Report: Alzheimer’s Poses Greater Risk for Older Women than Men

Published in Pawtucket Times, May 11, 2014

According to the Alzheimer’s Association 2014 Alzheimer’s disease Facts and Figures report released last Month, a woman’s estimated lifetime risk of developing Alzheimer’s at age 65 is 1 in 6, compared with nearly 1 in 11 for a man. As real a concern as breast cancer is to women’s health, women age 60 and over are about twice as likely to develop Alzheimer’s over the rest of their lives as they are to develop breast cancer, says the this years’ report.

The Facts and Figures report, an official report of the Alzheimer’s Association, the world’s leading voluntary health organization in Alzheimer’s care, support and research, is a comprehensive compilation of national statistics and information on Alzheimer’s disease and related dementias. The 75 page report conveys the impact of Alzheimer’s on individuals, families, government and the nation’s health care system. Since its 2007 inaugural release, the detailed report has become the most cited source covering the broad spectrum of Alzheimer’s issues.

“Through our role in the development of The Shriver Report: A Woman’s Nation Takes on Alzheimer’s in 2010, in conjunction with Maria Shriver, we know that women are the epicenter of Alzheimer’s disease, representing majority of both people with the disease and Alzheimer’s caregivers. The recently released Alzheimer’s Association Facts and Figures examines the impact of this unbalanced burden,” said Angela Geiger, chief strategy officer of the Alzheimer’s Association. “Well-deserved investments in breast cancer and other leading causes of death such as heart disease, stroke and HIV/AIDS have resulted in substantial decreases in death. Geiger calls for comparable investments in research to reach the same levels of successfully preventing and treating Alzheimer’s as the other leading causes of death.

Adding to women’s Alzheimer’s burden, there are 2.5 times as many women as men providing intensive “on- duty” care 24 hours for someone living with Alzheimer’s disease, says the report, also noting that among caregivers who feel isolated, women are much more likely than men to link isolation with feeling depressed (17 percent of women verse. 2 percent of men).

Also noted in the 2014 Alzheimer’s’ Facts and Figures report released on March 19, 2014, the strain of caring for someone with Alzheimer’s is also felt in the nation’s workplace, too. Among caregivers who have been employed while they were also care giving, 20 percent of women verse. 3 percent of men went from working full-time to working part-time while acting as a caregiver. The report also noted that 18 percent of women versus. 11 percent of men took a leave of absence while 11 percent of women verses 5 percent of men gave up work entirely. Finally, 10 percent of women verse 5 percent of men lost job benefits.

Far Reaching Fiscal Human Impact of Alzheimer’s

Meanwhile the Alzheimer’s Association Facts and Figures report noted that there are more than 5 million Americans living with this devastating disorder, including 3.2 million women and 200,000 people under the age of 65 with younger-onset Alzheimer’s disease (see my May 9, 2013 Commentary). However, Alzheimer’s has far-reaching effects by impacting entire families. Also, it was reported that there are currently 15.5 million caregivers providing 17.7 billion hours of unpaid care throughout the nation, often severely impacting their own health. The physical and emotional impact of dementia care giving resulted in an estimated $9.3 billion in increased healthcare costs for Alzheimer’s caregivers in 2013.

The total national cost of caring for people with Alzheimer’s and other dementias is projected to reach $214 billion this year, says the 2014 Facts and Figures report, not including unpaid care giving by family and friends valued at more than $220 billion. In 2014, the cost to Medicare and Medicaid of caring for those with Alzheimer’s and other dementias will reach a combined $150 billion with Medicare spending nearly $1 in every $5 on people with Alzheimer’s or another dementia.

The Facts and Figures report predicts the cost numbers to soar as the baby boomers continue to enter the age of greatest risk for Alzheimer’s disease. Unless something is done to change the course of the devastating disorder, there could be as many as 16 million Americans living with Alzheimer’s in 2050, at a cost of $1.2 trillion (in current dollars) to the nation. This dramatic rise includes a 500 percent increase in combined Medicare and Medicaid spending and a 400 percent increase in out-of-pocket spending.

The country’s first-ever National Plan to Address Alzheimer’s disease has a goal of preventing and effectively treating Alzheimer’s disease by 2025. Ensuring strong implementation of the National Alzheimer’s Plan, including adequately funding Alzheimer’s research, is the best way to avoid these staggering human and financial tolls.

Lack of Understanding of the Alzheimer’s’ Disease

“Despite being the nation’s biggest health threat, Alzheimer’s disease is still largely misunderstood. Everyone with a brain — male or female, family history or not — is at risk for Alzheimer’s,” said Geiger. “Age is the greatest risk factor for Alzheimer’s, and America is aging. As a nation, we must band together to protect our greatest asset, our brains.”

In 2010, the Alzheimer’s Association in partnership with Maria Shriver and The Shriver Report conducted a groundbreaking poll with the goal of exploring the compelling connection between Alzheimer’s disease and women. Data from that poll were published in The Shriver Report: A Woman’s Nation Takes on Alzheimer’s, which also included essays and reflections that gave personal perspectives to the poll’s numbers. For the first time, that report revealed not only the striking impact of the disease on individual lives, but also its especially strong effects on women — women living with the disease, as well as women who are caregivers, relatives, friends and loved ones of those directly affected.

Realizing the impact Alzheimer’s has on women — and the impact women can have when they work together — the Alzheimer’s Association is launching a national initiative this spring highlighting the power of women in the fight against this disease. To join the movement, visit http://www.alz.org/mybrain.

Maureen Maigret, policy consultant for the Senior Agenda Coalition of Rhode Island and Coordinator of the Rhode Island Older Woman’s Policy Group, concurs with the findings of the Alzheimer’s disease Facts and Figures report. She calls for the education of elected officials on the facts about Alzheimer’s disease and its greater prevalence among women. “It is clearly a tragedy for the women effected with the disease, and can be devastating for their caregivers, mostly daughters, trying to keep them at home,” she says.

Maigret says that Alzheimer’s disease and other dementias at the state level have tremendous implications for this state’s budget. “Data show that in Rhode Island, about three-quarters of persons in nursing homes paid for by Medicaid are older women. An overwhelming number of them have some cognitive decline or dementia, she notes.

“We must do more to ensure that quality long-term care is available for persons with dementia and that robust caregiver support services are in place for the many families dealing with parents, spouses and other loved ones suffering from this disease,” says Maigret, stressing that government funding on research must also be greatly increased in the hopes of finding a cure or ways to prevent its onset.

Director Catherine Taylor, of the state’s Division of Elderly Affairs, believes that the Alzheimer’s’ Association’s released 2014 Facts and Figures report, about a woman’s lifetime risk of developing the devastating cognitive disorder verses breast cancer “really help us understand, in stark terms, what a public health crisis Alzheimer’s disease is, especially for women.”

Taylor notes that the Ocean State is in the implementation phase of its State Plan on Alzheimer’s disease and Related Dementias (see my November 13, 2013 commentary), where state officials are working to improve information, care and supports for every family that confronts Alzheimer’s disease. “The work will continue until there’s a cure,” she says.

“It’s important to note that new research findings also indicates that up to half of the cases of Alzheimer’s disease may be linked to risk factors “within our control,” states Taylor, adding that reducing the risk of developing Alzheimer’s disease may be a simple as eating a healthy diet, staying active, learning new skills, and maintaining maintain strong connections with family, friends and community.

For those concerned about their risk of developing Alzheimer’s disease, join Prevent AD, Rhode Island’s Alzheimer’s disease Prevention Registry. Prevent AD volunteers will learn about prevention studies for which they may be qualified to participate in, as well as the latest news on brain health. For more information, call (401) 444-0789.

The full text of the Alzheimer’s Association 2014 Facts and Figures can be viewed at http://www.alz.org/downloads/facts_figures_2014.pdf. The full report also appeared in the March 2014 issue of Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association (Volume 10, Issue 2).

Herb Weiss, LRI ’12, is a Pawtucket-based writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.

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GAO Study Reports New Trends Push Older Women into Poverty

Published in Pawtucket Times, March 7, 2014

Following on the heels of a Government Accountability Office (GAO) report released last week on March 5, the U.S. Senate Special Committee on Aging held a hearing to put a Congressional spotlight on the alarming increase of older Americans becoming impoverished.  The GAO policy analysts concluded that a growing number of the nation’s elderly, especially women and minorities, could fall into poverty due to lower incomes associated with declining marriage rates and the higher living expenses that individuals bear.

As many as 48 percent of older Americans live in or on the edge of poverty. “While many gains have been made over the years to reduce poverty, too many seniors still can’t afford basic necessities such as food, shelter and medicines,” said Aging Committee Chairman Bill Nelson (D-FL).

Senate Aging Committee Looks at Income Security for Elders

Policy experts told Senate lawmakers on Wednesday that millions of seniors have been spared from abject poverty thanks to federal programs such as Social Security, Medicaid, Medicare, SSI, and food stamps.  The testimony contrasted with the picture painted by House Budget Committee Chairman Paul Ryan (R-WI) earlier this week, who produced a report that labeled the federal government’s five-decade long war on poverty a failure.

Appearing before the U.S. Senate Special Committee on Aging, Patricia Neuman, a senior vice president at the Henry J. Kaiser Family Foundation, stressed the importance of federal anti-poverty programs.

“Between 1966 and 2011, the share of seniors living in poverty fell from more than 28 percent to about 9 percent, with the steepest drop occurring in the decade immediately following the start of the Medicare program,” said Neuman.  “The introduction of Medicare, coupled with Social Security, played a key role in lifting seniors out of poverty.”

Neuman’s remarks were echoed by Joan Entmacher of the National Women’s Law              Center, who credited food stamps, unemployment insurance and Meals on Wheels, along with Social Security, for dramatically reducing poverty among seniors.  The report was highly critical of many programs designed to help the poor and elderly saying they contribute to the “poverty trap.”  Ryan and other House lawmakers have long proposed capping federal spending and turning Medicaid, food stamps and a host of other programs for the poor into state block grants.

Older Women and Pension Benefits

GAO’s Barbara Bovbjerg also brought her views to the Senate Select Committee on Aging hearing. Bovbjerg, Managing Director of Education, Workforce, and Income Security Issues, testified that the trends in marriage, work, and pension benefits have impacted the retirement incomes of older Americans.

Over the last five decades the composition of the American household has changed dramatically, stated Bovbjerg, noting that the proportion of unmarried individuals has increased steadily as couples have chosen to marry at ever-later ages and as divorce rates have risen.  “This is important because Social Security is not only available to workers but also to spouses and survivors.  The decline in marriage and the concomitant rise in single parenthood have been more pronounced among low-income, less educated individuals and some minorities,” she says.

As marriage and workforce patterns changed, so has the nation’s retirement system, adds Bovbjerg.  Since 1990, employers have increasingly turned away from traditional defined benefit pensions to defined contribution plans, such as 401(k)s, she says, this ultimately shifting risk to individual employees and making it more likely they will receive lump sum benefits rather than annuities.

These trends have affected retirement incomes, especially for women and minorities, says Bovbjerg, that is fewer women today receive Social Security spousal and survivor benefits than in the past; most qualify for benefits on their own work history. While this shift may be positive, especially for those women with higher incomes, unmarried elderly women with low levels of lifetime earnings are expected to get less from Social Security than any other demographic group.

According to Bovbjerg, these trends have also affected household savings Married households are more likely to have retirement savings, but the majority of single-headed households have none. Obviously, single parents in particular tend to have fewer resources available to save for retirement during their working years.  With Defined Contribution pension plans becoming the norm for most, and with significant numbers not having these benefits, older Americans may well have to rely increasingly on Social Security as their primary or perhaps only source of retirement income.

Inside the Ocean State

Although the GAO report findings acknowledge a gender-based wage gap that pushes older woman into poverty, Maureen Maigret, policy consultant for the Senior Agenda Coalition of Rhode Island and Coordinator of the Rhode Island Older Woman’s Policy Group, observes that this inequity has been around since the 1970s when she chaired a legislative commission studying pay equity. “Progress in closing the gender wage gap has stagnated since 2000 with the wage ratio hovering around 76.5 percent”, she says.

GAO’s recent findings on gender based differences in poverty rates are consistent with what Maigret found researching the issue for the Women’s Fund of Rhode Island in 2010.  She found that some of the differences in the Ocean State can be attributed to the fact that older women are far less likely to be married than older men.  Almost three times as many older women are widowed when compared to men.

Maigret says that her research revealed that older women in Rhode Island are also less likely to live in family households and almost twice as likely as older men to live alone. Of those older women living alone or with non family members an estimated one out of five was living in poverty. For Rhode Island older women in non-family households living alone, estimated median income in 2009 was 85% that of male non-family householders living alone ($18,375 vs. $21,540).

Finally, Maigret’s report findings indicate that around 11.3 percent of older Rhode Island women were living below the federal poverty level as compared to 7.3 percent of older men in the state. Older women’s average Social Security benefit was almost 30 percent less than that of older men and their earnings were only 58 percent that of older men’s earnings.

             There is no getting around peoples’ fears about outliving their savings becoming a reality if they live long enough,” said AARP Rhode Island State Director Kathleen Connell. “One thing that the latest statistics reveals [including the GAO report] is the critical role Social Security plays when it comes to the ability of many seniors to meet monthly expenses. Social Security keeps about 38 percent of  Rhode Islanders age 65 and older out of poverty, according to a new study from the AARP Public Policy Institute.”

“Nationally, figures jump off the page,” Connell added. “Without Social Security benefits, 44.4 percent of elderly Americans would have incomes below the official poverty line; all else being equal; with Social Security benefits, only 9.1 percent do, she says, noting that these benefits lift 15.3 million elderly Americans — including 9.0 million women — above the poverty line.”

“Just over 50 percent of Rhode Islanders age 65 and older rely on Social Security for at least half of their family income—and nearly 24 percent rely on Social Security for 90 percent of their family income” states Connell.

             “Seniors trying to meet the increasing cost of utilities, prescription drugs and groceries would be desperate without monthly Social Security benefits they worked hard for and planned on. As buying power decreases, protecting Social Security becomes more important than ever. Older people know this; younger people should be aware of it and become more active in saving for retirement. Members of Congress need to remain aware of this as well,” adds Connell.

Kate Brewster, Executive Director of Rhode Island’s The Economic Progress Institute, agrees with Maigret that older women in Rhode Island are already at greater risk of poverty and economic security than older men.   “This [GAO] report highlights several trends that make it increasingly important to improve women’s earnings today so that they are economically secure in retirement.  Among the “policy to-do list” is shrinking the wage gap, eliminating occupational segregation, and raising the minimum wage. State and federal proposals to increase the minimum wage to $10.10 would benefit more women than men, demonstrating the importance of this debate to women’s economic security today and tomorrow.”

House Speaker Gordon Fox is proud that the General Assembly in the last two legislation sessions voted to raise minimum wage to its current level of $8 per hour.  That puts Rhode Island at the same level as neighboring Massachusetts, and we far surpass the federal minimum wage of $7.25, he said.  He says he will carefully consider legislation that has been introduced to once again boost the minimum wage.

“Bridging this gap is not only the right thing to do to ensure that women are on the same financial footing as men, but it also makes economic sense”, says Rep. David N. Cicilline.  At the federal level, the  Democratic Congressman has supported the ‘When Women Succeed, America Succeeds’ economic agenda that would address issues like the minimum wage, paycheck fairness, and access to quality and affordable child care. “Tackling these issues is a step toward helping women save and earn a secure retirement, but we also have to ensure individuals have a safety net so they can live with dignity in their retirement years,” says Cicilline.

With Republican Congressman Ryan in a GOP-controlled House, captured by the Tea Party, leading the charge to dismantle the federal government’s 50 year war on poverty, the casualties of this ideological skirmish if he succeeds will be America’s seniors.  Cutting the safety net that these programs created will make economic insecurity in your older years a very common occurrence.

.             Herb Weiss, LRI ’12, is a Pawtucket writer who covers aging, health care and medical issues.  He can be contacted at hweissri@aol.com.