A recent study, highlighted in a New York Times article, published in Nature Medicine predicts that by 2060, the number of Americans experiencing cognitive impairment (Alzheimer’s, dementia, etc.) will double to one million new cases annually.

This increase, driven by an aging population, highlights the urgency of creating systems that provide equitable and inclusive support for individuals navigating cognitive impairment. Particularly troubling is the projection that cases among Black Americans will triple, reflecting the compounded impact of systemic inequities.

Currently, over six million Americans are living with conditions like Alzheimer’s or other forms of cognitive impairment, placing a significant burden on families and the healthcare system. With annual caregiving costs exceeding $600 billion, the need for transformative solutions is evident.

Equity in Cognitive Care: A Critical Imperative

The study found that Americans over 55 face a 42% lifetime risk of developing cognitive impairment, with women and Black Americans experiencing disproportionately higher risks. Women are affected more often due to their longer lifespans, while Black Americans face earlier onset and more severe outcomes due to systemic factors such as higher rates of hypertension, diabetes, and reduced access to quality healthcare. These disparities underscore the importance of addressing cognitive care through the lens of equity.

Creating equity in Alzheimer’s care means not only mitigating these systemic factors but also fostering environments where individuals with cognitive changes are valued and their voices are heard. Too often, assumptions about a person’s capabilities lead to their exclusion from decisions about their care and surroundings. By adopting inclusive practices, we can ensure that everyone—regardless of their background or cognitive condition—feels empowered and respected.

A Person-Centered Approach to Cognitive Care

As highlighted in the Nature Medicine study, preventive measures like managing diabetes, hypertension, and hearing loss can significantly reduce the risk of cognitive impairment. Yet, prevention alone isn’t enough. For those already experiencing cognitive changes, care must prioritize connection, dignity, and humanity.

Person-centered care begins with simple yet transformative practices:

• Engaging at Eye Level: Meeting someone at their physical level communicates respect and fosters connection.
• Using Clear, Concise Statements: Simplifying communication helps individuals process and respond.
• Allowing Time to Respond: Patience ensures their voices are heard, not rushed or dismissed.

These approaches shift the focus from managing symptoms to fostering meaningful interactions that honor the individual.

Transforming Systems for Lasting Impact

While individual caregivers play a crucial role, systemic change is essential to sustaining equitable and inclusive cognitive care. Organizations must integrate person-centered practices into their culture and operations, ensuring that all staff are trained to interact with individuals experiencing cognitive changes respectfully and effectively.

Consider this scenario: A care community welcomes a new resident navigating cognitive impairment. Instead of a traditional tour where staff speak about the resident, the organization models inclusive practices by involving them in the conversation. These small but intentional adjustments create a sense of belonging and dignity.

Systemic changes can also mitigate distress caused by routine disruptions. For instance, training vendors or maintenance staff before they enter a care community ensures their presence is non-disruptive and respectful. These efforts not only improve quality of life for residents but also foster a culture of inclusion and equity in Alzheimer’s care.

From Ethics to Outcomes

Equity-focused cognitive care is not only ethically sound—it delivers measurable benefits. Studies show that person-centered approaches reduce the use of antipsychotic medications, lower the incidence of disruptive behaviors, and decrease staff injuries. These outcomes highlight that inclusion and operational efficiency go hand in hand.

The Nature Medicine study also emphasized the limitations of new Alzheimer’s drugs, which offer modest benefits at best and carry safety risks. Instead, researchers advocated for public health and lifestyle interventions, which have broader, more sustainable impacts on reducing risks and improving quality of life.

The Path Forward

As the number of cognitive impairment cases rises, so does the opportunity to transform care. By focusing on equity, inclusion, and person-centered practices, we can create systems that not only address the growing needs of individuals but also ensure that every person feels valued and empowered.

This transformation begins with small but significant changes: seeing every behavior as communication, listening deeply, and creating environments where dignity and humanity are at the forefront. As the Nature Medicine study highlights, addressing the challenges of cognitive impairment will require significant societal and healthcare efforts—but the rewards will be profound.

Let’s commit to a future where cognitive care is not just about managing conditions but about fostering connection, belonging, and equity. The time to act is now, and the path forward begins with us.