Dementia's End-of-Life Costs Surpass Cancer, Heart Disease

During the last 5 years of life, the cost of dementia eclipses that of other diseases, according to a study published in the Annals of Internal Medicine.

The National Institute on Aging (NIA), part of the National Institutes of Health, found that the total healthcare expenditures for people with dementia was 57% greater than the costs associated with death from cancer and heart disease. Researchers analyzed data from the Health and Retirement Study and linked Medicare and Medicaid records and other data to determine the “social” costs of all types of care for 1702 Medicare fee-for-service beneficiaries age 70 years and older.

The investigators divided patients into 4 groups: those with high probability of dementia; those with cancer; those with heart disease; and those with another cause of death. They calculated costs from Medicare, Medicaid, private insurance, out-of-pocket, and informal care during the last 5 years of life.

“This complex analysis lays out the significant health care costs to society and individuals in the last five years of life,” NIA Director Richard J. Hodes, MD, said in a statement. “It provides an important picture of the risks that families face, particularly those with dementia and those who may be least able to bear major financial risk. Such insights are critically important as we examine how best to support the aging of the U.S. population.”

Average Medicare expenditures were similar across all 4 disease groups, but almost all other costs were consistently higher for people with dementia. Medicaid expenditures for people with dementia averaged $35,346 compared with just $4552 for people without dementia. Out-of-pocket spending for those with dementia was $61,522 compared with $34,068 for people without dementia (81% higher) and informal care costs were $83,022 for people with dementia compared with $38,272 for those without.

"This study is the latest evidence that, in addition to the human suffering caused by this disease, Alzheimer's is creating an enormous strain on families, the health care system and the federal budget," Matthew Baumgart, senior director of public policy for the Alzheimer's Association, said in a statement.

According to Baumgart, American voters are seeing Alzheimer’s disease, a leading cause of dementia, as a significant priority for the 2016 congressional and presidential elections. Study results from his association found that 52 million voters have provided care or personal assistance to a relative, friend, or neighbor with Alzheimer’s disease, 73 million have had a family member or close friend with the disease, and 82% are concerned about Alzheimer’s disease.

"The overwhelming cost to American families to care for people with dementia, as shown in this NIA-funded study, explains why Alzheimer's will be a voting issue for millions of Americans in 2016," said Baumgart. “Voters expect presidential and Congressional candidates to share their specific plans for addressing the mounting Alzheimer's crisis.”