Roundup: New Dementia Cases in U.S. Could Double by 2060; and More News

New Study Projects Alarming Rise in Dementia Risk for Those Over 55, With Cases Doubling by 2060

A new study has found that the lifetime risk of developing dementia for U.S. adults over the age of 55 is 42 percent— more than double what previous studies have reported.  The researchers project an estimated half a million new cases of dementia this year -- with estimates suggesting that number could surge to a million new cases annually by 2060.

The study, published in Nature Medicine, sheds light on the growing burden dementia could place on the U.S. healthcare system as the population ages. Dementia, which causes progressive decline in memory, concentration, and judgment, is already a leading cause of disability and death. While age remains the primary risk factor, experts warn that other lifestyle and genetic factors are contributing to the alarming rise in cases.

The anticipated surge in dementia cases will most significantly affect women, Black Americans and all adults over the age of 75.

G. Peter Gliebus, M.D., a neurologist and director of Cognitive and Behavioral Neurology at Marcus Neuroscience Institute, part of Baptist Health, at Boca Raton Regional Hospital, said the study represents "compelling evidence" that the growing aging population and increasing longevity will fuel dementia cases in coming decades.

"One of the primary factors contributing to this trend is the increasing longevity of the population," said Dr. Gliebus. "As life expectancies rise, there is a growing cohort of individuals who are living into older age, which naturally elevates the incidence of age-related conditions, including dementia."

On the positive side, there is a trend of increasing awareness and diagnoses of dementia across the nation. "We are witnessing a broader societal awareness and willingness to seek medical evaluations, as well as improved diagnostic practices," adds Dr. Gliebus. "Healthcare professionals are becoming more adept at identifying various conditions that may predispose individuals to dementia, resulting in more cases being diagnosed than in previous generations."

This new analysis comes from an extensive study funded by the National Institutes of Health and led by NYU Langone Health, in collaboration with Johns Hopkins University and other U.S. institutions. The research draws from the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), a long-running project that has tracked the health and cognitive function of nearly 16,000 people since 1987.

According to the study, between 1987 and 2020, 3,252 participants were documented as developing dementia. The study concluded that the lifetime risk of dementia for middle-aged Americans is 42 percent, with women facing a higher risk (48 percent) compared to men (35 percent). This discrepancy is largely due to women’s longer life expectancy.

The study highlights several factors that contribute to the rising dementia risk, including genetic predisposition, hypertension, diabetes, obesity, poor diet, lack of physical activity, and poor mental health. Furthermore, the study revealed a particularly elevated risk among Black adults and those carrying the APOE4 gene variant, which is linked to Alzheimer's disease.

"It is crucial to recognize that beyond longevity and improved diagnosis, several other important factors are at play," explains Dr. Gliebus. "Lifestyle choices, such as diet, physical activity, and social engagement, have a profound impact on cognitive health. The prevalence of chronic conditions — such as hypertension, diabetes, and obesity — also plays a significant role in the development of dementia. These chronic issues often intertwine with lifestyle factors, creating complex risks that can lead to cognitive decline. This study also demonstrated racial disparities as the risk of developing dementia in Black American population will increase significantly."

One of the most pressing aspects of the new research is the projected rise in dementia cases due to the aging U.S. population. With 58 million Americans over the age of 65, and life expectancies continuing to rise, the study predicts that the number of dementia cases will more than double over the next 40 years. For individuals who reach 75, the lifetime risk of dementia jumps to more than 50 percent.

“Our study results forecast a dramatic rise in the burden from dementia in the United States over the coming decades, with one in two Americans expected to experience cognitive difficulties after age 55,” said study senior investigator and epidemiologist Josef Coresh, M.D., PhD, who serves as the founding director of the Optimal Aging Institute at NYU Langone, in a statement.

A key takeaway from the study is the racial disparity in dementia rates. While dementia cases are expected to double among White Americans, they are projected to triple among Black Americans. The researchers point to systemic inequities in healthcare, education, and nutrition as contributing factors that disproportionately affect Black communities. Dr. Coresh, the senior investigator of the study, urges health policies to prioritize addressing these disparities to reduce the risk of cognitive decline later in life.

The study also highlights the importance of lifestyle factors in reducing dementia risk. Heart disease prevention strategies, such as controlling blood pressure and managing diabetes, have been shown to also help slow cognitive decline. Dr. Coresh stresses that these measures must be prioritized in public health policy to mitigate the looming dementia crisis.

Redefining Obesity: A Global Call for More Nuanced Diagnosis Beyond BMI

For years, Body Mass Index (BMI) has been the primary tool used to diagnose obesity. However, a new proposal from a global commission, a partnership between the medical journal The Lancet Diabetes & Endocrinology and King’s Health Partners in London, may reshape how obesity is defined and diagnosed.

This redefinition proposed by the Lancet Diabetes & Endocrinology Commission on Clinical Obesity, with more than 50 experts, is designed to better reflect the complexities of obesity, moving beyond the limitations of BMI to provide a more personalized, medically relevant approach to care.

The report has been endorsed worldwide by more than 75 medical organizations, including the American Association of Clinical Endocrinologists, the American Diabetes Association and the American Heart Association.

BMI, a simple ratio of weight to height, has been the standard measure for diagnosing obesity. While BMI can help identify individuals who may be at risk for obesity-related health issues, it fails to capture essential details about body fat distribution and the specific health status of individuals. This leads to misclassification—some people with a high BMI may not suffer from obesity-related illnesses, while others with a normal BMI may have significant fat deposits that increase their health risks.

As Commissioner Robert Eckel, a professor at University of Colorado Anschutz Medical Campus, notes in a statement: "Relying on BMI alone to diagnose obesity is problematic as some people tend to store excess fat at the waist or in and around their organs, such as the liver, the heart or the muscles, and this is associated with a higher health risk compared to when excess fat is stored just beneath the skin in the arms, legs or in other body areas.”

To address these shortcomings, the Commission recommends a multi-faceted approach to diagnosing obesity. Instead of relying solely on BMI, health professionals should also use measurements like waist circumference, waist-to-hip ratio, and advanced techniques such as DEXA scans, which directly measure body fat. These methods provide a more accurate picture of fat distribution and its potential impact on health.

For example, someone with a BMI over 40 might be assumed to have excess body fat, but for individuals with lower BMI scores, additional tests can determine whether they have unhealthy fat deposits around vital organs that increase their risk for diseases like diabetes, heart disease, and certain cancers.

The Commission's new approach acknowledges that obesity is not an “all-or-nothing” condition. Some individuals with obesity may not experience any symptoms or have normal organ function, while others may suffer from serious health issues like heart failure, joint pain, and respiratory problems directly caused by excess fat. The Commission's reframing of obesity allows for a more nuanced, individualized diagnosis that moves beyond the binary disease/no disease categorization.

As Commission chair, Francesco Rubino, M.D., a bariatric surgeon at King’s College London, explains: The new model recognizes that not all individuals with obesity require immediate intervention, and treatments should be tailored to the individual’s health status. “The question of whether obesity is a disease is flawed because it presumes an implausible all-or-nothing scenario where obesity is either always a disease or never a disease,” said Dr. Rubino, in a statement. “Evidence, however, shows a more nuanced reality.”

The Commission is introducing two new categories to further refine obesity diagnosis: clinical obesity and pre-clinical obesity.

1. Clinical Obesity: This category applies to individuals who show signs and symptoms of reduced organ function or other significant health issues directly due to excess body fat. Examples include breathlessness, obesity-induced heart failure, and joint pain. People with clinical obesity should be treated as having a chronic disease and provided with appropriate care and management.
2. Pre-Clinical Obesity: This refers to individuals with excess body fat but without any current symptoms or organ dysfunction. Although they are at an increased risk of developing health issues in the future, their condition does not yet require the same level of intervention as clinical obesity. These individuals should be supported with strategies to reduce their risk, such as diet and lifestyle modifications.

By recognizing these two distinct categories, the Commission aims to ensure that people with clinical obesity receive timely care while also offering preventive strategies for those in the pre-clinical stage.

Mediterranean Diet Wins 2025's "Best of the Best" Ranking

The Mediterranean diet has once again taken the top spot, earning the "Best of the Best" title in U.S. News & World Report's annual ranking of diets for 2025. This diet, known more as a lifestyle than a weight-loss plan, has dominated the rankings since 2019, and continues to impress nutrition experts for its health benefits and sustainable approach to eating.

What makes the Mediterranean diet stand out? It’s rooted in traditional eating habits of countries bordering the Mediterranean Sea, focusing on nutrient-rich, plant-based foods like fruits, vegetables, grains, nuts, and olive oil. Fish—especially fatty varieties like sardines—is a cornerstone, while meat and dairy are consumed in smaller quantities.

This year’s ranking system also took a new approach, with nutritional experts rating diets on a 5-star scale, allowing for a more nuanced comparison. This shift is designed to offer people more flexibility as they weigh their health priorities. The Mediterranean diet, alongside the DASH (Dietary Approaches to Stop Hypertension) and flexitarian diets, each earned 4+ stars in multiple categories, including overall health, ease of adherence, and suitability for long-term lifestyle changes.

The DASH diet, with a focus on reducing sodium intake to manage blood pressure, and the flexitarian diet, which allows occasional meat in a predominantly vegetarian regimen, also earned high marks. All three diets emphasize whole, minimally processed foods, with an emphasis on reducing red meat, refined sugars, and ultra-processed foods.

In addition to the overall rankings, U.S. News & World Report’s 2025 list includes specific categories for diets aimed at addressing chronic conditions such as arthritis, fatty liver disease, and irritable bowel syndrome (IBS). These rankings offer personalized advice for individuals facing specific health challenges, making it easier to find the right diet for their needs.

The DASH diet, which is endorsed by the American Heart Association for heart health, received top marks for its ability to control both blood pressure and promote cardiovascular health, scoring an impressive 4.9 stars. This reinforces its reputation as a heart-healthy option for those looking to manage hypertension and improve overall well-being.

With so many diet options available, it’s important to remember that what works for one person may not be suitable for another. Many experts recommend seeking personalized advice from healthcare providers before making any major dietary changes, especially when managing specific health conditions. U.S. News & World Report’s new rankings provide a helpful guide, but always consult with a doctor for the most appropriate dietary approach for your individual needs.