The burden of dementia

Dementia care is a significant and growing healthcare need that will have major economic and medical impact as the prevalence of Alzheimer's disease (AD) and related dementias continues to increase in the United States during the next 50 years. The ability to differentiate the signs and symptoms of the most common dementing illnesses-AD, vascular dementia, frontotemporal dementia, and dementia with Lewy bodies-is essential to dementia care and management. Additionally, dementia patients in long-term care (LTC) facilities are prone to significantly greater risk of negative outcomes compared with nondemented residents as a result of a decline in activities of daily living, physical capacities, and behavioral manifestations. Careful and active assessment of risk factors and their management provides opportunities for improving outcomes. These include behavioral manifestations of pain, wandering, and risks of malnutrition, falls and injuries, and restraint use. Specific non-pharmacologic interventions to promote restraint- and pain-free care in LTC are highlighted.