{"doi":"10.1093/ppar/prad011","title":"Promoting Healthy Aging: Public Health as a Leader for Reducing Dementia Risk","abstract":"Alzheimer’s disease and related dementias (ADRD) remain a public health priority, with prevalence of Alzheimer’s disease—the most common cause of dementia—among people aged 65 years and older living in the United States expected to grow to nearly 13.8 million people by 2060 (Alzheimer’s Association, 2023). ADRD are not normal aging; they impair memory and cognitive functioning, disrupting daily life. Over time, people with ADRD need increased assistance with basic activities of daily living and must rely on others for support, affecting family, friends, professional caregiving infrastructures, health and long-term care systems, and financial institutions designed to pay for care. In 2023, the formal cost of caring for people with ADRD to the health and long-term care systems in the United States is projected to total $345 billion (Alzheimer’s Association, 2023). Additionally, unpaid caregiving by family and friends was valued at nearly $339.5 billion in 2022 (Alzheimer’s Association, 2023). The lifetime cost of care for a person with Alzheimer’s disease was more than double the cost of care for a person without Alzheimer’s disease (Alzheimer’s Association, 2023). The total formal cost of ADRD care is projected to reach around $1 trillion in 2050 (Alzheimer’s Association, 2023; Zissimopoulos et al., 2014). These estimates do not consider the loss of quality of life for people with ADRD and their caregivers. It is imperative for the health of our systems and our population that public health address modifiable risk factors of ADRD. Not all populations are affected similarly by ADRD. It is estimated that for people aged 65 years and older, the risk of developing Alzheimer’s disease was nearly double for women compared with men (Weinstein et al., 2012). Nearly two-thirds of people living with Alzheimer’s disease in the United States are women (Rajan et al., 2021). Additionally, certain racial and ethnic populations are disproportionately affected, thus experiencing a higher prevalence of Alzheimer’s disease (Matthews et al., 2019). From 2014 to 2050, the overall U.S. population aged ≥65 years is expected to nearly double from 46 million to 88 million (Colby & Ortman, 2015), but some populations will see larger increases than others. From 2012 to 2050, the population growth of older adults is expected to vary widely by race and ethnicity: Native Hawaiian and other Pacific Islander persons (424% increase), Hispanic persons (390%), persons of two or more races (358%), American Indian and Alaska Native persons (274%), Asian American persons (266%), African American persons (172%), and White persons (75%; Ortman et al., 2014). ADRD has shared and unique impacts for different groups and is affected by intersectionality for people within and across groups. Although cognitive decline affects people in all groups, people may experience ADRD differently in terms of access to care and caregiving expectations. Healthy People 2030 defines social determinants of health (SDOH) as the conditions in places where people are born, live, learn, work, play, worship, and age (Office of Disease Prevention and Health Promotion, 2023). SDOH account for half of health outcome variation at the county level and continue to drive health disparities, which may affect risk for ADRD (CDC, 2020). Healthy People 2030 note that SDOH include safe housing, neighborhoods, and transportation; racism, discrimination, and violence within the home or community; education, job opportunities, and income; access to nutritious foods and physical activity opportunities; access to health care; polluted air and water; and language and literacy skills (Office of Disease Prevention and Health Promotion, 2023). Other structural and social determinants of health that have been linked to ADRD include classism, sexism, and homophobia (Adkins-Jackson et al., 2023). Many of these SDOH may be related to cognitive health and risk factors that affect cognitive health, particularly through ","journal":"Public Policy & Aging Report","year":2023,"id":346373,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9505,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1087238,"name":"Kelly O’Brien","orcid":null,"position":1,"is_corresponding":false},{"id":331372,"name":"Lisa C. McGuire","orcid":"0000-0002-8513-2517","position":2,"is_corresponding":false},{"id":1086749,"name":"Matthew Baumgart","orcid":"0000-0001-5205-3188","position":3,"is_corresponding":false},{"id":758612,"name":"Janelle Gore","orcid":"0000-0003-4506-0229","position":4,"is_corresponding":false},{"id":1087239,"name":"Katie Brandt","orcid":null,"position":5,"is_corresponding":false},{"id":68010,"name":"Allan I. Levey","orcid":"0000-0002-3153-502X","position":6,"is_corresponding":false},{"id":1087240,"name":"Helen Lamont","orcid":null,"position":7,"is_corresponding":false},{"id":1086748,"name":"Eva M. J. Jackson","orcid":"0000-0002-4270-0051","position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":null,"created_at":"2026-07-19T01:11:48.317335Z","pmid":"37736523","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}