New report reveals dementia workforce shortage in Indiana, lack of awareness of MCI

INDIANA – The Alzheimer’s Association 2022 Alzheimer’s Disease Facts and Figures report found significant shortages in the dementia care workforce, both nationwide and in Indiana.

According to the report, there are currently 66 geriatricians in Indiana. By 2050, the state will need 299 geriatricians to serve 10% of those 65 and older – a 353% increase.

In 2018, there were approximately 43,640 home health and personal care aides in Indiana. To meet the growing demand for these services, by 2028, the state will need 59,990 home health aides – a 37.5% increase. The report states that these aides and other direct care workers often lack adequate dementia training, receive low wages, and experience high turnover rates.

Natalie Sutton

“We have known for some time that the dementia care workforce in the state was not keeping up with the demand, but this report provides further insights into just how critical it is that we address these issues,” said Natalie Sutton, executive director, Alzheimer’s Association Greater Indiana Chapter. “The report comes just days after Governor Eric Holcomb signed legislation to establish – for the first time – minimum dementia training standards for home health aides in Indiana. We’re hopeful that ensuring these professionals receive proper training will reduce burnout in the industry.” 

The report also found stark differences in the number of available dementia specialists in urban vs. rural areas. Nationwide, 44% of primary care physicians (PCPs) in a large city and 54% of those in a suburb reported that there are not enough dementia specialists in their area. In contrast, 63% of PCPs in a small city or town and 71% in a rural area reported a lack of specialists.

“This shortage of specialists creates a significant barrier to an early and accurate diagnosis,” continued Sutton. “That has huge implications for Hoosiers living with dementia and their families. It means they have less time to enroll in potentially life-changing clinical trials, to make important financial and care planning decisions, to access early treatment options, and to receive support services that can help them through their journey. With new treatments on the horizon, a timely diagnosis will be critical to ensuring maximum benefit from these newly approved and future treatments for Alzheimer’s disease.”

Challenges in distinguishing mild cognitive impairment vs. normal aging

An accompanying special report, “More than Normal Aging: Understanding Mild Cognitive Impairment (MCI),” unearthed challenges both doctors and the American public face in understanding and diagnosing mild cognitive impairment (MCI).

MCI is characterized by subtle changes in memory and thinking and is often a precursor to Alzheimer’s disease. It is estimated 12% to 18% of people age 60 or older have MCI. Despite the prevalence among aging Americans, more than 4 in 5 Americans (82%) know very little or are not familiar with MCI. When prompted with a description of MCI, more than half (55%) say MCI sounds like “normal aging.”

Maria Carrillo,

“Mild cognitive impairment is often confused with ‘normal aging,’ but is not part of the typical aging process,” said Maria Carrillo, Ph.D., chief science officer, Alzheimer’s Association. “Distinguishing between cognitive issues resulting from normal aging, those associated with MCI and those related to MCI due to Alzheimer’s disease is critical in helping individuals, their families and physicians prepare for future treatment and care.”

Additional findings illuminate why individuals exhibiting MCI symptoms are reluctant to discuss them with their doctors, who face persistent challenges in the diagnosis of their patients. Among the findings:

● Fewer than half of respondents (40%) said they would see a doctor right away if they experienced MCI symptoms, while the majority (60%) would wait or not see a doctor at all.

● Nearly 8 in 10 respondents (78%) expressed concerns about seeing a doctor for symptoms of MCI, citing reasons such as fear of receiving an incorrect diagnosis (28%); learning they have a serious problem (27%); fear of receiving an unnecessary treatment (26%); or believing symptoms will resolve in time (23%).

● 75% of PCPs say they are on the front lines of providing care for patients with MCI. However, just two-thirds feel comfortable answering patient questions related to MCI (65%) and/or discussing how MCI may be related to Alzheimer’s disease (60%).

● PCPs are committed to learning more about MCI due to Alzheimer’s disease and see clear benefits of making a specific diagnosis (90%). Yet, more than three-quarters of PCPs (77%) report MCI due to Alzheimer’s being difficult to diagnose, and a half (51%) do not usually feel comfortable diagnosing it.

Future outlook and opportunities

Despite the devastating toll Alzheimer’s disease continues to have on individuals and families across the country, both patients and PCPs express optimism that new treatments to combat Alzheimer’s disease are on the horizon. The surveys found more than 7 in 10 Americans (73%) expect new treatments to delay the progression of Alzheimer’s disease will be available within the next decade. More than one-half of Americans believe there will be new treatments to stop progression (60%) and to prevent (53%) Alzheimer’s disease. Among PCPs, 82% expect there will be new treatments to delay the progression of Alzheimer’s disease within the next decade. More than half of PCPs (54%) anticipate there will be treatments to stop disease progression and 42% believe there will be treatments to prevent Alzheimer’s disease.

The last two decades have marked an increase in the development of a new class of medicines that target the underlying biology and aim to slow the progression of Alzheimer’s disease. As of February 2022, there are 104 disease-modifying treatments being evaluated in clinical trials or at various stages of regulatory approval. These potential therapies are aimed at slowing the progression of MCI due to Alzheimer’s disease and mild Alzheimer’s dementia, according to the Alzheimer’s Association.

Local education programs offered

The Alzheimer’s Association Greater Indiana Chapter is hosting a two-part virtual education series titled “Matter of Fact” on Tues., March 29, and Thurs., March 31 from noon until 1 p.m. ET. The series will delve into the latest statistics in the Facts and Figures report, as well as describe the 10 warning signs of Alzheimer’s and the difference between dementia and normal aging. There will also be information on the latest dementia research. The programs are free, and registration is available at