2025 Alzheimer’s Disease Facts and Figures
Cognitive/Dementia
Understanding Digital Literacy of Persons With Dementia and Their Caregivers: A Scoping Review and an Evolutionary Concept Analysis of Empirical Studies
WHAT THIS MEANS FOR YOU: This scoping review of 22 studies examined digitial literacy for people with dementia and their caregivers across settings and aimed to understand antecedents, attributes, and consequences of digital literacy. Support systems, and individual and sociodemographic characteristics were identified as antecedents; technological and critical thinking skills are attributes; and technology acceptance, psychosocial impacts, and digital equity were consequences. These concepts could guide the development and implementation of digital interventions for people with dementia and their caregivers.
Understanding Digital Literacy of Persons With Dementia and Their Caregivers: A Scoping Review and an Evolutionary Concept Analysis of Empirical Studies
WHAT THIS MEANS FOR YOU: This scoping review of 22 studies examined digitial literacy for people with dementia and their caregivers across settings and aimed to understand antecedents, attributes, and consequences of digital literacy. Support systems, and individual and sociodemographic characteristics were identified as antecedents; technological and critical thinking skills are attributes; and technology acceptance, psychosocial impacts, and digital equity were consequences. These concepts could guide the development and implementation of digital interventions for people with dementia and their caregivers.
Empowering Family Care Partners to Optimize Delirium Care for Persons Living with Dementia
WHAT THIS MEANS FOR YOU: This qualitative study interviewed twelve family care partners from an assisted living community in Virginia and a memory care clinic in Georgia to gain insight into intervention development for delirium superimposed on dementia (DSD). Themes such as education, proactive strategies, and empathetic communication emerged as relevant for improving outcomes for people with DSD. The study highlights the need for interventions targeting education and the mental and emotional needs of care partners.
Empowering Family Care Partners to Optimize Delirium Care for Persons Living with Dementia
WHAT THIS MEANS FOR YOU: This qualitative study interviewed twelve family care partners from an assisted living community in Virginia and a memory care clinic in Georgia to gain insight into intervention development for delirium superimposed on dementia (DSD). Themes such as education, proactive strategies, and empathetic communication emerged as relevant for improving outcomes for people with DSD. The study highlights the need for interventions targeting education and the mental and emotional needs of care partners.
Artificial Intelligence in Assisted Living and Memory Care: Enhancing Care or Increasing Exposure?
WHAT THIS MEANS FOR YOU: This editorial uses data from the CAN Aging Servces Claim Report to examine how artificial intelligence (AI) can alter care, liability, and decision-making in assisted living and memory care settings.
Artificial Intelligence in Assisted Living and Memory Care: Enhancing Care or Increasing Exposure?
WHAT THIS MEANS FOR YOU: This editorial uses data from the CAN Aging Servces Claim Report to examine how artificial intelligence (AI) can alter care, liability, and decision-making in assisted living and memory care settings.
Differing Realities Among Assisted Living Residents With Dementia: Understanding Care Partner Responses
WHAT THIS MEANS FOR YOU: This analysis of 73 residents with dementia and 103 care partners from eight assisted living communities in the Atlanta area examined differing realities of residents with dementia and their care partners' responses. A qualitative analysis revealed most residents experienced confusion, which led to reality management strategies deployed by care partners. These strategies ranged from ignoring or dismissing to correcting, redirecting, or joining the resident in their reality. Factors such as type of confusion and resident/care partner characteristics influenced which strategy was deployed.
Differing Realities Among Assisted Living Residents With Dementia: Understanding Care Partner Responses
WHAT THIS MEANS FOR YOU: This analysis of 73 residents with dementia and 103 care partners from eight assisted living communities in the Atlanta area examined differing realities of residents with dementia and their care partners’ responses. A qualitative analysis revealed most residents experienced confusion, which led to reality management strategies deployed by care partners. These strategies ranged from ignoring or dismissing to correcting, redirecting, or joining the resident in their reality. Factors such as type of confusion and resident/care partner characteristics influenced which strategy was deployed.
Two New Positive Psychosocial Measures for Persons Living with Dementia
WHAT THIS MEANS FOR YOU: Two pilot studies created and tested two new instruments for evaluating wellbeing for people living with dementia, the Living Well Inventory for Dementia (LWI-D) and the Quality of Day Scale (QODS). Seventeen individuals with early-stage dementia tested the LWI-D, and 30 care dyads tested the QODS. Both measures were supported for acceptability and feasibility, with initial support for reliability and validity; further testing of the instruments is recommended.
Two New Positive Psychosocial Measures for Persons Living with Dementia
WHAT THIS MEANS FOR YOU: Two pilot studies created and tested two new instruments for evaluating wellbeing for people living with dementia, the Living Well Inventory for Dementia (LWI-D) and the Quality of Day Scale (QODS). Seventeen individuals with early-stage dementia tested the LWI-D, and 30 care dyads tested the QODS. Both measures were supported for acceptability and feasibility, with initial support for reliability and validity; further testing of the instruments is recommended.
Considerations for Use of the Cornell Scale for Depression in Dementia Among Assisted Living Residents: Factor Analysis Results
WHAT THIS MEANS FOR YOU: This study tested the Cornell Scale for Depression in Dementia (CSDD) with 511 residents from 85 assisted living (AL) communities in three states to understand if it is an appropriate scale for assessing depression in AL residents. Measure-related analysis led to three items being removed from the scale and a five-factor model showed a better fit than the four-factor model, although both showed poor fit. Although a modified CSDD is partially supported for use with this population, future research should explore more appropriate measures for measuring depression in AL residents.
Considerations for Use of the Cornell Scale for Depression in Dementia Among Assisted Living Residents: Factor Analysis Results
WHAT THIS MEANS FOR YOU: This study tested the Cornell Scale for Depression in Dementia (CSDD) with 511 residents from 85 assisted living (AL) communities in three states to understand if it is an appropriate scale for assessing depression in AL residents. Measure-related analysis led to three items being removed from the scale and a five-factor model showed a better fit than the four-factor model, although both showed poor fit. Although a modified CSDD is partially supported for use with this population, future research should explore more appropriate measures for measuring depression in AL residents.
What Happens Behind Closed Doors? Investigating Care Practices in Nursing Home and Assisted Living Memory Care Units
WHAT THIS MEANS FOR YOU: This study investigated care practices in memory care units using data from the 2021 Biennial Survey of Ohio Long-Term Care Facilities. Analysis revealed that about 20% of nursing homes and AL communities had memory care units, and that physician monitoring, staffing, and adoption of practices and policies were similar in both settings, but that psychotropic medications were used more frequently in NH memory care units. This analysis indicates that improving memory care may require different interventions in NH vs. AL settings.
What Happens Behind Closed Doors? Investigating Care Practices in Nursing Home and Assisted Living Memory Care Units
WHAT THIS MEANS FOR YOU: This study investigated care practices in memory care units using data from the 2021 Biennial Survey of Ohio Long-Term Care Facilities. Analysis revealed that about 20% of nursing homes and AL communities had memory care units, and that physician monitoring, staffing, and adoption of practices and policies were similar in both settings, but that psychotropic medications were used more frequently in NH memory care units. This analysis indicates that improving memory care may require different interventions in NH vs. AL settings.
The Impact of Enhanced Group Activity Kits (EGAKs) on Well-being of Persons with Dementia
WHAT THIS MEANS FOR YOU: This study examined 123 people living with dementia (PLwD) from 6 nursing centers and 4 adult day units in Israel to investigate the impact of group activities and whether group activity kits (EGAKs) enhanced activity quality. Use of EGAKs significantly improved resident well-being compared to activities without EGAKs, and participating in no activities at all significantly lowered well-being, supporting possible implementation of EGAKs to improve group activities for residents.
The Impact of Enhanced Group Activity Kits (EGAKs) on Well-being of Persons with Dementia
WHAT THIS MEANS FOR YOU: This study examined 123 people living with dementia (PLwD) from 6 nursing centers and 4 adult day units in Israel to investigate the impact of group activities and whether group activity kits (EGAKs) enhanced activity quality. Use of EGAKs significantly improved resident well-being compared to activities without EGAKs, and participating in no activities at all significantly lowered well-being, supporting possible implementation of EGAKs to improve group activities for residents.
Understanding Urinary Incontinence and Urinary Tract Infections as Key Contributors to Falls in Assisted Living and Memory Care Communities
WHAT THIS MEANS FOR YOU: This editorial examined how urinary incontinence (UI) and urinary tract infections (UTIs) are contributors to falls for assisted living and memory care residents. Impacts on balance, stability, confusion, and fatigue all contribute to the increased risk. Future falls prevention approaches should consider UI and UTIs, structured toileting, and caregiver training to reduce risk.
Understanding Urinary Incontinence and Urinary Tract Infections as Key Contributors to Falls in Assisted Living and Memory Care Communities
WHAT THIS MEANS FOR YOU: This editorial examined how urinary incontinence (UI) and urinary tract infections (UTIs) are contributors to falls for assisted living and memory care residents. Impacts on balance, stability, confusion, and fatigue all contribute to the increased risk. Future falls prevention approaches should consider UI and UTIs, structured toileting, and caregiver training to reduce risk.
Assisted Living, Residential Care, and Memory Care Staffing Level Dynamics: Oregon, 2017-2023
WHAT THIS MEANS FOR YOU: This longitudinal study examined staffing levels, as measured by care hours per resident per day, from 535 long-term care communities in Oregon between 2017-2023. There was an increase in staff immediately after the pandemic and staffing levels were, on average, 28 minutes higher in 2023 than 2017. However, there was significant variation among AL communities' staffing levels, likely due to organizational-level factors like resource allocation, resident case mix, and operational structures.
Assisted Living, Residential Care, and Memory Care Staffing Level Dynamics: Oregon, 2017-2023
WHAT THIS MEANS FOR YOU: This longitudinal study examined staffing levels, as measured by care hours per resident per day, from 535 long-term care communities in Oregon between 2017-2023. There was an increase in staff immediately after the pandemic and staffing levels were, on average, 28 minutes higher in 2023 than 2017. However, there was significant variation among AL communities’ staffing levels, likely due to organizational-level factors like resource allocation, resident case mix, and operational structures.
The Meaningful Engagement Assessment for Residents with Dementia in Assisted Living Settings
WHAT THIS MEANS FOR YOU: This study tested the Meaningful Engagement Assessment (MEA) tool with 31 residents with mild to severe dementia in two assisted living communities. The MEA is designed to create individualized care plannning for residents. With brief training, this pilot study revealed that the tool can feasibly be used by staff to promote meaningful activity for AL residents.
The Meaningful Engagement Assessment for Residents with Dementia in Assisted Living Settings
WHAT THIS MEANS FOR YOU: This study tested the Meaningful Engagement Assessment (MEA) tool with 31 residents with mild to severe dementia in two assisted living communities. The MEA is designed to create individualized care plannning for residents. With brief training, this pilot study revealed that the tool can feasibly be used by staff to promote meaningful activity for AL residents.
Examining Engagement Calendar Deviations in Assisted Living: A Focus on Residents With Dementia
WHAT THIS MEANS FOR YOU: This study used data from 3 AL communities over one year to examine deviations from scheduled activity programming, identify influential factors, and understand the outcomes on residents. The analysis showed general adherence to calendars, but deviations did occur. Staffing, capacity, programming guidance and support, staff attitudes, and unforeseen circumstances all influenced these deviations. Cancellations of programming were more detrimental to resident well-being than substitutions.
Examining Engagement Calendar Deviations in Assisted Living: A Focus on Residents With Dementia
WHAT THIS MEANS FOR YOU: This study used data from 3 AL communities over one year to examine deviations from scheduled activity programming, identify influential factors, and understand the outcomes on residents. The analysis showed general adherence to calendars, but deviations did occur. Staffing, capacity, programming guidance and support, staff attitudes, and unforeseen circumstances all influenced these deviations. Cancellations of programming were more detrimental to resident well-being than substitutions.
The Efficacy of a Mobile-Based Multidomain Program on Cognitive Functioning of Residents in Assisted Living Facilities
WHAT THIS MEANS FOR YOU: This study of 20 AL residents who scored in the range of mild cognitive impairment on the MoCA was designed to test the efficacy of a mobile-based program on cognitive functioning (the Silvia program). The intervention group received the mobile program's lifestyle intervention for 50-60 mins, twice weekly, for 12 weeks. The intervention group showed significant improvement in MoCA scores (23.6 vs. 24.3) while the control group declined (22.0 vs. 21.7).
The Efficacy of a Mobile-Based Multidomain Program on Cognitive Functioning of Residents in Assisted Living Facilities
WHAT THIS MEANS FOR YOU: This study of 20 AL residents who scored in the range of mild cognitive impairment on the MoCA was designed to test the efficacy of a mobile-based program on cognitive functioning (the Silvia program). The intervention group received the mobile program’s lifestyle intervention for 50-60 mins, twice weekly, for 12 weeks. The intervention group showed significant improvement in MoCA scores (23.6 vs. 24.3) while the control group declined (22.0 vs. 21.7).
Staffing Patterns in Nursing Homes, Assisted Living Communities, and Memory Care Units: Variation Across Shifts
WHAT THIS MEANS FOR YOU: This study used observational data from 678 nursing staff at NHs and 432 nursing staff at AL communities in Ohio to assess their direct care nursing staffing patterns. Both NHs and AL communities had better daytime staffing ratios than overnights, although NH staffing ratios were superior to those in AL communities. In AL and NH memory care units, staffing patterns were similar. As acuity increases in AL communities, more nursing staff will likely be required, especially on overnight shifts.
Staffing Patterns in Nursing Homes, Assisted Living Communities, and Memory Care Units: Variation Across Shifts
WHAT THIS MEANS FOR YOU: This study used observational data from 678 nursing staff at NHs and 432 nursing staff at AL communities in Ohio to assess their direct care nursing staffing patterns. Both NHs and AL communities had better daytime staffing ratios than overnights, although NH staffing ratios were superior to those in AL communities. In AL and NH memory care units, staffing patterns were similar. As acuity increases in AL communities, more nursing staff will likely be required, especially on overnight shifts.
The Relationship between Perceived Engagement in Meaningful Activity and Behavioral and Psychological Symptoms of Dementia among Assisted Living Residents
WHAT THIS MEANS FOR YOU: This study of 71 residents with dementia in 5 AL communities assessed the relationship between engagement in meaningful activities and symptoms of dementia. Perceived engagement in meaningful activities was significantly associated with decreased agitation, but not apathy, depression, or irritability.
The Relationship between Perceived Engagement in Meaningful Activity and Behavioral and Psychological Symptoms of Dementia among Assisted Living Residents
WHAT THIS MEANS FOR YOU: This study of 71 residents with dementia in 5 AL communities assessed the relationship between engagement in meaningful activities and symptoms of dementia. Perceived engagement in meaningful activities was significantly associated with decreased agitation, but not apathy, depression, or irritability.
Clinical and Sociodemographic Characteristics of New Residents of Assisted Living: A Nested Case-Control Study
WHAT THIS MEANS FOR YOU: This nested case-control study in Ontario examined differences between community-dwelling and new AL residents to understand transitions to AL communitiess. New residents had higher rates of diagnosed dementia, mood disorders, cardiac arrhythmias, mild cognitive impairment, and falls than community-dwelling peers. New AL residents also had lower odds of having a spousal caregiver than a child caregiver. However, these residents also had higher rates of participation in activities of interest in the last seven days.
Clinical and Sociodemographic Characteristics of New Residents of Assisted Living: A Nested Case-Control Study
WHAT THIS MEANS FOR YOU: This nested case-control study in Ontario examined differences between community-dwelling and new AL residents to understand transitions to AL communitiess. New residents had higher rates of diagnosed dementia, mood disorders, cardiac arrhythmias, mild cognitive impairment, and falls than community-dwelling peers. New AL residents also had lower odds of having a spousal caregiver than a child caregiver. However, these residents also had higher rates of participation in activities of interest in the last seven days.
Health of the Pandemic: Dementia Paid Staff and Unpaid Caregiver Workforce in Congregate Care and Community Settings
WHAT THIS MEANS FOR YOU: This study used questionnaires to capture the experiences of 182 paid staff and 148 unpaid caregivers of people living with dementia living in the community and long-term care settings across the US during theCOVID-19 pandemic. Paid staff were more likely to have been exposed, tested, hospitalized, or been ill with COVID-19 and had more medical and mental health services impacts than unpaid caregivers. Unpaid caregivers showed higher rates of depressive symptom severity and scored lower for hope than paid staff, showing disparate negative impacts from COVID-related stressors.
Health of the Pandemic: Dementia Paid Staff and Unpaid Caregiver Workforce in Congregate Care and Community Settings
WHAT THIS MEANS FOR YOU: This study used questionnaires to capture the experiences of 182 paid staff and 148 unpaid caregivers of people living with dementia living in the community and long-term care settings across the US during theCOVID-19 pandemic. Paid staff were more likely to have been exposed, tested, hospitalized, or been ill with COVID-19 and had more medical and mental health services impacts than unpaid caregivers. Unpaid caregivers showed higher rates of depressive symptom severity and scored lower for hope than paid staff, showing disparate negative impacts from COVID-related stressors.
Differences in Medication Use by Gender and Race in Hospitalized Persons Living with Dementia
WHAT THIS MEANS FOR YOU: This study examined how demographic differences in 352 older adults living at home, in assisted living, and in nursing homes were associated with differing use of medications. Most medication use was significantly higher for white, compared to Black, older adults, except for antihypertensives. Females received more anxiolytics than males, and differences in medication use existed by at-home and residential setting. These treatment differences were notable even when adjusting for age, cognitive status, hospital, delirium, and comorbidities, showing disparities in treatment regimens by race and gender that may need to be addressed.
Differences in Medication Use by Gender and Race in Hospitalized Persons Living with Dementia
WHAT THIS MEANS FOR YOU: This study examined how demographic differences in 352 older adults living at home, in assisted living, and in nursing homes were associated with differing use of medications. Most medication use was significantly higher for white, compared to Black, older adults, except for antihypertensives. Females received more anxiolytics than males, and differences in medication use existed by at-home and residential setting. These treatment differences were notable even when adjusting for age, cognitive status, hospital, delirium, and comorbidities, showing disparities in treatment regimens by race and gender that may need to be addressed.
Aging in Isolation: Sexual Orientation Differences in Navigating Cognitive Decline
WHAT THIS MEANS FOR YOU: This cross-sectional study examined data from 2015-19 to investigate subjective cognitive decline differences among individuals with different sexual orientations. Sexual minorities (e.g., lesbian, gay, bisexual, and queer individuals) were more likely to experience cognitive decline, and sexual minority women were less likely to receive social support than non-sexual minority individuals. Therefore, specific strategies to increase support and services to prevent cognitive decline in sexual minority populations are recommended.
Aging in Isolation: Sexual Orientation Differences in Navigating Cognitive Decline
WHAT THIS MEANS FOR YOU: This cross-sectional study examined data from 2015-19 to investigate subjective cognitive decline differences among individuals with different sexual orientations. Sexual minorities (e.g., lesbian, gay, bisexual, and queer individuals) were more likely to experience cognitive decline, and sexual minority women were less likely to receive social support than non-sexual minority individuals. Therefore, specific strategies to increase support and services to prevent cognitive decline in sexual minority populations are recommended.
Associations between Specialized Dementia Care, COVID-19 and Central Nervous System Medication Use in Assisted Living: A Population-Based Repeated Cross-Sectional Study
WHAT THIS MEANS FOR YOU: This cross-sectional study examined the associations between AL setting (general or memory care), COVID-19 waves, and drug use among residents with dementia in Alberta between 2018-2021. In waves 2-4, antipsychotic drug use increased in all AL communities, but in waves 3 and 4, this was more pronounced in dementia care units. Other drug type uses were similar, although gabapentinoid usage increased for dementia care residents only.
Associations between Specialized Dementia Care, COVID-19 and Central Nervous System Medication Use in Assisted Living: A Population-Based Repeated Cross-Sectional Study
WHAT THIS MEANS FOR YOU: This cross-sectional study examined the associations between AL setting (general or memory care), COVID-19 waves, and drug use among residents with dementia in Alberta between 2018-2021. In waves 2-4, antipsychotic drug use increased in all AL communities, but in waves 3 and 4, this was more pronounced in dementia care units. Other drug type uses were similar, although gabapentinoid usage increased for dementia care residents only.
Adaptive Biking for Assisted Living Memory Care Residents and Staff: A Feasibility Study
WHAT THIS MEANS FOR YOU: This study paired 8 memory care residents and 7 staff members from an AL community to test a biking program as an intervention to improve health and well-being. The pairs completed eight 20-30 minute bike rides over 4 weeks. The rides gave residents and staff a chance to discuss issues around health and well-being. Qualitative results indicate further piloting of the program could be warranted given its acceptability and feasibility.
Adaptive Biking for Assisted Living Memory Care Residents and Staff: A Feasibility Study
WHAT THIS MEANS FOR YOU: This study paired 8 memory care residents and 7 staff members from an AL community to test a biking program as an intervention to improve health and well-being. The pairs completed eight 20-30 minute bike rides over 4 weeks. The rides gave residents and staff a chance to discuss issues around health and well-being. Qualitative results indicate further piloting of the program could be warranted given its acceptability and feasibility.
Treatments for Alzheimer’s and Dementia
Alzheimer’s Association Special Report: Mapping a Better Future for Dementia Care Navigation
