Primary Care Physicians on the Front Lines of Diagnosing and Providing Alzheimer’s and Dementia Care: Half Say Medical Profession Not Prepared to Meet Expected Increase in Demands
A new survey of primary care physicians appearing in the Alzheimer’s Association 2020 Alzheimer’s Disease Facts and Figures report finds 9 in 10 primary care physicians (87%) expect to see an increase in people living with dementia during the next five years, but half (50%) say the medical profession is not prepared to meet this demand. The new report estimates there are currently more than 5 million Americans 65+ living with Alzheimer’s – a number expected to nearly triple by 2050.
The 2020 Facts and Figures report provides and in-depth look at the latest national and state-specific statistics on Alzheimer’s prevalence, incidence, mortality, costs and impact on caregivers. New disease-related statistics for North Carolina revealed the following:
- Number of North Carolina residents aged 65 and older living with Alzheimer’s: 180,000
- Estimated number of North Carolina residents living with Alzheimer’s in 2025: 210,000
- Percentage change: 16.7% increase
- Statewide deaths from Alzheimer’s disease (2018): 4,495
- Number of North Carolina residents serving as unpaid family caregivers: 479,000
- Total hours of unpaid care provided: 545 million hours
- Total value of unpaid care: $7.15 billion
“The new Facts and Figures report shows that Alzheimer’s disease and other dementias continue to be a significant burden for too many North Carolina families,” said Katherine L. Lambert, CEO of the Western Carolina Chapter. “We must continue to work aggressively to advance new treatments that can stop or slow the progression of Alzheimer’s, while also continuing to provide care and support services to help all those affected.”
In addition to new state disease-related data, for the first time, the Facts and Figures accompanying special report, “On the Front Lines: Primary Care Physicians and Alzheimer’s Care in America,” examines the experiences, exposure, training and attitudes related to dementia care among primary care physicians (PCPs), recent medical school graduates, and recent residency program graduates, now in primary care practice.
The report found that 82% PCPs say they are on the front lines of providing dementia care, but not all are confident in their care for patients with Alzheimer’s and other dementias.
- Nearly 2 in 5 (39%) report they are “never” or only “sometimes comfortable” making a diagnosis of Alzheimer’s or other dementias.
- Nearly one-third (27%) report they are “never” or only “sometimes comfortable” answering patient questions about Alzheimer’s or other dementias.
- 22% of all PCPs had no residency training in dementia diagnosis and care. Of the 78% who did undergo training, 65% reported that the amount was “very little.”
Ensuring PCPs are adequately prepared to deliver dementia care is critically important given a shortage of dementia care specialists. A state-by-state analysis in the report examines the number of geriatricians needed to meet future care needs of seniors living with dementia in 2050. It revealed severe shortages in several states, with 14 states needing to increase the number of practicing geriatricians at least five-fold to meet the projected care needs of people living with dementia in 2050.
In 2019, there were 159 practicing geriatricians in North Carolina, according to the report. It is estimated that 535 are needed to meet the meet the future dementia care needs of North Carolina seniors in 2050 – a 1,606% increase.
While one-third of PCPs (32%) say they refer dementia patients to specialists at least once a month, more than half (55%) say there are not enough dementia care specialists in their area to meet patient demand, a problem more common in rural areas. According to the report, 44% of PCPs practicing in large cities and 54% in suburbs reported there are not enough specialists in their area, while 63% practicing in small cities or towns and 71% in rural areas noted this challenge.
“With the number of North Carolina residents living with Alzheimer’s and other dementias increasing, it’s critically important that we take steps to ensure primary care physicians and other providers across the state are fully prepared to meet current and future dementia care needs,” said Lisa Roberts, executive director of the Eastern North Carolina Chapter. “The Alzheimer’s Association in North Carolina is committed to helping primary care physicians and all who provide care to the 180,000 North Carolina residents living with Alzheimer’s and other dementias.”
PCPs participating in the survey report that 4 in 10 of their current patients are age 65 and older, and, on average, 13% of those patients have been diagnosed with dementia. The majority of PCPs (53%) say they are answering questions related to Alzheimer’s or other dementias every few days or more. More than 9 in 10 PCPs (92%) believe patients and caregivers expect them to know the latest thinking and best practices around dementia care.
The Facts and Figures report reveals nearly all PCPs (99%) say it is important to stay current on new developments in diagnosis and care for Alzheimer’s and other dementias. Areas cited as most important by PCPs include: management and treatment (83%), screening and testing (69%), diagnosis (64%), prevention (49%), family support (49%), managing dementia alongside other conditions (46%) and signs and symptoms (44%).
The Alzheimer’s Association 2020 Alzheimer’s Disease Facts and Figures report is a comprehensive compilation of national statistics and information on Alzheimer’s disease and related dementias. The report conveys the impact of Alzheimer’s on individuals, families, government and the nation’s health care system. Since its 2007 inaugural release, the report has become the preeminent source covering the broad spectrum of Alzheimer’s issues. The Facts and Figures report is an official publication of the Alzheimer’s Association.