The Care Abyss
Scientific American
|October 2025
As dementia cases rise, memory-care facilities are shuttering. A national collaboration wants to help solve the looming long-term-care challenge
THE RATE OF ALZHEIMER’S diagnosis has declined steadily in recent decades, but as baby boomers age, the number of new cases continues to rise. The top risk factor for dementia is age, and by 2030 more than one in five Americans will be 65 or older. That means the prevalence of Alzheimer’s in the U.S. could exceed 13.8 million people by 2060.
If current trends continue, many of them will have no place to go. Save Our Seniors, a collaboration of the American Health Care Association and the National Center for Assisted Living, estimates that more than 770 nursing homes have closed in the U.S. since 2020, and recent federal cuts to Medicare and Medicaid will almost certainly decrease access to long-term care. Older adults overwhelmingly prefer to age in place and receive care at home, but for that to be possible, there must be support for home caregivers, enough people willing to do those jobs, and coordination between local and state services.
A recently launched national resource funded by the National Institute on Aging, the State Alzheimer’s Research Support Center (StARS), aims to help make all that a reality. By gathering data on the effectiveness, accessibility, and equity of state and regional programs for dementia care, then sharing those data, the researchers involved in the project hope to help states build partnerships that will aid policymakers at all levels in identifying the best solutions. SCIENTIFIC AMERICAN spoke with Regina Shih, an Emory University epidemiologist and co-principal investigator of StARS, about the problems our aging population is facing and how she and her colleagues are working to solve them. The following interview has been edited for length and clarity.
As the U.S. population ages, how is the country meeting the needs of people with dementia?
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