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ON THE HORIZON

During the next 30 years, the proportion of Americans older than 65 will increase dramatically-from 13 percent in 2000 to 20 percent in 2030. Similarly, during the next 50 years, the proportion of people over age 85 will increase from 1.5 percent in 2000 to 4.6 percent in 2050 (see figure 1).

Source: Population Projections of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050, U.S. Bureau of the Census, 1996.

Since the number of older adults with or at-risk for mental illnesses is greater than that of younger adults, the effect of an aging population on a state's mental health system will be significant.

• Twenty percent of people older than 55 have a diagnosable mental disorder-like schizophrenia, an anxiety or mood disorder, or cognitive impairment-that is not part of "normal" aging. This number does not include those with Alzheimer's disease. (Source: Mental Health: A Report of the Surgeon General, 1999.)
• Although the prevalence of major depression decreases with age, the occurrence of depressive symptoms increases with age; 37 percent of older people in primary care settings have depressive symptoms. Treatment of late-life depression is especially costly because of its interaction with physical health. (Source: Mental Health: A Report of the Surgeon General, 1999.)
• The number of psychiatrically ill elderly people (older than 65) will rise by 275 percent-from 4 million in 1970 to 15 million in 2030. (Source: Consensus of participants at a workshop on "The Future of Mental Health and the Aging" in March 1998.)
• The prevalence of dementia (Alzheimer's or other) nearly doubles with every five years of age after 60. (Source: Mental Health: A Report of the Surgeon General, 1999.)
• One in 10 people over age 65 have Alzheimer's disease, while almost half of those over age 85 have the disease. Currently, 4 million people in the U.S have Alzheimer's; by 2050, that number will increase to 14 million. (Source: Alzheimer's Association, 2000.).

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