The majority of people with Alzheimer’s disease die in long-term care facilities, although the percentage is decreasing, whereas the number of people with the disease who die at home is increasing, according to a new report released Thursday by the Centers for Disease Control and Prevention.

Of those who died with Alzheimer’s disease in 2014, the most recent year studied:

  • 54.1% died in a nursing home or other long-term care facility, compared with 67.5% in 1999;
  • 24.9% died at home, compared with 13.9% in 1999;
  • 6.6% died in a hospital, compared with 14.7% in 1999; and
  • 6.1% died in a hospice.

These realities, wrote the authors of an article in the CDC’s Morbidity and Mortality Weekly Report, have implications for the government and the healthcare system, because some states and counties operate publicly funded long-term care facilities and because payments for more than two-thirds of the anticipated $259 billion in healthcare and long-term care costs for people with Alzheimer’s and other dementias in the United States in 2017 are expected to come from public sources such as Medicare and Medicaid.

And implications exist for professional and family caregivers as well.

“Alzheimer’s deaths can be an indicator of paid and unpaid caregiver burden because nearly everyone in the final stages of Alzheimer’s needs constant care, regardless of the setting, as the result of functional and cognitive declines,” the authors said.

Interventions such as education, respite care and case management might lessen the caregiving burden for unpaid caregivers as well as improve care for their loved ones, they said.

Other highlights from the CDC research:

  • 93,541 Alzheimer’s deaths occurred in the United States in 2014, the most recent year studied.
  • From 1999 to 2014, rates of Alzheimer’s deaths significantly increased in 41 states and Washington, D.C. Only Maine saw a significant decrease in Alzheimer’s deaths.
  • From 1999 to 2014, deaths attributed to Alzheimer’s increased among adults aged 75 to 84 years, from 129.5 to 185.6 per 100,000 population, and among adults aged 85 or more years, from 601.3 to 1,006.8 per 100,000 population. The number of documented Alzheimer’s deaths has increased in part because of the growing population of older adults and in part because of an increase in the number of people receiving an Alzheimer’s diagnosis before death that can be included on a death certificate.