Annual bill now tops $200 billion, largely for long-term care, researchers say
WEDNESDAY, April 3, 2013 (HealthDay News) -- The cost of caring for Americans with Alzheimer's and other forms of dementia may now be as high as $215 billion a year -- more than the cost of caring for heart disease or cancer, a new study finds.
And that number is expected to escalate as the elderly population grows.
In 2010, the United States spent somewhere between $157 billion and $215 billion on dementia care, researchers reported in the April 4 issue of the New England Journal of Medicine. That includes direct medical expenses and the costs of caring for people with dementia -- both professional care and the "informal" care that families provide.
Dementia is a progressive deterioration in memory, thinking ability, judgment and other vital brain functions.
Alzheimer's disease is the most common form of dementia, and a recent study estimated that with the aging baby boom generation, the number of Americans with Alzheimer's could triple by 2050, to nearly 14 million.
The new study tried to take a "comprehensive look" at the financial impact -- including the costs to family caregivers, said lead researcher Michael Hurd, a senior principal researcher at the nonprofit research institute RAND.
"It's not a happy situation," Hurd said. "A lot of the costs fall on families, and right now, there's no solution in sight."
The researchers based their estimates on a government study of older Americans, plus Medicare records and other data sources. Of the billions spent on dementia in 2010, only a small portion went to medical treatments, the study found.
Instead, long-term care -- either nursing homes, or home care provided by professionals or family members -- was the big expense, accounting for up to 84 percent of the total.
Per person, the costs ranged from about $41,700 to $56,300, depending on how the researchers calculated the cost of family caregiving. In the first case, they considered only family members' lost wages; in the second, they gave family members' time the same value as formal paid care.
As for who paid, Medicare foot the bill for $11 billion out of the up to $215 billion in total expenses, Hurd's team said.
It's a small share because Medicare does not usually cover nursing home or other long-term care. Medicaid, the government health insurance program for the poor, will cover it -- but only after certain patient assets have been spent down.
"A large part of the burden is borne by families," said Dr. Richard Hodes, director of the U.S. National Institute on Aging, which funded the study.
Hodes noted that things could get tougher in the years to come. The younger baby boomers had fewer children compared with past generations -- so along with the rise in the number of elderly adults with dementia, there will be fewer family members to care for them.
Study author Hurd said the findings highlight two big needs: some sort of health insurance program to cover long-term care and more research into ways to slow the progression of dementia or delay its onset.
"If we could delay the onset of dementia, the payoff would be high," Hurd said.
NIA director Hodes agreed. "We don't have an effective treatment or an effective way to prevent dementia," he said. "And the results from studies so far have been disappointing, to say the least."
But there are clinical trials under way, looking at both drugs and other approaches -- such as exercise -- to forestall dementia.
"There is reason for hope and optimism," Hodes said.
Hurd said dementia may already be having a bigger financial impact than heart disease and cancer -- which cost the nation $102 billion and $77 billion, respectively, in 2010.
Those estimates do not include the costs of family caregiving, Hurd said. "But it's likely they would be lower compared with dementia," he added.
He and Hodes both stressed that this study looked only at one aspect of dementia care -- the financial one. "We calculated the monetary cost," Hurd said. "This says nothing about the huge emotional burden on families."
The U.S. National Institute on Aging has more information on dementia (http://www.nia.nih.gov/health/publication/forgetfulness-knowing-when-ask-help ).
SOURCES: Michael Hurd, Ph.D., senior principal researcher, RAND Center for the Study of Aging, Santa Monica, Calif.; Richard Hodes, M.D., director, U.S. National Institute on Aging; April 4, 2013, New England Journal of Medicine