is the only public program that covers long-term care, and most families cannot afford years of nursing home or memory care costs without it. The spend-down process, in which families must exhaust their savings to qualify for Medicaid, is covered in detail in Series 1 of this publication. It is financial devastation by design.

The new disease-modifying treatments add another layer of cost. Lecanemab runs approximately $26,500 per year for the drug alone. Add the amyloid PET scans required for diagnosis, the MRIs required for monitoring, the infusion center visits, and the specialist appointments, and first-year costs can exceed $40,000. Medicare covers these treatments, but not without copays, travel costs, and time away from work for caregivers who must drive patients to appointments. Access depends on geography and resources. The treatments exist; the infrastructure to deliver them equitably does not.

The Map

Where you live determines what Alzheimer’s care looks like.

Prevalence varies by state, shaped by demographics, longevity, and diagnostic practices. So does access to specialists. Rural areas have fewer neurologists, longer travel distances to infusion centers, and less access to the PET imaging required to confirm amyloid pathology and qualify for treatment. A person in rural Mississippi and a person in suburban Boston may have the same disease, but they do not have the same options.

The new blood biomarker tests may narrow this gap over time, moving initial diagnosis out of specialty centers and into primary care offices. But the treatments still require infusion infrastructure, monitoring, and specialist oversight. Geography remains a barrier that no blood test can fully overcome.

Series 10 of this publication will examine how place shapes aging across rural, suburban, and urban America. The Alzheimer’s story is a case study in that larger pattern: where you live determines not just quality of life but access to care itself.

What the Numbers Mean

These statistics are not an abstraction. They are a context for understanding where you and your family sit in this landscape.

If you are over sixty-five, your risk is roughly one in nine. If you are a woman, your lifetime risk is higher. If you are Black or Hispanic, your risk is higher still. If you have a family history, if you carry the APOE ε4 gene, if you have untreated hearing loss or uncontrolled hypertension or diabetes, the probabilities shift further.

This is not cause for panic. It is cause for attention. Many of the risk factors are modifiable, not through willpower alone but through access to healthcare, information, and resources. Early detection, which the previous installment discussed, matters more now that early-stage treatments exist. Planning (financial, legal, relational) matters because the costs and caregiving demands are predictable even when the disease itself is not.

And here is what the numbers do not capture: the quality of a Tuesday afternoon with someone you love. The way a song can unlock a memory that conversation cannot reach. The moments of recognition and connection that persist even as the disease progresses. The statistics tell us what we are facing. They do not tell us what remains possible.

The data portrait of Alzheimer’s is a picture of compounding crisis. The scale is immense. The trajectory is worsening. The burdens fall hardest on women, on communities of color, on families without wealth, on regions without specialists. The care economy depends on unpaid labor that damages the people providing it. The financial architecture bankrupts families by design.

Understanding this is the first step toward changing it. The numbers are not destiny. They are a diagnosis of a system that can be rebuilt, if we choose to rebuild it.