Costs and Impact of Dementia

Dementia is said to kill more people than breast and prostate cancer combined. One in three seniors die with Alzheimer’s or another form of dementia. Of course, co-morbidities contribute to the death rate. Between the years 2000 and 2019 deaths from Alzheimer’s has doubled while deaths from the leading cause of death – heart disease – have decreased. Most recently notable is the increase of 17% in Alzheimer’s and dementia deaths related to COVID-19 in 2020.

As with all health issues, the economic impact of dementia is significant. Of the total lifetime costs for caring for a person living with dementia, it is estimated that 70% is borne by families through out-of-pocket health expenses, long-term care expenses, and/or the value of unpaid care. In 2022 it was estimated that dementia would cost about $321 billion annually and could reach nearly $1.1 trillion in annual costs by 2050. This reflects a three-fold increase in spending under Medicare/Medicaid and out-of-pocket costs. These costs reflect more than twice as many hospital stays, more skilled nursing facility stays, and more home health visits than older people without dementia.

Let’s compare these costs to the direct medical costs of the leading health and mortality issues in the United States. About 90% of annual health care costs in the United States are spent for chronic and mental health conditions. Heart disease and stroke are estimated to cost the health care system about $216 billion per year, cancer care costs are expected to rise to more than $240 billion by 2030, and diabetes care is estimated to cost $237 billion. This comparison demonstrates the significant impact of dementia on health care costs in the United States.

Dementia death rate: 1 in 3 seniors     Co-morbidities increase death rate   Economic and human cost of care impact     2022: $321 billion, increasing to $1.1 trillion by 2050     Unpaid care value estimated at $272 billion     70% of care costs borne by families   Increasing demand for direct care workers and geriatric specialists

It is estimated that in 2021 about 11 million people provided unpaid care for people with dementia contributing more than 16 billion hours of care valued at nearly $272 billion. More about caregivers: nearly a third are 65 years of age or older themselves and about two-thirds of these caregivers live with the person with dementia in a community setting. Two-thirds of caregivers are women with over on-third of those who are daughters. And, about a quarter of caregivers care not only for the person with dementia, but also care for at least one child. Surveys of caregivers demonstrate that this work substantially impacts their own emotional, physical, and financial well-being.

It is estimated that the demand for direct care workers, such as nurses aids and home health aids, will continue to grow more than 40% even as their availability is projected to decline. A survey of primary care physicians suggested that half felt they were not adequately prepared to care for patients living with dementia. At this time, there are few professionals who specialize in geriatric care, a category most suited to working with people living with dementia. About 12% of nurse practitioners and less than 1% of registered nurses, physician assistants, and pharmacists have expertise in gerontological care. About 4% of social workers have formal certification in geriatric social work. It is estimated that the number of professionals with geriatric specialties will need to at least triple to provide care for people living with Alzheimer’s by 2050. 

 

Alzheimer's Disease

The Alzheimer’s form of dementia accounts for between 60%-80% of dementia types in the United States. It is an irreversible disease that progressively destroys memory and thinking/reasoning skills, eventually taking away the ability to carry out even very simple tasks. Symptoms of Alzheimer’s disease include memory loss, trouble communicating, confusion, anxiety, and paranoia. The brain region associated with Alzheimer’s is the hippocampus, which is the where learning and memory functions. It is why memory loss may be one of the early symptoms of Alzheimer’s during mild stages, which may last 10 or more years. The middle stage of Alzheimer’s lasts an average of 3-8 years, while the late stage more commonly lasts for one to two years before death.