The Alzheimer’s Association released its “2022 Alzheimer’s Disease Facts and Figures” report, highlighting challenges for the public and healthcare professionals to understand mild cognitive impairment (MCI), an early stage of memory loss or other cognitive ability loss. The report also includes statistics on Alzheimer’s prevalence, mortality, cost of care and dementia care workforce in Michigan and nationally.

Alzheimer’s prevalence 

According to the report, 190,000 Michigan residents aged 65 and older had Alzheimer’s in 2020, and the estimated number in 2025 will be 220,000. There were 4,467 statewide deaths from Alzheimer’s in 2019.

The report also includes data on the dementia-care workforce, suggesting a workforce shortage in most states. In Michigan, the number of practicing geriatricians needs to triple to meet the demand in 2050.

Jennifer Lepard, the president and CEO of the Michigan chapter of the Alzheimer’s Association, said the prevalence of Alzheimer’s in Michigan is due to the higher proportion of the aging population in the state compared to other states.

“We tend to use the phrase that the greatest risk for Alzheimer’s is aging,” Lepard said. “One of the challenges for Michigan right now is that Michigan is an aging state.”

This year’s report examines the public and primary care physicians’ (PCPs) understanding of MCI nationally. The report finds low public awareness of MCI, with fewer than one in five Americans familiar with MCI. The biggest challenge faced by PCPs is difficulty in differentiating MCI from normal aging.

Dr. Bruno Giordani, professor of psychology in psychiatry, neurology, and psychology and associate director for Michigan’s Alzheimer’s Disease Center, explained that MCI is a middle stage of dementia where symptoms are not severe enough to have adverse effects on daily life. 

“You don’t just turn on the switch for Alzheimer’s disease,” Giordani said. “What happens is this middle stage where somebody begins to develop signs and symptoms of problems without a marked significant effect on daily life and then eventually becomes very apparent that somebody has problems associated with daily life and then that becomes a whole another question. So mild cognitive impairment is this in between time.”

Giordani also said diagnosing MCI is critical because it alerts people of the risk of it developing to a more severe stage of dementia. According to Giordani, not all individuals with MCI will develop Alzheimer’s disease, but the diagnosis of MCI and biomarkers in the brain can suggest a higher risk of developing dementia. Biomarkers such as beta-amyloid and tau levels in cerebrospinal fluid (CSF) are strongly linked to Alzheimer’s and can be detected by PET scan. 

“MCI is important because if somebody is just beginning to have memory problems, and if you could tell if they had amyloid in the brain, you could tell there was really a risk,” Giordani said. “It’s an alerting stage. It’s important to diagnose it so that people are aware of it. So they can begin to do things.”

Giordani also said research has been done to try to find predictors of MCI and dementia so people know how to reduce the risks. The earlier people can catch the predictors, the earlier they can intervene. 

“(There are) studies looking at a lot of predictive factors and trying to intervene early,” Giordani said. “They are trying to say, as you get into middle age or older age, you should be doing cognitive training to keep your brain alert. You should check your heart disease problems. You should check your diabetes … you (should) know to eat a better diet and look at the stress … But all that research also tells you about risk groups that may be there.”

Caregiver burden

According to the report, there are 466,000 Michigan residents serving as unpaid family caregivers and the total value of unpaid care is $8.6 billion. Lepard said caregiver burden can cause a significant amount of stress emotionally, physically and even financially.

“One of the facts that gets glossed over a lot is the stress on the caregivers,” Lepard said. “This is a 24/7 (job), especially in later stages of the disease, and the amount of stress that it can cause especially when you’re talking about an older person living with disease and potentially their older spouse … There are people that have reduced their hours or left the workforce due to (caregiving) and that certainly is a financial strain.” 

Giordani also said caregiver burden exists for patients with MCI as much as for patients with Alzheimer’s and the burden often causes caregivers to forget about taking care of themselves.

“And then you have the problem of creating this large group of people who are constantly under stress,” Giordani said. “One of the things that contributes to the risk of Alzheimer’s disease is stress. So you’ve got older unpaid people who are in stress, who might be depressed themselves trying to deal with all this you’re creating another whole group of people with potential problems. And many caregivers of mild cognitive impairment tend to stop caring for themselves … This is kind of a vicious circle.”

Moving forward 

Jean Barnas, director of program services for the Michigan chapter of the Alzheimer’s Association, said the data motivates them to better support the patients they see and their families. Barnas said the Alzheimer’s Association is determined to provide care through their programs, such as the Community Connect program which provides social and cultural opportunities throughout Metro Detroit. Barnas also mentioned their app that provides the latest news and research about Alzheimer’s disease. 

“I love having these data and facts because I think it arms people to say this is an issue … We need to fix this and look at all these people that are dealing with it,” Barnas said. “Our goal is to meet a family or an individual who’s diagnosed where they are, and to wrap services and care and support around them … We really connect people together and they soon become their own family, and they rely on one another.”

Learn from someone living with MCI

Lepard, Giordani and Barnas all mentioned their personal experiences with family members diagnosed with MCI and Alzheimer’s disease. The Michigan Daily sat down with a patient with MCI to talk about her experience. 

Libby Ford used to be a nurse with a specialty in solid organ transplants at Michigan Medicine. But because of her diagnosis of MCI when at the age of 57, she had to give up the career she has been working in for 34 years. 

“Even though I’m a nurse, I was very shocked (about the diagnosis),” Ford said. “Because I didn’t know that somebody in their middle age could have Alzheimer’s.”

Ford first started to notice some inefficiencies in her work like how she couldn’t do things as quickly as before. She switched to an easier position in the hope of improving things, but her situation worsened. 

“I was horrified … My brain does the opposite of what I’m supposed to do,” Ford said. “(I figured) I need to stop or put my nursing on hold until we figure out what’s going on.”

Ford said the diagnosis was difficult for her because of how she had to adjust to a new lifestyle and grieve the loss of her past cognitive ability. 

“There’s a certain amount of adjustment, and just even grieving knowing that I’m not the same person cognitively,” Ford said. 

But she also said the support of family and friends is significant to her and she has been involved in patient advocacy and various support programs.

“It’s a stigma that when somebody says Alzheimer’s, they automatically think of somebody older and very much more debilitating,” Ford said. “People just don’t know about (MCI). I didn’t know about it. And it’s certainly been part of my mission to enlighten people.”

Ford said many MCI patients are still able to do daily activities and keep their personalities. She said people should try to understand them better. 

“Don’t be afraid of us. We’re all still people … we’re all still pretty capable of things,” Ford said. “If you really have concerns about anybody in your life that might be developing some problems, do not ignore it … A lot of people say oh, it’s just because I’m getting older. Maybe it is, but it doesn’t hurt to get checked out.”

Art & Design freshman Felicia Gordon used to volunteer in an Alzheimer’s care facility in Virginia when she was in high school. Gordon said she assisted in helping with art therapy and got to know the patients pretty well. 

“I assisted in talking to the patients, helping them with the activities such as coloring and painting,” Gordon said. “I got to know some of the patients decently well, like their personality, because I had a good bit of conversations with some of them.”

Gordon said her grandmother has some memory loss and needs to be taken care of. Since her grandmother has trouble doing activities such as remembering pills and preparing food, Gordon’s mom moved in with them to provide care. Gordon said it’s important to understand the patients and have empathy with them.

“You need to have a lot of patience and empathy with Alzheimer’s patients,” Gordon said. “A lot of the time they say and do things that you have seen … Especially if it’s a family member and they start to cut people out, I think it’s important to be aware that it’s not the person themselves’s fault.”

Daily Staff Reporter Jingqi Zhu can be reached at