Direct and indirect cost of managing alzheimer’s disease and related dementias in the United States

Deb, Arijita; Thornton, J. Douglas; Sambamoorthi, Usha; Innes, Kim E.

doi:10.1080/14737167.2017.1313118

Cited by 144 publications

(123 citation statements)

References 54 publications

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“…Seventy percent of the lifetime cost of care is borne by family caregivers in the forms of unpaid caregiving and out‐of‐pocket expenses for items ranging from medications to food for the person with dementia 312,313 . Current estimates of the lifetime costs of care may underestimate the impact of a relative's dementia on family caregivers’ health and workplace productivity 314 …”

Section: Caregivingmentioning

confidence: 99%

“…312,313 Current estimates of the lifetime costs of care may underestimate the impact of a relative's dementia on family caregivers' health and workplace productivity. 314 Three of the main reasons caregivers provide care and assistance to a person with Alzheimer's or another dementia are (1) the desire to keep a family member or friend at home (65%), (2) proximity to the person with dementia (48%) and (3) the caregiver's perceived obligation to the person with dementia (38%). A13 Caregivers often indicate love and a sense of duty and obligation when describing what motivates them to assume care responsibilities for a relative or friend living with dementia.…”

Section: Unpaid Caregiversmentioning

confidence: 99%

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2020 Alzheimer's disease facts and figures

2020

Alzheimer's & Dementia

2,046

653

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This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the future challenges of meeting care demands for the growing number of people living with Alzheimer's dementia in the United States with a particular emphasis on primary care. By mid‐century, the number of Americans age 65 and older with Alzheimer's dementia may grow to 13.8 million. This represents a steep increase from the estimated 5.8 million Americans age 65 and older who have Alzheimer's dementia today. Official death certificates recorded 122,019 deaths from AD in 2018, the latest year for which data are available, making Alzheimer's the sixth leading cause of death in the United States and the fifth leading cause of death among Americans age 65 and older. Between 2000 and 2018, deaths resulting from stroke, HIV and heart disease decreased, whereas reported deaths from Alzheimer's increased 146.2%. In 2019, more than 16 million family members and other unpaid caregivers provided an estimated 18.6 billion hours of care to people with Alzheimer's or other dementias. This care is valued at nearly $244 billion, but its costs extend to family caregivers’ increased risk for emotional distress and negative mental and physical health outcomes. Average per‐person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2020 for health care, long‐term care and hospice services for people age 65 and older with dementia are estimated to be $305 billion. As the population of Americans living with Alzheimer's dementia increases, the burden of caring for that population also increases. These challenges are exacerbated by a shortage of dementia care specialists, which places an increasing burden on primary care physicians (PCPs) to provide care for people living with dementia. Many PCPs feel underprepared and inadequately trained to handle dementia care responsibilities effectively. This report includes recommendations for maximizing quality care in the face of the shortage of specialists and training challenges in primary care.

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Section: Caregivingmentioning

confidence: 99%

Section: Unpaid Caregiversmentioning

confidence: 99%

2020 Alzheimer's disease facts and figures

2020

Alzheimer's & Dementia

2,046

653

View full text Add to dashboard Cite

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“…Alzheimer's disease (AD) and stroke are severe cerebral pathologies with a very high socioeconomic impact and burden for society. These pathologies can occur together, may even interact [1,2], and both contribute to dementia. Vascular factors predisposing to stroke and cerebrovascular disease have been associated with dementia and more specifically with the enhancement of amyloid-β (Aβ) deposition [3].…”

Section: Introductionmentioning

confidence: 99%

From Stroke to Dementia: a Comprehensive Review Exposing Tight Interactions Between Stroke and Amyloid-β Formation

Goulay

Romo

Hol

et al. 2019

Transl. Stroke Res.

100

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Stroke and Alzheimer's disease (AD) are cerebral pathologies with high socioeconomic impact that can occur together and mutually interact. Vascular factors predisposing to cerebrovascular disease have also been specifically associated with development of AD, and acute stroke is known to increase the risk to develop dementia. Despite the apparent association, it remains unknown how acute cerebrovascular disease and development of AD are precisely linked and act on each other. It has been suggested that this interaction is strongly related to vascular deposition of amyloid-β (Aβ), i.e., cerebral amyloid angiopathy (CAA). Furthermore, the blood-brain barrier (BBB), perivascular space, and the glymphatic system, the latter proposedly responsible for the drainage of solutes from the brain parenchyma, may represent key pathophysiological pathways linking stroke, Aβ deposition, and dementia. In this review, we propose a hypothetic connection between CAA, stroke, perivascular space integrity, and dementia. Based on relevant pre-clinical research and a few clinical case reports, we speculate that impaired perivascular space integrity, inflammation, hypoxia, and BBB breakdown after stroke can lead to accelerated deposition of Aβ within brain parenchyma and cerebral vessel walls or exacerbation of CAA. The deposition of Aβ in the parenchyma would then be the initiating event leading to synaptic dysfunction, inducing cognitive decline and dementia. Maintaining the clearance of Aβ after stroke could offer a new therapeutic approach to prevent post-stroke cognitive impairment and development into dementia.

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“…In spite of all these home healthcare available, patients who stay home need some level of informal care by their family members which add to the indirect costs. Published studies reported that indirect costs of diseases were 27%-89% of the total cost of healthcare (American Diabetes, 2018; Dagenais, Caro, & Haldeman, 2008;Deb, Thornton, Sambamoorthi, & Innes, 2017) which means that indirect cost is a major component of total healthcare cost.…”

mentioning

confidence: 99%

Direct and indirect costs of home healthcare in Japan: A cross‐sectional study

Tomita

Hoshino

Kamiya³

et al. 2020

Health Soc Care Community

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To tackle the rising healthcare expenditure in an ageing society in Japan, home healthcare has been promoted over the past several years. However, there is a dearth of literature on total costs incurring for home healthcare. In this study, we conducted a cross‐sectional study among patients, who received home healthcare in the month of May, 2018. Direct healthcare costs and patients’ clinical characteristics were collected from medical records and long‐term care databases (n = 166). Indirect costs were estimated using a questionnaire survey which obtained information on job absenteeism and care time from the caregiver. A total of 112 patients responded to the survey. The median age was 82 years (interquartile range: 74–88). Total per‐person per month home‐care costs averaged USD 6,163 with direct costs (USD 2,547) and indirect costs (USD 3,596) accounted for 41.3% and 58.3% of the total costs, respectively. The largest components of direct costs were long‐term care costs (48%) and medical costs (47%). Multivariable adjusted model showed that those with heavy healthcare were more likely to incur higher total as well as direct and indirect home healthcare cost (p<.05 for each). Patients aged >75 years (p = .041) were less likely and those who used oxygen at home were more likely to incur direct home healthcare cost (p = .001) than their counterpart. Our study findings show that indirect cost is a major contributor to total home healthcare costs in Japan. Also for patients who need heavy healthcare, both direct and indirect costs are large burden.

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Direct and indirect cost of managing alzheimer’s disease and related dementias in the United States

Cited by 144 publications

References 54 publications

2020 Alzheimer's disease facts and figures

2020 Alzheimer's disease facts and figures

From Stroke to Dementia: a Comprehensive Review Exposing Tight Interactions Between Stroke and Amyloid-β Formation

Direct and indirect costs of home healthcare in Japan: A cross‐sectional study

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