A survey by the Alzheimer’s Association found that only 1 in 3 older adults were aware that these visits should include a cognitive assessment.228 Furthermore, while 82% of older adults believe it is important to have their memory and thinking checked, only 16% report having their memory and thinking checked. Most (93%) older adults said they trust their doctor to recommend testing for memory and thinking problems; however, despite 94% of primary care physicians stating that it is important to assess all older patients for cognitive impairment, fewer than half (47%) say it is their standard protocol to do so. The primary reasons given by surveyed physicians for not assessing 22 Alzheimer’s Association. 2021 Alzheimer’s Disease Facts anSound (now Kaiser Permanente Northwest), a health care delivery system in the Seattle, Washington, area, reported similar incidence rates to the CHAP study.242 The number of new cases of Alzheimer’s increases dramatically with age: according to estimates from CHAP, in 2011 the average annual incidence in people age 65 to 74 was 0.4% (meaning four of every 1,000 people age 65 to 74 developed Alzheimer’s dementia in 2011); in people age 75 to 84, the annual incidence was 3.2% (32 of every 1,000 people); and for age 85 and older (the “oldest-old”), the incidence was 7.6% (76 of every 1,000 people).241 Because of the increasing number of people age 65 and older in the United States, particularly the oldest-old, the annual number of new cases of Alzheimer’s and other dementias is projected to double by 2050.243 Incidence of Alzheimer’s Dementia While prevalence refers to existing cases of a disease in a population at a given time, incidence refers to new cases of a disease that develop in a given period of time in a defined population — in this case, the U.S. population age 65 or older. Incidence provides a measure of risk for developing a disease. According to estimates using data from the CHAP study and the U.S. Census, approximately 910,000 people age 65 or older developed Alzheimer’s dementia in the United States in 2011, a number that would be expected to be even higher in 2021 if CHAP estimates were available for that year.241 A study using data from the Adult Changes in Thought Study, a cohort of members of Group Health Cooperative of Puget Change from 2020 to 2025 for Washington, D.C.: