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The Milken Institute Center for the Future of Aging estimates that dementia — defined as a group of symptoms affecting memory, social abilities and other cognitive functions — will impact one in five older adults by 2060. Dementia care already costs U.S. healthcare $360 billion each year, excluding the labor for unpaid caregivers. To make matters worse, long COVID, which already affects 20 million Americans, can cause cognitive impairments that resemble dementia diseases like Alzheimer's.
"When people think of dementia, they think of it as an older person's disease, when in fact, it's really a disease of the young and middle-aged," says Diane Ty, managing director at the Milken Institute Center for the Future of Aging. "Changes to the brain are happening up to 20 years before symptoms actually begin to manifest. You really want to detect it as early as possible."
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The good news is that the rise in dementia diagnoses can be mitigated, especially if employers are involved, underlines Ty. There are 14 modifiable risk factors for dementia, including smoking, excessive alcohol use, physical activity, obesity, diabetes, hypertension, infrequent social interaction and depression. According to the Lancet Commission, addressing those risk factors could prevent 45% of dementia cases.
Notably, many employers already have benefits focused on mental health, fitness and weight loss. Not to mention, a good workplace culture is also a good opportunity for healthy socialization. This missing ingredient is awareness, emphasizes Ty.
"What's good for the heart is good for the brain," she says. "But we need to normalize brain health. The more we normalize it, the more discussions about potential issues around cognitive decline are palatable."
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For benefit leaders, this may mean highlighting certain benefits as being good for the brain or adding benefits that target chronic conditions like diabetes and obesity. Ty also encourages workplaces to train leaders to know the early warning signs of dementia. This includes getting lost in familiar places, constantly losing things, having difficulty following a conversation and notable changes in personality.
"Forgetting where I put my keys isn't necessarily cause for concern, but putting my keys in the freezer should catch someone's attention," says Ty. "One of the challenges for employers is creating a safe space where employees can share their observations of themselves or colleagues."
Ty reminds employers that under the Americans with Disabilities Act, dementia is considered a disability and is protected from employment discrimination. This means an affected employee can request a work accommodation.
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"We have anecdotal stories of employees being let go because employers think the issue is laziness or substance abuse," says Ty. "HR and supervisors need to be aware there are protections."
Ty acknowledges that finding accommodations is not an easy task. It may come down to reducing work hours, providing more flexibility or modifying job duties in a way that places emphasis on the individual's institutional knowledge rather than their day-to-day memory retention.
"You can't imagine how important it is for that person to stay socially connected, to stay connected to their identity with working," says Ty. "You can't imagine how important it is for not only that person but for their family to get that type of support."
