Costs of dementia as high as $215B in U.S.

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 - elderly;  Alzheimer's

The financial burden imposed on society by treating cases of dementia rivals the costs associated with heart disease and cancer, according to a study published April 4 in the New England Journal of Medicine.

Total monetary cost of dementia in the U.S. in 2010 was between $157 billion and $215 billion, reported Michael D. Hurd, PhD, director of the RAND Center for the Study of Aging in Santa Monica, Calif., and colleagues.

“Our estimate places dementia among the diseases that are the most costly to society,” wrote the authors.

The estimates were based on a subsample of 856 individuals from the Health and Retirement Study, a nationally representative longitudinal study of older adults. In-home cognitive assessments were administered to the subsample, and the results were assigned to the full study sample of nearly 11,000 people. Costs of care were determined by self-reported out-of-pocket spending and the use of nursing home care, as well as Medicare claims data. Informal unpaid care given by family members was also estimated.

Prevalence of dementia among persons older than 70 years was pegged at 14.7 percent in 2010, according to Hurd and colleagues. Yearly monetary costs per case was between $41,689 and $56,290. Medicare paid roughly $11 billion of the total costs of dementia care.

The reason for the wide range in the cost estimate is differing estimates of the cost of informal care, explained the authors. Hours of informal care were valued either as equivalent to formal, paid care, or estimated wages forgone by informal caregivers. The main component of dementia costs was institutional or home-based long-term care, representing 75 to 84 percent of the total costs.

Hurd and colleagues noted that attributing costs to dementia is a challenge because individuals suffering from dementia often have other chronic health problems that must be adjusted for in estimates. Value of informal care is also hard to pin down.

Looking ahead, the costs of dementia care in the U.S. stand to rise considerably, wrote the authors. Due to the aging population, there will be an 80 percent increase in total societal costs per individual case of dementia by 2040.