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Rising Alzheimer's rates, costs expected to 'overwhelm' U.S. health care system.

PHILADELPHIA -- Rising rates of Alzheimer's disease and its projected costs will likely pose a major burden to the U.S. health care system in coming years, data from three studies presented at the 9th International Conference on Alzheimer's Disease and Related Disorders suggest.

"Unless a prevention or cure is found soon, Alzheimer's disease [AD] will overwhelm our already stretched health care system and bankrupt Medicare and Medicaid," said Sheldon Goldberg, president and CEO of the Alzheimer's Association, which sponsored the conference.

Medicare expenditures for people with Alzheimer's disease are almost three times higher than the average for all beneficiaries, and Medicare spending for beneficiaries with Alzheimer's will triple between 2000 and 2015, from $62 billion to $189 billion. State and federal spending on people with AD, for nursing home care only, is estimated to rise from $19 billion in 2000 to $27 billion in 2015, an association statement said.

Dr. P. Murali Doraiswamy and his associates at Duke University's Center for Health Policy, Law & Management examined Medicare claims for 29,679 beneficiaries aged 65 and older during 1991-1999. Age-adjusted rates of beneficiaries identified as having Alzheimer's disease rose by 250% during the 9-year period and by 460% for African Americans. In 1991, African Americans made up 6.5% of the identified AD population but accounted for 11% in 1999, possibly reflecting improved health care access. Rates of increased identification also rose dramatically among women, he said in a poster presentation.

In a second study, presented in a poster by Dr. Henry Glick of the University of Pennsylvania, statistical modeling was used to project long-term costs of care for patients at various degrees of disease severity, based on data from 1,565 individuals aged 65 and older with suspected AD. The average cost of care per year for a man with AD was about $9,700, compared with $16,300 for a woman.

The gender difference was attributable to several factors: During 15 years' follow-up, women lived an average of 5.99 years and spent 1.44 years in institutional care. In contrast, men lived an average of 4.83 years, during which they spent 0.59 years in institutional care. Moreover, women lived an average of 2.73 years with two or more limitations in basic activities of daily living, compared with just 1.47 years for the men.

Men also had substantially fewer hours of paid care while living in the community than did women, and caregivers reported providing men and women with similar numbers of hours of informal care, suggesting that men did not receive more hours of informal care to make up for spending less time in institutions. Dr. Glick reported.

The costs per year increased with the time since diagnosis. Women who survive 10 years or more with any severity of AD have annual costs totaling more than $30,000 per year, whereas men with moderate to severe AD who survive for 11 or more years cost more than $20,000 per year, he said.

A literature review presented in a third poster suggested that AD-associated costs rise dramatically with greater severity of disease. Direct medical costs alone are 60% higher among patients with moderate dementia, compared with the mild form, and 200% higher for severe dementia versus mild, Shalini Kulasingham, Ph.D., of Duke University, reported.

BY MIRIAM E. TUCKER

Senior Writer
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Author:Tucker, Miriam E.
Publication:Clinical Psychiatry News
Geographic Code:1USA
Date:Oct 1, 2004
Words:557
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