BY ED SUSMAN
LONDON—By the year 2025, researchers predict that 20 states will have the most significant projected gaps in available neurologists to attend to the health needs of people with Alzheimer's and other dementias.
Wyoming, North Dakota, South Carolina, South Dakota, and Oklahoma were identified as the top five states facing the most severe shortages — which they termed "neurology deserts."
The statistics, presented here at the Alzheimer's Association International Conference, were based on population health data recorded by the Centers for Medicare and Medicaid Services. The researchers assumed that 50 percent of dementia cases are undiagnosed, and developed the dementias' Neurology Desert Index, defined as the ratio of neurologists to the dementia population.
For example, they said, in less than a decade, there will be 26,000 people in Nevada who will be diagnosed with Alzheimer's disease and related dementias, leaving about five neurologists for every 10,000 people with dementia, reported Anitha Rao, MD, co-founder of Neurocern, a Palo Alto, CA-based company developing instruments that can train health care professionals and family members in treating dementia patients.
All 20 of the states will have fewer than 10 neurologists per 10,000 people with dementia by 2025, Dr. Rao's study suggests. While most of those states are rural areas, it does include states such as Delaware and Hawaii where there will be eight neurologists for every 10,000 patients with dementia.
"We found a great disparity among states, with a range of five to 57 neurologists for 10,000 persons with dementia," she said.
Altogether, the so-called "desert states" will be inhabited by 2,078,000 people with a projected dementia diagnosis.
In her poster presentation, Dr. Rao said that the diagnosed population with dementia will increase from 5.2 million persons in the United States in 2016 to a projected 7.1 million in 2025 — a 40 percent increase. "Along with the increase of Alzheimer's disease and related dementia patients, there will be more demand placed on health care providers, specifically neurologists who are often consulted to diagnose, treat and manage dementia symptoms and behaviors," she told the Neurology Today Conference Reporter.
"Based on these projections, primary care providers and other licensed clinicians in the dementia neurology 'desert states' may require additional training and education in using clinical support software to facilitate diagnosis and treatment to bridge the lack of neurological providers in these states," she said.
Commenting on the study, Keith Fargo, PhD, director of scientific programs at the Chicago-based Alzheimer's Association, said the greatest risk factor for Alzheimer's disease and other dementias is age. "We can look at this as a challenge but also as an opportunity. In the areas where you don't have these specialists, we need to be doing a better job in training primary care physicians and nurse practitioners and physicians' assistants. They can be taught and trained how to deal with people who have dementia."
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AAIC abstracts are available for viewing at: https://ep70.eventpilot.us/web/planner.php?id=AAIC17
AAIC Abstract 17947: Rao A, Manteau-Rao M, Neelum T, Aggarwal NT, et al. Dementia neurology deserts: What are they and where are they located in the US?