The greatest price of Alzheimer's and other types of dementia isn't drugs or other medical therapies, but the care that's required just to get mentally impaired people through everyday life, the charitable RAND Corp.'s study found. Additionally, it gives what experts say may be the most reliable estimate for exactly how many Americans have dementia - around 4.1 million. That's less than the widely reported 5.2 million estimation from the Alzheimer's Association, which comes from a study that involved individuals with less serious impairment. "The important thing here's the same: Dementia is among the most costly diseases to society, and we need to handle this if we are planning to come to terms with the cost to the Medicare and Medicaid system," explained Matthew Baumgart, senior director of public policy at the Alzheimer's Association. Dementia's direct costs, from drugs to nursing facilities, are $109 billion annually this season dollars, the new RAND record found. That even compares to $102 billion for cardiovascular disease and $77 billion for cancer. Everyday care by family members and others forces dementia's total even higher, according to how that care and lost wages are valued. "The casual treatment costs are substantially greater for dementia than for cancer or heart conditions," said Michael Hurd, the study was led by a RAND economist who. It had been sponsored by the government's National Institute on Aging and will be published in Thursday's New England Journal of Medicine. Alzheimer's is the most typical kind of dementia and the sixth leading cause of death in america. Dementia also can derive from a stroke or other diseases. It is rapidly increasing in as the population prevalence ages. Current treatments slow the disease and do only briefly ease symptoms. People live four to seven years on average after an Alzheimer's diagnosis, however, many live 20 years. By age 80, about 75 percent of individuals with Alzheimer's will be in a home compared with only 4 percent of the normal population, the Alzheimer's group says. "Most folks have understood the tremendous cost when it comes to human suffering and cost," but the new evaluations to heart problems and cancer may surprise some, explained Dr. Richard Hodes, director of the Institute on Aging. "Alzheimer's infection includes a pressure that meets several different illnesses," specially because of just how long people stay with it and need care, he said. For the new study, researchers started with about 11,000 people in a long-running government health study of a representative sample of the population. They gave 856 of these people extensive tests to determine exactly how many had dementia, and predicted that to the bigger group to determine a prevalence rate - not quite 15 percent of people over age 70. Using Medicare and other documents, they tallied the cost of purchased care - nursing facilities, medicines, other treatments - including out-of-pocket costs for dementia this year. Next, they subtracted spending for different health conditions such as high blood pressure, diabetes or depression so they could identify the actual price of dementia alone. "This can be an important difference" from other studies which could not determine how much health care cost was attributable simply to dementia, mentioned Dr. Kenneth Langa, a of Michigan researcher who helped lead the task. Despite having that modification, dementia topped cancer and heart disease in cost, according to information on spending for those problems from the federal Agency for Healthcare Research and Quality. Finally, scientists considered unpaid care using two other ways to calculate its importance - foregone salaries for caregivers and if acquired from a company like a home health aide what the care would have cost. That gave an overall total annual cost of $41,000 to $56,000 per year for every dementia situation, depending on which valuation approach was used. "They did an extremely cautious job," and the newest estimate that dementia affects about 4.1 million Americans appears probably the most solidly centered than any before, Hodes said. The federal government does not have the state estimate but now has been expressing "up to 5 million" cases, he said. Probably the most worrisome part of the record may be the development it portends, having an aging population and fewer younger people "able to take on the casual caregiving role," Hodes said. "The most useful aspire to change this obvious potential would be to find a way to intervene" and avoid Alzheimer's or change its course once it develops, he said.
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