Annual dementia diagnoses worldwide are expected to more than double over the next quarter century, rising from 11.4 million in 2023 to 24.7 million in 2050, according to a new study in JAMA Neurology reported by The Guardian. In the United States, the paper points to a parallel trajectory: a separate JAMA study published in 2024 projected that yearly dementia diagnoses among American adults will grow from 514,000 in 2020 to 1 million by 2060. The Guardian reports that experts warn the increase will pressure a healthcare system that is already short of the workers and funding needed to care for these patients.
Why it matters
Dementia is a condition that typically requires years of supervision and hands-on assistance, and the people who study it say the country's care infrastructure was not built for the volume of patients now expected. Jordan Weiss, an assistant professor at the Optimal Aging Institute at NYU Langone, told The Guardian that families will bear large emotional and financial burdens because the system is not designed to supply the kind of long-term help dementia demands. The projected rise arrives as nursing homes report staffing problems, the number of geriatric physicians has fallen, and federal Medicaid funding has been cut.
What is driving the increase
Two demographic forces sit behind the projections, according to the reporting. Life expectancy has risen in recent decades, so more people are reaching the ages when dementia is most common. In the US, the Hispanic population nearly doubled between 2000 and 2024, and the Alzheimer's Association notes that this group is 1.5 times as likely as white people to develop dementia.
Weiss told The Guardian that even successful efforts to lower individual risk would not offset the effect of population size. The sheer number of adults entering the highest-risk age brackets, he said, will raise the count of people living with dementia and of those newly diagnosed.
A care workforce under strain
The staffing picture is already difficult. A 2024 report from the American Health Care Association, a nursing home lobbying group, found that nearly all facilities had trouble hiring new staff, about two-thirds cited a shortage of interested or qualified applicants as a main problem, and roughly half had capped new admissions, The Guardian reports.
Demand for nursing assistants and home health aides is expected to grow 48% and 42% respectively between 2020 and 2035, according to the Center for American Progress. Pay remains low: Bureau of Labor Statistics figures cited by The Guardian put the median wage in May 2025 at under $19 an hour for nursing assistants in assisted living and home healthcare, and at $17 an hour for home health aides.
Regina Shih, a professor of epidemiology at Emory University who studies dementia and caregiving, told The Guardian that retention among direct care workers is very low because the work is hard and reimbursement is inadequate. She added that artificial intelligence cannot substitute for that labor.
The supply of geriatric doctors has moved in the opposite direction. The US had 10,270 geriatricians in 2000 and 7,413 in 2022, according to a JAMA report cited by The Guardian, making it one of the lowest-paid medical specialties. Weiss attributed part of the decline to compensation and said residency interest has not kept pace with other fields.
Some states are responding. In 2025, nearly half reported offering incentive payments to recruit or retain Medicaid home care workers, according to a KFF survey. South Carolina set up loan forgiveness for physicians who finish geriatrics or geriatric psychiatry fellowships and then practice in the state for at least five years.
Medicaid cuts and new treatments
Those state efforts now overlap with the One Big Beautiful Bill Act, passed in 2025, which included close to $1 trillion in Medicaid reductions over ten years, The Guardian reports. KFF data cited in the article show Medicaid covers more than half of US long-term care spending. Shih told The Guardian that the cuts pose a serious obstacle to expanding access to home care, personal care assistance and respite services for the growing number of people with dementia who qualify for Medicaid.
There has been progress on the medical side. The Food and Drug Administration has approved two drugs, Kisunla and Leqembi, that can modestly slow cognitive decline in some patients with early Alzheimer's disease, and it has cleared blood tests that can aid diagnosis and may help estimate a person's likelihood of developing the disease.
Julie Zissimopoulos, a University of Southern California professor and principal investigator of the US Cost of Dementia Project, told The Guardian that these advances may improve lives and change how decline is slowed or prevented, but that they will be expensive for the healthcare system.
With no cure in sight, Weiss argued against waiting for one. He pointed to better cardiovascular health and physical activity as ways to lower risk, and said that alongside scientific progress the country needs a care system and infrastructure able to deliver the help patients already require.
Watch whether states expand recruitment incentives and loan forgiveness programs as Medicaid funding shrinks, and whether uptake of the newly approved drugs and diagnostic tests adds further cost pressure to long-term care budgets.
