Blog | Friday, April 5, 2013

QD: News Every Day--Dementia's price tag increasing

Dementia care costs $109 billion annually, and informal care drives the price up to a range of $159 billion to $215 billion, more than the costs of heart disease or cancer, researchers found. An aging population could double these costs by 2040.

To determine dementia's financial toll, researchers applied data from the Health and Retirement Study, a nationally representative longitudinal survey of people 51 years or older that began in 1992. All spending was converted to 2010 dollars by the medical care Consumer Price Index.

Results appeared online April 4 at the New England Journal of Medicine.

The study looked at costs for care purchased in the market, including out-of-pocket expenses and costs of Medicare, nursing homes and in-home care. A second metric included the monetary value of time spent by unpaid caregivers calculated as either the replacement cost or the cost of forgone wages.

Dementia care per person purchased in the market cost $33,329 (95% confidence interval [CI], $24,223 to $42,434), although coexisting conditions and demographics reduced the estimate. The largest cost was nursing home care (approximately $13,900), followed by out-of-pocket spending (approximately $6,200), formal home care (approximately $5,700), and Medicare (approximately $2,700).

After including the cost of informal care, dementia could cost was $41,689 (95% CI, $31,017 to $52,362) when the valuation of forgone wages was used and $56,290 (95% CI, $42,746 to $69,834) when the valuation of replacement cost was used.

After combining the adjusted cost per person with dementia with prevalence rates and Census projections, the study predicted a prevalence of 14.7% in the population older than 70 years of age and an annual population cost of $109 billion for care purchased in the market, with a cost of $159 billion to $215 billion when the estimated monetary value of informal care was included. These costs will more than double by 2040 because of the aging of the population.

"Our estimate places dementia among the diseases that are the most costly to society," the researchers wrote. "The cost for dementia care purchased in the marketplace ($109 billion) was similar to estimates of the direct health care expenditures for heart disease ($96 billion in 2008, or $102 billion in 2010 dollars) and significantly higher than the direct health care expenditures for cancer ($72 billion in 2008, or $77 billion in 2010 dollars). These costs do not include the costs of informal care, which are likely to be larger for dementia than for heart disease or cancer."

Editor's Note: QD: News Every Day will resume publishing after the conclusion of ACP's Internal Medicine 2013 meeting in San Francisco.