US Dementia Cases Set to Climb Sharply by 2050 as Care System Faces Strain

The number of people living with dementia in the United States is expected to rise steeply over the next 25 years, putting added pressure on a healthcare system that experts say is already stretched, particularly after funding cuts by the Trump administration.

A new study in Jama Neurology estimates that annual new dementia cases worldwide will climb from 11.4m in 2023 to 24.7m in 2050. For the US, a Jama study published in 2024 projected that the number of adults diagnosed each year will grow from 514,000 in 2020 to 1m by 2060.

Researchers point to longer life expectancy as a main driver, since more people are reaching the ages at which dementia is most common. The growth of the Hispanic population in the US is another factor. That population nearly doubled between 2000 and 2024, and the Alzheimer's Association says Hispanic people are 1.5 times as likely as white people to develop dementia. "Even if you reduce the risk of dementia, just the sheer number of adults who are entering the ages where dementia is most common will increase the number of people living with and who develop dementia," said Jordan Weiss, an assistant professor at the Optimal Aging Institute at NYU Langone.

The workforce meant to care for these patients is already thin. A 2024 report from the American Health Care Association, a nursing home lobbying group, found that almost all facilities had trouble recruiting staff, and two-thirds cited a lack of interested or qualified candidates as a primary issue. About half said they had limited new admissions.

Demand for nursing assistants and home health aides is expected to rise by 48% and 42% respectively between 2020 and 2035, according to the Center for American Progress. Yet the Bureau of Labor Statistics reported that the median wage in May 2025 for nursing assistants at assisted living facilities and in home healthcare was under $19 an hour, and $17 an hour for home health aides. Regina Shih, a professor of epidemiology at Emory University, said retention of direct care workers is very low because the work is difficult, and that it cannot be replaced with AI.

The supply of geriatric doctors has also shrunk. A Jama report found the US had 10,270 geriatricians in 2000 but only 7,413 in 2022. It is among the lowest-paid medical specialties, and Weiss said compensation is part of the reason.

Some states are responding. Almost half reported offering incentive payments in 2025 to recruit or retain Medicaid home care workers, according to a KFF survey, and South Carolina created a loan forgiveness program for physicians who complete geriatrics or geriatric psychiatry fellowships and practice in the state for at least five years. But states now must also deal with the One Big Beautiful Bill Act, passed in 2025, which included nearly $1tn in Medicaid cuts over 10 years. Medicaid pays for more than half of US long-term care spending, KFF reports.

There is some encouraging news. The Food and Drug Administration has approved two drugs, Kisunla and Leqembi, that can modestly slow cognitive decline in some patients with early Alzheimer's disease, along with blood tests that can help diagnose the illness and possibly predict who may develop it. Julie Zissimopoulos, a University of Southern California professor, said such advances may improve lives but "will be costly" for the healthcare system.

With no cure in sight, Weiss urged against simply waiting for one. He said there is a real opportunity to lower dementia risk through better cardiovascular health and physical activity, adding that breakthroughs matter, but so does building a system "capable of delivering the care that people already need."