Alzheimer's disease mortality and lost productivity among adults aged 40-64 years, 1999-2008

Background: Worldwide, Alzheimer's disease (AD) affects an estimated 35.6 million people. By 2050, the prevalence of this disease is expected to triple. Currently it is estimated that annual costs associated with treatment and caregiving total to more than $604 billion (U.S. dollars). While AD most commonly affects individuals aged 65 years and older, few studies have quantified the burden of AD (mortality, morbidity, and lost productivity) among adults aged 40-64 years. To address this gap, we examined mortality and lost productivity trends for this age group in the United States, using 1999-2008 U.S. multiple-cause-of-death data.

Methods: Number of cases; crude, age-specific, and age-adjusted mortality rates; and AD-related productivity losses were estimated. The disease burden was compared to those of other chronic conditions.

Results: From 1999-2008, a total of 7,039 AD-related deaths were identified for the 40-64 age group in the United States. The age-adjusted mortality rate remained relatively static: 0.75 per 100,000 population in 1999 (95% CI: 0.69-0.80) to 0.71 per 100,000 population in 2008 (95% CI: 0.66-0.76). Differences in mortality trends were observed by age, sex, race and ethnicity, and place of death. AD-attributable productivity losses were nearly $3.7 billion.

Conclusion: Despite common perceptions that this disease is rare among younger adults (<65), the AD burden in the 40-64 age group was not trivial during 1999-2008. These findings have policy implications in social service allocation, healthcare planning, caregiving, and end-of-life care.