reaching age 65, the age at which the risk for Alzheimer’s and other dementias begins to increase. By 2030, the segment of the U.S. population age 65 and older will have grown substantially, and the projected 74 million older Americans will make up over 20% of the total population (up from 18% in 2022).221,347 As the number of older Americans grows rapidly, so too will the numbers of new and existing cases of Alzheimer’s dementia, as shown in Figure 5.A6,224 • By 2025, the number of people age 65 and older with Alzheimer’s dementia is projected to reach 7.2 million — an 11% increase from the 6.5 million age 65 and older affected in 2022.224 • By 2060, the number of people age 65 and older with Alzheimer’s dementia is projected to reach 13.8 million, barring the development of medical breakthroughs to prevent, slow or cure Alzheimer’s disease.A6,224 28 Alzheimer’s Association. 2022 Alzheimer’s Disease Facts and Figures. Alzheimers Dement 2022;18. The older adult population also will continue to increase relative to the population age 64 and younger — a shift is known as population aging. Population aging takes place primarily due to a decline in fertility, defined as the number of children born per woman, and secondarily due to mortality improvements at older ages. Even after members of the baby boom generation have died, population aging is expected to continue in the United States. The average number of children per woman in the United States was 3.7 in 1960 and has fluctuated between 1.7 and 2.1 from 1976 to 2019.348 With fewer babies born each year, older adults will make up a larger proportion of the population. As a result, a smaller share of the population will be of working age — the group of people who financially support older adults349 and provide health care in the professional workforce350 and informal caregiving.351 In 2010 for every 100 working-age people 15-64, there were 49 people age 65 and older; in 2019 this value was 54.352 Growth of the Oldest-Old Population The number of Americans surviving into their 80s, 90s, and beyond is expected to grow dramatically due to the aging of the large baby-boom cohort.347 This will lead to an increase in the number and percentage of Americans 85 and older, the oldest-old. Between now and 2050, the oldest-old are expected to comprise an increasing proportion of the U.S. population age 65 and older — from 12% in 2022 to 22% in 2050.347 This will result in an additional 12 million oldest-old people — individuals at the highest risk for developing Alzheimer’s dementia.347 • In 2022, about 2.3 million people who have Alzheimer’s dementia are age 85 or older, accounting for 35% of all people with Alzheimer’s dementia.224 • By 2060, 6.7 million people age 85 and older are expected to have Alzheimer’s dementia, accounting for about half (48%) of all people 65 and older with Alzheimer’s dementia.224 Diversification of Older Adults The group of older adults who will be at risk for Alzheimer’s in the coming years will be socially, culturally and economically different from previous groups of older U.S. adults. For example, between 2018 and 2040, the Black older adult population will increase by 88%, and the Hispanic older adult population will increase by 175%.353 In addition, in the coming decades women age 65 and older will be among the first generations of women to have widely worked outside the home, and they will have more years of formal education than previous generations of women.354 In parallel these generations of women came of age during a decrease in the birth rate, resulting in smaller family size.355 The role of these social and economic experiences in Alzheimer’s risk and resilience for women will become clearer in the decades ahead. Given the different life experiences of future older adult populations, it is unclear what the accompanying changes will be to dementia incidence and prevalence, both at the population level and within racial/ethnic, socioeconomic, and sex/gender groups. A birth cohort perspective, which considers how a certain group of people has passed through different stages of life in particular years, will be increasingly important for understanding factors of risk and resilience that may be unique to the groups of people at risk for dementia in the coming decades.356-358 MORTALITY AND MORBIDITY 1 in 3 seniors dies with Alzheimier's or another dementia. Alzheimer’s disease remains the fifth-leading cause of death among individuals age 65 and older.359-360 However, it may cause even more deaths than official sources recognize. Alzheimer’s is also a leading cause of disability and poor health (morbidity) in older adults.361 Before a person with Alzheimer’s dies, they live through years of morbidity as the disease progresses. Alzheimer’s disease was officially listed as the sixth-leading cause of death in the United States in 2019359 and the seventh-leading cause of death in 2020 and 2021,360 when COVID-19 entered the ranks of the top 10 causes of death. Deaths from Alzheimer’s Disease The data presented in this section are through 2019. These data precede the COVID-19 pandemic and give an accurate representation of long-term trends in mortality and morbidity due to Alzheimer’s and other dementias in the United States prior to the large increase in deaths due to