The Free Press, Mankato, MN

April 13, 2013

Study puts a hefty price tag on dementia

Toll also can have costs that aren’t measured with dollar signs

By Robb Murray
Free Press Staff Writer

— A new study shows caring for dementia patients is now costlier than heart disease and cancer, and those costs will double by the time baby boomers reach their 70s.

More than 5 million Americans are suffering from some kind of dementia, which is the loss of brain function that most notably manifests itself with decreased memory capacity. It also affects language, judgment and behavior.

The majority of those dealing with dementia are suffering from Alzheimer’s disease.

According to the study, commissioned by the Rand Corporation, dementia care in the U.S. costs between $157 billion and $215 billion annually.

The study estimates that about 15 percent of Americans aged 71 or older suffered from dementia in 2010. The total economic cost of dementia in 2010 was estimated to be $109 billion for care delivered directly to patients, and $159 billion to $215 billion when the monetary value of so-called “informal care” is included.

The per-person cost of dementia, the study found, was $56,290 or $41,689 annually. Medicare paid about $11 billion of dementia-related costs.

Costs for heart disease and cancer are comparable in terms of care purchased. In fact, both see higher costs than dementia. But when the informal care costs are added, the study showed, dementia care becomes more costly.

Winnie Pao, a neurologist with Mayo Clinic Health System in Mankato, says costs associated with treatment of dementia can come from both inpatient and outpatient settings.

Pao said dementia patients are prone to falls, delirium, sleep-wake dysregulation and behavior issues while in unfamiliar environments.

“They require more home care or, if they are in a long-term care environment, it can be very costly,” she said. “If they stay at home, then there is the unpaid caregiver cost, that includes loss of work productivity, caregiver’s own stress and health issue.”

Costs in dementia care, Pao said, are multi-leveled.

In a non-hospital environment, patients often need a paid caregiver, depending on the level of dementia. If a patient had behavioral issues or sleep issues, Pao said, it could make caring for them more demanding.

“A paid caregiver is expensive, since this is currently an illness that will only progress,” Pao said.

An unpaid caregiver, she said, is usually a family member who may undergo lost wages or decreased income because of disruption or time off from work.

In addition, Pao said, the toll also can have costs that aren’t always measured with dollar signs.

“Increased emotional stress, depression, their own health impairment because of taking care of a chronically ill family member — these are all costs beyond the actual medical bill of a patient with dementia,” Pao said.

The way the medical community treats dementia has changed over the years as well.

Laura Meyer, a nurse practitioner in neurology at the Mankato Clinic, said the changes have been driven by the growing number of people affected. There are more specialty care units and day programs available to people suffering from dementia than a decade ago.

“Years ago we did not have these community resources available, and they are tremendously valuable to those families who need them,” Meyer said. “We also have medications available to slow the progression of the disease, and this has changed the way we are looking at and treating it.”