What is America\’s costliest health condition? I suppose the two obvious guesses might be cancer or heart disease. But the answer may well be Alzheimer\’s disease, according to \”Monetary Costs of Dementia in the United States,\” written by Michael D. Hurd, Paco Martorell, Adeline Delavande,
Kathleen J. Mullen, and Kenneth M. Langa, and published in the April 3, 2013 issue of the New England Journal of Medicine. They write:
\”The estimated prevalence of dementia among persons older than 70 years of age in the United States in 2010 was 14.7%. The yearly monetary cost per person that was attributable to dementia was either $56,290 … or $41,689 …, depending on the method used to value informal care. These individual costs suggest that the total monetary cost of dementia in 2010 was between $157 billion and $215 billion. … By 2040, assuming that prevalence rates and cost per person with dementia remain the same, our estimates suggest that these costs will more than double because of the aging of the population. …
Our estimate places dementia among the diseases that are the most costly to society. 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.\”
The fact that 1 person in 7 in the United States over the age of 70 has dementia now was an unpleasant surprise to me: I would not have guessed the proportion was that high. As the population ages, my guess is that the proportion will tent to rise. The calculations in this study show that only for those in the 71-74 age bracket, just 2.8% have dementia, but that percentage steadily rises to 4.9% for those in the 75-79 age bracket, 13.0% for those in the 80-84 age bracket, 20.3% for those in the 85-89 age bracket, and a frankly terrifying 38.5% for those over age 90.
The cost-per-person of dealing with dementia seem likely to rise, too, like so many other service-related health care costs. With generally lower birthrates in the last few decades, finding unpaid family caregivers to look after those with dementia will become harder. But pushing all of those with Alzheimer\’s into America\’s ultra-costly health care system isn\’t practical, either. Barring some medical breakthrough that dramatically holds down the number of future cases of dementia, thinking about a model of care for growing numbers of dementia patients that is acceptable and affordable is going to pose some difficult social challenges.