Dementia and Older Persons in USA

Dementia has a prevalence of about 13.9% among US adults and is projected to increase in the next three decades to over 20% with the graying of the US population. Increases in prevalence will likely affect populations with historic health disparities such as women and racial minorities. Early diagnosis, coupled with person-centric living arrangements, improves their longevity and quality of life. Dementia care practices in the USA increasingly address the cultural safety of people with dementia who are racial or ethnic minorities. These practices prioritize the capabilities of persons with dementia based on diagnostic evidence, family involvement, and professional accountability by care providers applying the best scientific evidence to guide treatment decisions. Integrated care services that provide consistent feedback on treatment progress provide person-centered care with a high probability of success, building on the strengths of older adults with dementia as well as their family and caregivers. This chapter discusses the legal and professional definitions of dementia, the history of dementia diagnosis and care in the USA, current evidence-based care and intervention programs, the role of culture, policy, and professional issues in dementia care practices, matters for research and other forms of scholarship, and future directions.