As the population ages, more people have various forms of dementia. The disease category is becoming the largest single cause of health spending and also causes a lot of non-health spending. Research in the Annals of Internal Medicine attempts to quantify and compare these costs. (Annals Article) The researchers looked at Medicare beneficiaries aged 70 or older who died between 2005 and 2010. Cause of death was segregated into four categories: dementia, heart disease, cancer or other diseases. Total health and non-health cost over the last five years of life were measured and out-of-pocket spending as a proportion of household wealth was analyzed as well. The average total cost for people who died of dementia was $287,000, much larger than for those who died of heart disease, $175,000, of cancer, $173,000, or other causes, $197,000. Actual Medicare expenditures were similar across the death causes, but out-of-pocket spending was very different. For dementia these out-of-pocket costs were $61,500, 81% higher than for patients without dementia, $34,000. Informal care costs showed a similar pattern. Median out-of-pocket spending for the dementia cohort, $37,000, was 32% of household wealth, compared to only 11% of non-dementia groups. In addition, this out-of-pocket spending was 84% of household wealth for African-Americans, 48% for people with less than a household education and 58% for unmarried or widowed women. The research validates the terrible burden this disease imposes on Americans. The toll is not just financial, but the physical and mental debilitation endured by informal caregivers. There are few, if any, effective treatments for dementia today, and projections are that its costs will grow substantially in the next few years. In the absence of new treatments that lessen the effects the misery of this disease will continue to spread.
