By Salma El-Sakka
The number of people with dementia in the United States is projected to increase dramatically over the next 25 years, placing growing strain on a healthcare system already struggling with staffing shortages and funding cuts, according to a new study published in Jama Neurology.
Projected surge in cases
Global annual incidence of new dementia cases is expected to more than double, from 11.4 million in 2023 to 24.7 million in 2050. In the US, annual diagnoses are projected to rise from 514,000 in 2020 to 1 million by 2060, based on a 2024 Jama study. The increase is driven by longer life expectancy, which pushes more people into age brackets where dementia is most common, and by demographic shifts: the Hispanic population nearly doubled between 2000 and 2024 and is 1.5 times as likely to develop dementia as white populations, according to the Alzheimer’s Association.
Strain on healthcare system
The US already lacks enough geriatric specialists, home-care workers, and nursing-home staff. Medicaid, which covers more than half of national long-term-care spending, faces nearly $1 trillion in cuts over 10 years under the One Big Beautiful Bill Act passed in 2025. Experts warn that families will absorb enormous emotional and financial costs because the healthcare system is not designed to provide years of increasing supervision and hands-on care.
Workforce shortages
Nursing homes report widespread difficulty recruiting staff; two-thirds cite a lack of interested or qualified candidates, and about half have limited new admissions. Demand for nursing assistants and home health aides is expected to grow 48% and 42% respectively between 2020 and 2035, yet median wages in 2025 were below $19 an hour for nursing assistants and $17 for home health aides. The number of geriatricians has fallen from 10,270 in 2000 to 7,413 in 2022, partly due to low compensation.
Policy responses and challenges
Some states have introduced incentive payments for Medicaid home-care workers and loan forgiveness for geriatric fellows, but the federal Medicaid cuts complicate expansion of services such as home care, personal care aides, and respite care.
Treatment advances
The FDA has approved two drugs, Kisunla and Leqembi, that modestly slow cognitive decline in early Alzheimer’s, and new blood tests may aid diagnosis and prediction. However, experts caution that these treatments will be costly and a cure is not imminent, emphasizing the need for prevention through cardiovascular health and physical activity alongside building care infrastructure.
