Published online by Cambridge University Press: 10 January 2005
There is a direct relationship between years lived beyond age 65 and the number of individuals diagnosed with dementia, primarily Alzheimer's disease (AD). The occurrence of AD has no socioeconomic, geographical, or ethnic limitations. The problem is worldwide. Its magnitude is demonstrated by the following facts: (a) approximately 6% to 8% of persons 65 years or older have AD, and the prevalence of the disease doubles each 5 years after 60 years of age; (b) 30% of 85-year-old individuals can be expected to have the disease; (c) AD affects an estimated 4 million people in the United States, and is expected to affect approximately 14 million Americans within the next few decades; (d) AD patients average 6 to 10 years of comprehensive treatment from symptom onset to death; (e) AD is the fourth leading cause of mortality among elderly Americans, more than 100,000 each year; (f) caregiver attempts at management of the behavioral and psychological symptoms of AD result in up to 50% developing significant psychological distress themselves; and (g) the cost for the management of AD patients is estimated to be between US $80 billion and US $120 billion annually. Primary care is essential for the appropriate diagnosis and treatment of the complex set of behavioral and psychological symptoms of dementia (BPSD) associated with AD.