Demographic and Need Analysis

Exhibits of Leslie Hendrickson, Ph.D.

December 18, 2008 Hamilton Township, New Jersey,
Zoning Board of Adjustment

Dementia: Definition and Specific Types

“Dementia is the general term for a group of disorders that cause

irreversible cognitive decline as a result of various biological
mechanisms that damage brain cells. To be classified as a type of
dementia, a disorder must meet the following two criteria:

1. It must cause decline in at least two of the following four essential

cognitive functions:

(i) memory;
(ii) ability to generate coherent speech or understand spoken or written
language;
(iii) capacity to plan, make sound judgments and carry out complex
tasks; and
(iv) ability to process and interpret visual information.

2. The decline must be severe enough to interfere with day-to-day

life.

Different types of dementia are historically associated with distinct

symptom patterns and distinguishing microscopic brain abnormalities.
Increasing evidence from long-term epidemiological observation and
autopsy studies suggests these distinctions are somewhat artificial.
Symptoms and pathologies frequently overlap, and can be further
complicated by coexisting health conditions.

Current classification of specific types of dementia:

Alzheimer’s disease is the most common dementia, accounting for 50

to 70 percent of cases. Its “classic” symptom pattern begins with
memory loss for recent events. Its two hallmark abnormalities are (1)
plaques, deposits of a protein fragment called beta-amyloid, and (2)
tangles, twisted strands of another protein called tau. Alzheimer’s
disease is discussed in more detail in the following sections.

Vascular dementia (also called multi-infarct dementia, post-stroke

dementia or vascular cognitive impairment) is widely considered the
second most common type after Alzheimer’s disease. Impairment is

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 caused by reduced blood flow to parts of the brain, often due to a series
of tiny strokes blocking small arteries. Symptoms often overlap with
those of Alzheimer’s disease, although memory may or may not be as
seriously affected as in Alzheimer’s, depending on whether the
blockage occurs in the brain’s memory regions.

Mixed dementia is characterized by the presence of hallmark

abnormalities of both Alzheimer’s disease and vascular dementia. Many
experts believe mixed dementia is also very common.

Parkinson’s disease primarily affects movement, resulting in tremors,

stiffness, difficulty walking, and impaired speech. A significant
percentage of individuals with Parkinson’s disease also develop
dementia in later stages of the disease. The hallmark abnormality in
Parkinson’s disease is Lewy bodies, deposits of a protein called alpha-
synuclein, in a specific brain region critical for control of movement.
Lewy bodies also occur in different brain regions in other types of
dementia, including dementia with Lewy bodies and some cases of
Alzheimer’s disease.”
Prevalence
The Current Prevalence of Alzheimer’s

“An estimated 5.1 million Americans have Alzheimer’s disease in 2007.

This number includes 4.9 million people age 65 and older. It also includes
at least 200,000 individuals younger than 65 with early-onset
Alzheimer’s. The Alzheimer’s Association estimates there are
approximately 500,000 Americans younger than 65 with Alzheimer’s or
another dementia. At a conservative estimate, at least 40 to 50 percent of
them are likely to have Alzheimer’s disease.
By age group, the proportion and number of the 4.9 million Americans age
65 and over with Alzheimer’s disease breaks down as follows:

Age 65-74: 2 percent 300,000 people

Age 75-84: 19 percent 2,400,000 people
Age 85+: 42 percent 2,200,000 people

13 percent, or one in eight, persons age 65 and over have Alzheimer’s

disease.Nearly half of persons over age 85 have Alzheimer’s disease. Every
72 seconds, someone in America develops Alzheimer’s disease; by mid-
century, someone will develop Alzheimer’s every 33 seconds.”
Data Source: Pages 2 and 5 from 2007 Alzheimer’s’ Facts and Figures, published by
Alzheimer’

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Percentages of Persons Needing Help with Activities of Daily Living
Freestanding
Help Required with Activities Freestanding
Assisted
of Daily Living Dementia Care Units
Living
Need Bathing Assistance 60% 90%
Need Dressing Assistance 41% 83%
Need Toileting Assistance 30% 78%
Need Transferring Assistance 25% 65%
Need Eating Assistance 19% 60%
Source : American Association of Homes and Services for the Aging
2006 Assisted Living Table 7.2

Figure Data from the Alzheimer’s Associations Fact and

Figures, 2008 ---1999 study.

Percentage
of Persons
with
Coexisting Condition
Alzheimer's
that have
this condition
Hypertension 60%
Coronary heart disease 30%
Congestive heart failure 28%
Osteoarthritis 26%
Diabetes 21%
Peripheral vascular disease 19%
Chronic obstructive pulmonary disease 17%
Thyroid disease 16%
Stroke - late effects 10%
Source: Alzheimer’s Facts and Figures, 2008.

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 Estimates by Age of the Number of Persons with Dementia in Mercer County
2000-2030
Age
Est. Dementia Proj. Dementia Proj. Dementia Proj. Dementia
Group
Population Population Population Population
in 2000 in 2010 in 2020 in 2030
22
65 - 69 9 281 447 837
22
70 - 74 3 216 301 513
1,85
75 - 79 0 1,699 1,969 3,003
1,21
80 - 84 1 1,346 1,528 2,590
2,27
85+ 9 3,332 5,630 12,043
5,79
Total 2 6,874 9,876 18,986
Table Prepared by Hendrickson Development, September 2008, from U.S. Census Data and
and Alzheimer's Disease Fact and Figures 2007

Estimates by Age of the Number of Persons with Dementia in Hamilton Township

2000-2030
Age Group Est. Dementia Proj. Dementia Proj. Dementia Proj. Dementia
Population Population Population Population
in 2000 in 2010 in 2020 in 2030
65 - 69 68 84 133 249
70 - 74 70 67 94 160
75 - 79 599 550 637 972
80 - 84 389 433 491 833
85+ 638 933 1,577 3,374
Total 1,765 2,067 2,933 5,588
Table Prepared by Hendrickson Development, September 2008, from U.S. Census Data and
and Alzheimer's Disease Fact and Figures 2007

Population 85 Years and Older

From 1660 Whitehorse-Hamilton Square 20 20 201
Road 00 07 2
1,07
799 1,267
Within Two-Mile Circle 2
2,96 3,98
4,698
Within Five-Mile Circle 5 4
Within Ten-Mile Circle 6,18 8,45 10,141

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 8 3
Claritas, November 2007 data

APPENDICES
Population Pyramids of New Jersey with Row Headers in Column b and Column Headers in Rows 23 to 25
Population Pyramids of New Jersey
Percent of Total Population
2000 2010
85+
Male Female 80 - 84 Male Female
75 - 79
70 - 74
65 - 69
60 - 64
55 - 59
50 - 54
45 - 49
40 - 44
35 - 39
30 - 34
25 - 29
20 - 24
15 - 19
10 - 14
5- 9
0- 4

5 4 3 2 1 0 1 2 3 4 5 5 4 3 2 1 0 1 2 3 4 5
Axis Title

Census 2000 Projection 2010 2000 - 2010 Change

Age Group Number Percent Number Percent Total
Total Male Female Total Total Male Female Total Number Percent
Total 8,414,350 4,082,813 4,331,537 100.0 9,018,231 4,388,763 4,629,468 100.0 603,881 7.2
0-4 563,785 288,085 275,700 6.7 587,220 299,991 287,229 6.5 23,435 4.2
5-9 604,529 309,563 294,966 7.2 594,068 303,327 290,741 6.6 -10,461 -1.7
10 - 14 590,577 302,708 287,869 7.0 570,463 293,085 277,378 6.3 -20,114 -3.4
15 - 19 525,216 271,020 254,196 6.2 557,371 289,558 267,813 6.2 32,155 6.1
20 - 24 480,079 244,628 235,451 5.7 557,799 286,447 271,352 6.2 77,720 16.2
25 - 29 544,917 272,873 272,044 6.5 586,871 295,821 291,050 6.5 41,954 7.7
30 - 34 644,123 319,031 325,092 7.7 582,609 291,071 291,538 6.5 -61,514 -9.6
35 - 39 727,924 360,230 367,694 8.7 619,667 309,234 310,433 6.9 -108,257 -14.9
40 - 44 707,182 348,061 359,121 8.4 684,132 337,468 346,664 7.6 -23,050 -3.3
45 - 49 611,357 297,845 313,512 7.3 731,182 359,345 371,837 8.1 119,825 19.6
50 - 54 547,541 263,357 284,184 6.5 678,635 331,714 346,921 7.5 131,094 23.9
55 - 59 423,338 202,559 220,779 5.0 557,684 267,616 290,068 6.2 134,346 31.7
60 - 64 330,646 156,073 174,573 3.9 478,945 222,443 256,502 5.3 148,299 44.9
65 - 69 293,196 132,558 160,638 3.5 359,668 162,693 196,975 4.0 66,472 22.7
70 - 74 281,473 121,639 159,834 3.3 272,038 119,762 152,276 3.0 -9,435 -3.4
75 - 79 240,131 95,560 144,571 2.9 220,532 91,360 129,172 2.4 -19,599 -8.2
80 - 84 162,337 58,291 104,046 1.9 180,512 67,769 112,743 2.0 18,175 11.2
85+ 135,999 38,732 97,267 1.6 198,835 60,059 138,776 2.2 62,836 46.2

Under 18 2,087,558 1,069,475 1,018,083 24.8 2,088,224 1,071,081 1,017,143 23.2 666 0.0
5-17 1,523,773 781,390 742,383 18.1 1,501,004 771,090 729,914 16.6 -22,769 -1.5
18-24 676,628 346,529 330,099 8.0 778,697 401,327 377,370 8.6 102,069 15.1
25-44 2,624,146 1,300,195 1,323,951 31.2 2,473,279 1,233,594 1,239,685 27.4 -150,867 -5.7
45-64 1,912,882 919,834 993,048 22.7 2,446,446 1,181,118 1,265,328 27.1 533,564 27.9
65+ 1,113,136 446,780 666,356 13.2 1,231,585 501,643 729,942 13.7 118,449 10.6

Demograp hic Indicator 2000 2010 Change Demographic Indicator 2000 2010 Change
Median Age 36.7 38.9 2.2 Child-Women Ratio ( 4) 31.1 33.0 1.9
Male 35.5 37.3 1.8 Sex Ratio (5) 94.3 94.8 0.5
Female 38.0 40.4 2.4 Under 18 105.0 105.3 0.3
Dependency Ratio (1) 67.7 64.6 -3.1 18-64 97.0 97.7 0.7
Youth (2) 45.5 42.2 -3.4 65-84 71.7 74.7 3.0
Old Age (3) 22.2 22.5 0.3 85+ 39.8 43.3 3.5

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6
Population Pyramids of New Jersey with Row Headers in Column b and Column Headers in Rows 23 to 25
Population Pyramids of New Jersey
Percent of Total Population
2000 2020
85+
Male Female 80 - 84 Male Female
75 - 79
70 - 74
65 - 69
60 - 64
55 - 59
50 - 54
45 - 49
40 - 44
35 - 39
30 - 34
25 - 29
20 - 24
15 - 19
10 - 14
5- 9
0- 4

5 4 3 2 1 0 1 2 3 4 5 5 4 3 2 1 0 1 2 3 4 5

Census 2000 Projection 2020 2000 - 2020 Change

Age Group Number Percent Number Percent Total
Total Male Female Total Total Male Female Total Number Percent
Total 8,414,350 4,082,813 4,331,537 100.0 9,461,635 4,611,980 4,849,655 100.0 1,047,285 12.4
0-4 563,785 288,085 275,700 6.7 611,635 312,819 298,816 6.5 47,850 8.5
5-9 604,529 309,563 294,966 7.2 610,898 312,313 298,585 6.5 6,369 1.1
10 - 14 590,577 302,708 287,869 7.0 585,436 300,847 284,589 6.2 -5,141 -0.9
15 - 19 525,216 271,020 254,196 6.2 539,048 279,355 259,693 5.7 13,832 2.6
20 - 24 480,079 244,628 235,451 5.7 524,258 269,630 254,628 5.5 44,179 9.2
25 - 29 544,917 272,873 272,044 6.5 600,736 305,508 295,228 6.3 55,819 10.2
30 - 34 644,123 319,031 325,092 7.7 650,638 329,288 321,350 6.9 6,515 1.0
35 - 39 727,924 360,230 367,694 8.7 656,851 330,305 326,546 6.9 -71,073 -9.8
40 - 44 707,182 348,061 359,121 8.4 615,448 306,147 309,301 6.5 -91,734 -13.0
45 - 49 611,357 297,845 313,512 7.3 622,641 308,681 313,960 6.6 11,284 1.8
50 - 54 547,541 263,357 284,184 6.5 650,657 319,088 331,569 6.9 103,116 18.8
55 - 59 423,338 202,559 220,779 5.0 657,685 318,658 339,027 7.0 234,347 55.4
60 - 64 330,646 156,073 174,573 3.9 583,160 275,961 307,199 6.2 252,514 76.4
65 - 69 293,196 132,558 160,638 3.5 466,718 212,475 254,243 4.9 173,522 59.2
70 - 74 281,473 121,639 159,834 3.3 393,518 170,890 222,628 4.2 112,045 39.8
75 - 79 240,131 95,560 144,571 2.9 278,222 115,929 162,293 2.9 38,091 15.9
80 - 84 162,337 58,291 104,046 1.9 184,272 71,649 112,623 1.9 21,935 13.5
85+ 135,999 38,732 97,267 1.6 229,814 72,437 157,377 2.4 93,815 69.0
Under 18 2,087,558 1,069,475 1,018,083 24.8 2,138,364 1,097,048 1,041,316 22.6 50,806 2.4
5-17 1,523,773 781,390 742,383 18.1 1,526,729 784,229 742,500 16.1 2,956 0.2
18-24 676,628 346,529 330,099 8.0 732,911 377,916 354,995 7.7 56,283 8.3
25-44 2,624,146 1,300,195 1,323,951 31.2 2,523,673 1,271,248 1,252,425 26.7 -100,473 -3.8
45-64 1,912,882 919,834 993,048 22.7 2,514,143 1,222,388 1,291,755 26.6 601,261 31.4
65+ 1,113,136 446,780 666,356 13.2 1,552,544 643,380 909,164 16.4 439,408 39.5

Demograp hic Indicator 2000 2020 Change Demographic Indicator 2000 2020 Change
Median Age 36.7 39.6 2.9 Child-Women Ratio ( 4) 31.1 34.6 3.5
Male 35.5 37.9 2.5 Sex Ratio (5) 94.3 95.1 0.8
Female 38.0 41.4 3.4 Under 18 105.0 105.4 0.3
Dependency Ratio (1) 67.7 70.1 2.4 18-64 97.0 99.0 2.1
Youth (2) 45.5 42.2 -3.3 65-84 71.7 75.9 4.2
Old Age (3) 22.2 27.9 5.7 85+ 39.8 46.0 6.2

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Population Pyramids of New Jersey with Row Headers in Column b and Column Headers in Rows 23 to 25
Population Pyramids of New Jersey
Percent of Total Population
2000 2030
85+
Male 80 - 84 Male Female
Female
75 - 79
70 - 74
65 - 69
60 - 64
55 - 59
50 - 54
45 - 49
40 - 44
35 - 39
30 - 34
25 - 29
20 - 24
15 - 19
10 - 14
5- 9
0- 4

5 4 3 2 1 0 1 2 3 4 5 5 4 3 2 1 0 1 2 3 4 5

Census 2000 Projection 2030 2000 - 2030 Change

Age Group Number Percent Number Percent Total
Total Male Female Total Total Male Female Total Number Percent
Total 8,414,350 4,082,813 4,331,537 100.0 9,802,440 4,778,485 5,023,955 100.0 1,388,090 16.5
0-4 563,785 288,085 275,700 6.7 612,218 313,242 298,976 6.2 48,433 8.6
5-9 604,529 309,563 294,966 7.2 620,866 317,681 303,185 6.3 16,337 2.7
10 - 14 590,577 302,708 287,869 7.0 605,224 311,393 293,831 6.2 14,647 2.5
15 - 19 525,216 271,020 254,196 6.2 549,194 284,997 264,197 5.6 23,978 4.6
20 - 24 480,079 244,628 235,451 5.7 532,133 273,758 258,375 5.4 52,054 10.8
25 - 29 544,917 272,873 272,044 6.5 580,085 293,415 286,670 5.9 35,168 6.5
30 - 34 644,123 319,031 325,092 7.7 617,911 312,830 305,081 6.3 -26,212 -4.1
35 - 39 727,924 360,230 367,694 8.7 671,518 341,494 330,024 6.9 -56,406 -7.7
40 - 44 707,182 348,061 359,121 8.4 683,554 345,320 338,234 7.0 -23,628 -3.3
45 - 49 611,357 297,845 313,512 7.3 658,968 329,359 329,609 6.7 47,611 7.8
50 - 54 547,541 263,357 284,184 6.5 588,382 290,775 297,607 6.0 40,841 7.5
55 - 59 423,338 202,559 220,779 5.0 563,653 275,501 288,152 5.8 140,315 33.1
60 - 64 330,646 156,073 174,573 3.9 559,189 265,809 293,380 5.7 228,543 69.1
65 - 69 293,196 132,558 160,638 3.5 548,439 252,925 295,514 5.6 255,243 87.1
70 - 74 281,473 121,639 159,834 3.3 478,835 212,669 266,166 4.9 197,362 70.1
75 - 79 240,131 95,560 144,571 2.9 366,291 154,624 211,667 3.7 126,160 52.5
80 - 84 162,337 58,291 104,046 1.9 275,069 106,397 168,672 2.8 112,732 69.4
85+ 135,999 38,732 97,267 1.6 290,911 96,296 194,615 3.0 154,912 113.9
Under 18 2,087,558 1,069,475 1,018,083 24.8 2,175,752 1,117,291 1,058,461 22.2 88,194 4.2
5-17 1,523,773 781,390 742,383 18.1 1,563,534 804,049 759,485 16.0 39,761 2.6
18-24 676,628 346,529 330,099 8.0 743,883 383,780 360,103 7.6 67,255 9.9
25-44 2,624,146 1,300,195 1,323,951 31.2 2,553,068 1,293,059 1,260,009 26.0 -71,078 -2.7
45-64 1,912,882 919,834 993,048 22.7 2,370,192 1,161,444 1,208,748 24.2 457,310 23.9
65+ 1,113,136 446,780 666,356 13.2 1,959,545 822,911 1,136,634 20.0 846,409 76.0

Demograp hic Indicator 2000 2030 Change Demographic Indicator 2000 2030 Change
Median Age 36.7 40.8 4.1 Child-Women Ratio ( 4) 31.1 34.3 3.3
Male 35.5 39.2 3.7 Sex Ratio (5) 94.3 95.1 0.9
Female 38.0 42.5 4.5 Under 18 105.0 105.6 0.5
Dependency Ratio (1) 67.7 79.7 12.0 18-64 97.0 100.3 3.4
Youth (2) 45.5 43.8 -1.8 65-84 71.7 77.1 5.4
Old Age (3) 22.2 35.9 13.7 85+ 39.8 49.5 9.7

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 Data Set: Census 2000 Summary File 1 (SF 1)
100-Percent Data
Geographic Area: Mercer County, New Jersey
Age Number

Both
sexes Male Female
Total population 350,761 170,750 180,011
Under 5 years 22,189 11,266 10,923
5 to 9 years 24,527 12,455 12,072
10 to 14 years 24,148 12,382 11,766
15 to 19 years 24,798 12,629 12,169
20 to 24 years 24,599 12,605 11,994
25 to 29 years 23,347 11,956 11,391
30 to 34 years 25,923 13,061 12,862
35 to 39 years 28,977 14,375 14,602
40 to 44 years 29,035 14,437 14,598
45 to 49 years 26,165 12,694 13,471
50 to 54 years 22,825 11,055 11,770
55 to 59 years 17,139 8,162 8,977
60 to 64 years 12,949 6,083 6,866
65 to 69 years 11,454 5,261 6,193
70 to 74 years 11,149 4,778 6,371
75 to 79 years 9,738 3,808 5,930
80 to 84 years 6,373 2,230 4,143
85 to 89 years 3,643 1,101 2,542
90 years and over 1,783 412 1,371

Source: U.S. Census Bureau, Census 2000 Summary File 1, Matrices P13 and PCT12.

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 Data Set: Census 2000 Summary File 1 (SF 1)
100-Percent Data
Geographic Area: Hamilton township, Mercer
County, New Jersey

Age Number

Both
sexes Male Female
Total population 87,109 41,530 45,579
Under 5 years 5,006 2,539 2,467
5 to 9 years 5,657 2,890 2,767
10 to 14 years 5,930 3,058 2,872
15 to 19 years 5,400 2,866 2,534
20 to 24 years 4,336 2,165 2,171
25 to 29 years 5,070 2,463 2,607
30 to 34 years 6,163 2,991 3,172
35 to 39 years 7,301 3,530 3,771
40 to 44 years 7,518 3,606 3,912
45 to 49 years 6,918 3,305 3,613

50 to 54 years 6,146 3,025 3,121

55 to 59 years 4,501 2,101 2,400

60 to 64 years 3,540 1,661 1,879

65 to 69 years 3,413 1,549 1,864
70 to 74 years 3,489 1,448 2,041
75 to 79 years 3,152 1,235 1,917
80 to 84 years 2,049 692 1,357
85 to 89 years 1,059 303 756
90 years and over 461 103 358

Nursing Facilities and Assisted Living Residences in Mercer

10
 County
September 2008
Nursing Assisted Living
Facilities Residences
Number of Facilities 18 10
Number of Beds 2,884 809
Dementia Capacity 60 208
Source: Prepared by Hendrickson Development, (2008, September)

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