The monetary cost of dementia in the United States ranges from $157 billion to $215 billion annually, making the disease more costly to the nation than either heart disease or cancer, according to a new RAND Corporation study.
The greatest economic cost of dementia is associated with providing institutional and home-based long-term care rather than medical services, according to the findings published in the April 4 edition of the New England Journal of Medicine. The cost of nursing home care, and formal and informal home care comprise 75 percent to 84 percent of dementia costs.
The prevalence of dementia increases strongly with age and the analysis suggests that the costs of dementia could more than double by 2040 if the age-specific prevalence rate of the disease remains constant as the nation’s population continues to grow older.
The cost of dementia care purchases ($109 billion) was similar to the estimated of the direct healthcare costs for heart disease ($102 billion) and significantly higher than the direct health costs for cancer ($77 billion). However, the costs for cancer and health disease do not include the cost of informal care, which is likely to be larger for dementia.
The new cost estimates are lower than ones reported previously by the Alzheimer’s Association. Researchers say the new study provides a clearer picture of the economic burden caused by the disease because it eliminates costs related to other illnesses suffered by dementia patients, accounts for variations in the severity of dementia and uses a better estimate of the incidence of the illness.
The new study, funded by the National Institute on Aging, is based on findings from the Health and Retirement Study, an ongoing survey of individuals in the United States age 51 and older that began in 1992, and is supported by the National Institute on Aging and the Social Security Administration. A subset of that study group received a detailed in-home clinical assessment for dementia as part of the Aging, Demographics and Memory Study, a nationally representative examination of dementia in the United States.
The survey included an assessment of whether people could perform daily activities such as dressing themselves and preparing their own meals. Participants also were asked about their out-of-pocket healthcare expenses for services such as nursing home stays, home health care and other medical services. Other questions asked whether they received help from others for their daily living activities. Medicare spending information was linked to medical claims for most participants.
The study, the most detailed examination done in recent decades on the costs of dementia, estimates that 14.7 percent of Americans aged 71 or older suffered from dementia in 2010, a number somewhat lower than what has been found in other, smaller studies.
The total economic cost of dementia in 2010 was estimated to be $109 billion for care purchased, and $159 billion to $215 billion when the monetary value of informal care is included.
Source: The RAND Corporation, April 3, 2013
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