There’s a reason Miami-Dade ranks No. 1 in the country in Alzheimer’s disease for seniors
Miami-Dade County leads the nation in the percentage of people 65 and older who have Alzheimer’s disease, as the memory-robbing condition has higher rates among Hispanic and Black populations, which make up more than 80 percent of the county’s population, according to recently published research.
Florida, which in 2021 had the second-highest senior population in the country after California, ranked among the top four states in Alzheimer’s rates. Nationally, about 1 in 9 people age 65 and older (10.7%) has Alzheimer’s, according to the Alzheimer’s Association.
Researchers from Rush University Medical Center in Chicago analyzed cognitive data from the Chicago Health and Aging Project, which looked at chronic health problems in people 65 and older from 1993 to 2012. They combined that with 2020 age, gender and racial/ethnic data from the National Center for Health Statistics to determine the prevalence of Alzheimer’s in adults 65 years and older in all U.S. states and counties.
Key findings
Some of the key findings of the study, published Monday in Alzheimer’s & Dementia, the Journal of the Alzheimer’s Association, include:
▪ The East and Southeastern regions of the United States have the highest rates of Alzheimer’s disease among people 65 and over with Maryland (12.9%), New York (12.7%), Mississippi (12.5%), and Florida (12.5%) leading the way. Maryland has the highest prevalence because of its older population combined with a high number of Black residents, according to the study. Blacks are twice as likely as whites to have Alzheimer’s or another form of dementia, according to the Alzheimer’s Association.
▪ California, Florida and Texas are estimated to have the highest number of people living with Alzheimer’s disease primarily because they are the top three U.S. states with senior populations. California has an estimated 719,700 people 65 and over with Alzheimer’s, followed by Florida with 579,900 and Texas with 459,300.
All three states have large Hispanic/Latino populations; Hispanics are 1.5 times more likely than non-Hispanic whites to be diagnosed with Alzheimer’s, according to the Alzheimer’s Association.
Heart disease and diabetes, which are prevalent in Hispanic and Black populations, may account for some of the racial and ethnic disparities in Alzheimer’s, according to the Centers for Disease Control and Prevention, along with higher rates of poverty, lower levels of education and obstacles to getting medical care.
▪ Among counties with more than 10,000 people 65 and older, Miami-Dade County in Florida, Baltimore City in Maryland and Bronx County in New York had the highest rates of Alzheimer’s (16.6%). Nationally, the rate is 10.7 percent.
Each of the counties have large populations of Hispanics and/or Blacks, two groups disproportionately at risk for Alzheimer’s. In Miami-Dade, Hispanics made up 69 percent of the county’s population in July 2022, followed by Blacks at 17 percent and non-whites at 14 percent, according to the latest U.S. Census numbers.
Additionally, people 85 and older represent about 14% of Miami-Dade County’s population, the study found. As you age, your risk of Alzheimer’s increases. Of the estimated 6.7 million Americans living with Alzheimer’s in 2023, 73 percent — or about 3 in 4 — are 75 or older, according to the Alzheimer’s Association.
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Poverty, lack of medical care leads to greater Alzheimer’s risk
Dr. Rosie Curiel Cid, an associate professor at the Center for Cognitive Neuroscience and Aging at the University of Miami Miller School of Medicine who was not involved with the study, wasn’t surprised by Miami-Dade or Florida’s high rankings.
Florida is a popular state for retired seniors and has cities like Miami and Hialeah that are home to large Hispanic and Black populations, groups that not only have higher risk levels but often have a more advanced stage of the disease when diagnosed.
A 2022 UM study found that Blacks and Hispanics are more at risk for developing Alzheimer’s due to socioeconomic factors such as income, and lack of access to health insurance and medical care. Poverty is the underlying determinant, researchers found.
“Because poor people have less access to health care, education, healthy food, and other resources throughout their lives, they’re more likely to develop obesity, frailty, diabetes, hypertension, high cholesterol, and other vascular risk factors that boost their chances for Alzheimer’s in their later years,” reads a UM Miller School of Medicine article about the 2022 study.
However, she said the data reiterates how critical it is for public health officials and lawmakers to improve access to diagnosis, care and education for Alzheimer patients, their families and caregivers.
“We just don’t have the infrastructure to take care of people who are aging and who are going to be unable to care for themselves because of Alzheimer’s disease,” said Cid, referring to the country as a whole.
In Florida, the state budget, which went into effect July 1, included an additional $12.5 million to expand the state’s 17 Memory Disorder Clinics and the Alzheimer’s Disease Initiative, which helps residents and caregivers affected by the disease.
Keith Gibson, state director for diversity, equity and inclusion for the Alzheimer’s Association, hopes the research will serve as a “guideline” for public health officials to “pinpoint the areas of high risk” in the country, with more region-specific studies and strategies for Alzheimer patients.
“This really paints the pathway for why we need to really look at how we can really create a path of access for care and treatment for all forms of society,” said Gibson.
Two of the study’s researchers were funded by the Alzheimer’s Association, along with grants from the National Institutes of Health.
Alzheimer’s by the numbers
▪ Alzheimer’s disease, which destroys neurons in the brain connected to memory, language, reasoning and social behavior, is the most common cause of dementia and primarily impacts people 65 and older. Younger people can get Alzheimer’s too, but it’s less common. Certain factors, such as age, genetics and family history, can increase a person’s risk of Alzheimer’s.
▪ Currently, there are more than 6 million people living with Alzheimer’s in the country, a count that’s forecast to balloon to nearly 14 million by 2060, according to the CDC.
▪ Women are nearly twice as likely to be diagnosed with Alzheimer’s than men, primarily because women live longer, the CDC says.
▪ Alzheimer’s disease is one of the top 10 leading causes of U.S. deaths, according to the CDC.
Where are we in the fight against Alzheimer’s
One recent milestone: Federal regulators earlier this month granted full approval to Lecanemab, sold under the brand name Leqembi, a drug that can be used to help slow the disease progression in people with early Alzheimer’s.
While not a cure, Alzheimer experts say the treatment, along with other Alzheimer treatments that are in the works, is a sign that Alzheimer’s research has entered a new era.
Top 10 counties with highest Alzheimer’s prevalence
Here are the Top 10 U.S. counties with at least 10,000 people 65 and older that have the highest Alzheimer prevalence, according to the study:
▪ Miami-Dade County, Florida
▪ Baltimore City, Maryland*
▪ Bronx County, New York
▪ Prince George’s County, Maryland
▪ Hinds County, Mississippi
▪ Orleans Parish, Louisiana
▪ Dougherty County, Georgia
▪ Orangeburg County, South Carolina
▪ Imperial County, California
▪ El Paso County, Texas
* Baltimore City is considered a county in Maryland
What about Broward, Palm Beach and the Keys?
Broward ranked No. 35 at 13.9% and Palm Beach County ranked No. 39 at 13.8%, according to the Alzheimer’s Association. Monroe County, which has a 10.6% prevalence, didn’t make the list because it has 1,900 people 65 and older, fewer than the 10,000 threshold, the association said.
Top 10 states with highest number of people living with Alzheimer’s
▪ Maryland
▪ New York
▪ Mississippi
▪ Florida
▪ Louisiana
▪ New Jersey
▪ California
▪ Illinois
▪ Georgia
▪ Connecticut
