Dementia diagnoses in US projected to reach 1 million a year by 2060

Medicaid cuts strain long-term care amid geriatrician and direct-care worker shortages

The studies place the scale of future dementia caseloads beside the constraints facing the US care system. The projections point to more people needing geriatric, home care and nursing-home services at a time when those services face worker shortages and reduced Medicaid funding. The Guardian reported, citing experts, that the growing US dementia population will place increasing strain on a healthcare system already struggling amid cuts by the Trump administration.

Projection and demographic drivers

The Guardian reports that the number of people with dementia in the United States is projected to increase dramatically over the next 25 years. A study in JAMA Neurology projects that the annual incidence of new dementia cases globally will more than double, from 11.4 million in 2023 to 24.7 million in 2050. In the United States, the number of adults diagnosed with dementia each year will increase from 514,000 in 2020 to 1 million by 2060, according to a JAMA study published in 2024.

The Guardian also attributes the projection to population aging: life expectancy has risen in recent decades, so larger numbers of people are entering the age brackets in which dementia is most common. “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 demographic mix is also changing. The Hispanic population in the United States almost doubled between 2000 and 2024, and the Alzheimer’s Association says that group is 1.5 times as likely to develop dementia as white people. People in the field said the country must focus on preventing dementia, discovering new drugs to at least delay its onset and recruiting people for the demanding jobs of providing care for individuals with Alzheimer’s.

Care capacity and compensation

Nursing homes are struggling to meet existing demand. Almost all facilities reported difficulty recruiting new staff, and two-thirds said a primary issue was a lack of interested or qualified candidates, according to a 2024 report from the American Health Care Association, a nursing home lobbying group. About half reported that they had limited new admissions of residents.

The nature of the work is a barrier to recruitment. “We are asking workers to perform what are very physically and emotionally demanding jobs. Helping people bathe, eat, dress and navigate cognitive decline, often for relatively low wages, unpredictable hours, and limited opportunities for advancement,” Weiss said.

Projected labor needs add to those pressures. The country’s need for nursing assistants and home health aides is expected to increase by 48% and 42%, respectively, between 2020 and 2035, according to the Center for American Progress. The median wage in May 2025 for nursing assistants at assisted living facilities and in home healthcare was less than $19 an hour, according to the Bureau of Labor Statistics, and the median wage for home health aides was $17 an hour. “The retention rate of those direct care workers is really, really low because it’s really difficult work. You can’t replace that with AI, and they are not getting adequately reimbursed,” said Regina Shih, a professor of epidemiology at Emory University who studies dementia and caregiving.

The supply of geriatricians has also fallen. There were 10,270 geriatricians in the United States in 2000 and 7,413 in 2022, according to a JAMA report. Geriatrics is among the lowest-paid medical specialties. Weiss tied the decline to compensation and residency interest: “I think it in part is related to compensation,” and “I just think residency interest hasn’t necessarily kept pace with some other fields.”

States have begun trying to change those incentives. In 2025, almost half of states reported offering incentive payments to recruit or retain Medicaid home care workers, according to a KFF survey. South Carolina created a loan forgiveness program for physicians who complete fellowships in geriatrics or geriatric psychiatry and practice in the state for at least five years.

Medicaid financing, access and family burden

Policy adds a separate financing strain on long-term care. The Guardian reported that the Trump administration has significantly cut Medicaid funding, which covers a substantial portion of long-term care. Donald Trump’s One Big Beautiful Bill Act, passed in 2025, included nearly $1 trillion in cuts to Medicaid spending over 10 years. KFF reports that Medicaid pays for more than half of what the country spends on long-term care.

Shih described the access challenge this way: “It’s a serious challenge for expanding access” to the growing number of people with dementia “who are eligible for Medicaid to get services like home care, personal care aid, respite care.”

The strain on the care system also reaches families. “Families will be absorbing enormous emotional and financial costs … because dementia often requires years of increasing supervision and hands-on care, which our healthcare system is not really designed to provide,” Weiss said.

Treatment and prevention

The Food and Drug Administration has approved two drugs, Kisunla and Leqembi, that can modestly slow cognitive decline among some patients with early Alzheimer’s disease. The agency has also recently approved blood tests that can help diagnose the disease and perhaps predict whether people are likely to develop it. Julie Zissimopoulos, a University of Southern California professor and principal investigator of the US Cost of Dementia Project, said: “It may improve people’s lives, and it may do a lot for how we slow decline or think about prevention, but it will be costly” for the healthcare system.

Weiss said a cure for Alzheimer’s does not appear imminent and said it was important not to wait for one. “We have a real opportunity to reduce dementia risk through better cardiovascular health [and] physical activity,” Weiss said. “Scientific breakthroughs matter, but so does building a healthcare system and infrastructure capable of delivering the care that people already need.”