Texans are aging: Is the state ready to battle Alzheimer's disease?

Nearly 12% of Texas seniors in 2020 were living with Alzheimer's disease.

That's an estimated 459,300 people, according to the Alzheimer's Association's latest Facts and Figures report on the progressive disease that slowly wipes memory and cognitive function.

Alzheimer's disease is the most common cause of dementia, accounting for up to 80% of cases. The disease causes nerve cells in the brain, or neurons, to die and brain tissue to shrink. Symptoms range from difficulty remembering conversations and names to depression, confusion and behavioral changes. The late stages of the disease—which has no cure—commonly feature difficulty walking, speaking and swallowing.

A number of studies have shown that the incidence rate of Alzheimer's and other dementias has decreased in recent decades, largely due to increased prevention and treatment of common risk factors like high blood pressure and greater access to education. But the total number of Americans living with the disease is expected to rise as the U.S. population ages.

By 2030, all members of the baby boom generation will be 65 or older. The number of seniors in the U.S. is expected to jump to 82 million by 2050, up from 58 million in 2022. Already, an estimated 6.9 million Americans aged 65 and older—or one in nine seniors—are living with Alzheimer's according to the report.

"It's a health crisis," said Mark Denzin, executive director of the Dallas and Northeast Texas chapter of the Alzheimer's Association. "It's something that we've been aware of, but I think what jumped out to me was the impact it's having on the family."

Family caregivers often shoulder the economic, mental and physical burden of the disease. Texas' more than 1 million caregivers worked 1.53 billion unpaid hours in 2023, which carried a value of $23.94 billion. More than a quarter of Texas caregivers have depression, while nearly 60% live with a chronic health condition themselves.

The state will need to rapidly staff up to keep pace with the needs of the aging population. Texas had 333 geriatricians, or primary care doctors who treat older adults, as of 2021, a number that will need to increase by about 277% by 2050. Home health and personal care aids, of whom there were nearly 321,000 in 2020, will have to grow by 30.5% to meet the number of Alzheimer's patients expected by 2030.

U.S. officials granted full approval to the Alzheimer's drug Leqembi last year, garnering excitement in the Alzheimer's community about potential relief. Nearly one year later, the drug has been plagued by logistical issues and dissatisfaction among neurologists.

While common, Alzheimer's is not a normal part of the aging process, and some people are more at risk of developing the disease than others. Age, genetics, family history, sleep and cardiovascular health can all play a role in whether someone will get Alzheimer's. Education and social engagement may reduce the risk of Alzheimer's and other dementias.

Black and Hispanic older adults are more likely than non-Hispanic white older adults to develop the disease, although they have historically been left out of Alzheimer's research.

El Paso County, which has the 10th highest Alzheimer's prevalence nationwide, is predominantly Hispanic or Latino, according to U.S. Census Bureau data. An estimated 15% of seniors in the county have the disease. Miami-Dade County, Florida, Baltimore County, Maryland, and Bronx County, New York tied for the highest prevalence rate, with 16.6% of seniors in each county having the disease.

Where you live matters when it comes to Alzheimer's, said Sid O'Bryant, executive director of the Institute for Translational Research at the University of North Texas Health Science Center. A county-by-county database of Alzheimer's prevalence published last year shows that counties along the Texas-Mexico border tend to fare worse than other parts of the state.

Environmental factors like air and noise pollution and living in high-stress areas can have major impacts on aging, although they are often overlooked.

"Many people think about how the environment and stressors play a role in heart health, but they don't think about it in terms of brain health," O'Bryant said.

O'Bryant is currently leading one of the largest-ever studies of Alzheimer's that looks at the biology of the disease across the nation's three largest racial and ethnic groups: African American, Mexican American and non-Hispanic white. Researchers are paying particular attention to how social and economic pressures influence Alzheimer's development in participants.

Both the 2023 and 2024 Facts and Figures reports by the Alzheimer's Association estimate Alzheimer's prevalence for 2020. The 2023 report estimated about 400,000 senior Texans were living with the disease.

The 2024 report based the statewide total in 2020 on an updated study published by researchers from Rush University medical Center in Chicago.

"Each year, the Association seeks to make estimates using the best available data," said Christina Wezwick, Alzheimer's Association public relations director for Texas. "In some cases, more recent data can cause state numbers to fluctuate up or down."

2024 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.