ABSTRACT
INTRODUCTION Managing the chronic health care needs of the elderly, including those with Alzheimer’s disease, will place an enormous burden on the health care system in the United States (1-4). The number of people aged 65 years and older will essentially double between now and 2030 (from approximately 36 million to 72 million), representing an increase from 12% to 20% of the U.S. population (5). The increase in the over-85 age group is noteworthy as well, reaching over 10 million by 2030 (5). Both the relative and absolute increase in the number of elderly people will affect the health care delivery system, including the relationship that exists between the primary care provider and the elderly consumer of health services (1,2). Family physicians, internists, nurse practitioners, and physician assistants will see more and more elderly patients as each wave of aging baby boomers becomes Medicare-eligible. The challenge of their increasing numbers will be matched by the heterogeneity of their health care expectations and needs, ranging from requests for anti-aging therapies and health maintenance on one end of the spectrum to management of frail elders with multiple medical and neuropsychiatric conditions on the other. In particular, the primary care clinician’s ability to diagnose and manage Alzheimer’s disease will become increasingly important for at least two reasons. First, it is prevalent and the number of people with Alzheimer’s disease is expected to increase dramatically. There are now 4.5 million Americans with Alzheimer’s disease, with an expected increase to 13.2 million by 2050 (4). Second, Alzheimer’s disease has a devastating effect on the people suffering from it, on those around them, especially their caregivers, and on society as a whole (1-5).
