Dementia, a chronic degenerative disease, originates in the cerebral cortex, which accounts for approximately two-thirds of the brain’s mass. This region controls crucial sensory and cognitive functions.
The condition can develop due to an injury or occur with a comorbidity of other diseases. At the onset of dementia, the cerebral cortex begins to deteriorate. The disease is progressive and does not currently have a cure.
Symptoms can manifest as mild cognitive impairments, which are often casually disregarded as normal forgetfulness. These can include the inability to focus and perform more than one task, taking an inordinately prolonged amount of time to perform activities, forgetting recent events and conversations, misplacing items, and frequently getting lost on familiar routes.
Depending on the degree of advancement, the person’s behavior may eventually become out of control; they may become angry, agitated, disoriented, and combative. They may also come off afraid, clingy, and childlike.
Over time the disease ultimately advances, interfering with independent functioning. Those afflicted with progressive neurological conditions require monitoring in assisted living. Monitoring is often done within the confines of facilities with professionals trained to interact and care for someone dealing with degenerative dementia. There is also the option of having live in or in home care. Either way, the maintenance can be expensive.
President Barack Obama signed the National Alzheimer’s Project Act into law in January 2011. One goal of the law was to improve the ability of the US government to track the monetary costs incurred by individuals and public programs from dementia.
The economic analysis of the “Monetary Costs of Dementia in the United States,” published in The New England Journal of Medicine, forecasted the alarming increase in the related expenditures to come.
The study, led by the RAND Corporation and financed by the National Institute on Aging, found the financial burden was as high if not higher than that of heart disease and cancer.
The direct health care expenses for dementia, including nursing home care, were $109 billion in 2010. For heart disease, those costs totaled $102 billion; for cancer, $77 billion. Each case of dementia costs $41,689 to $56,290 a year.
Analysts projected both the costs and the number of those afflicted with the chronic disease would double within 30 years.
Nearly 15 percent of people 70 or older, about 3.8 million people, have dementia. Based on those figures the researchers projected that by 2040, the number could surge to 9.1 million.
By 2040, because of the population increase, it was estimated the total burdensome cost of dementia care would fall between $379 billion to $511 billion. This is a notable increase from $159 billion to $215 billion paid out in 2010.
The data used to calculate cost projections was pulled from a database called the Health and Retirement Study (HRS). The longitudinal information followed 10,903 people over nearly a decade. All participants were subjected to cognitive and functional testing, establishing a baseline to measure mental decline against.
The expense associated with care for those with dementia was determined on the basis of self-reported out-of-pocket spending, the utilization of nursing home care, informal and formal care, and Medicare claims.
Dr. Richard J. Hodes, the director of the National Institute on Aging, which financed the study, expressed his concern with the findings. The New York Times quoted him saying, “I don’t know of any other disease predicting such a huge increase. And as we have the baby boomer group maturing, there are going to be more older people with fewer children to be informal caregivers for them, which is going to intensify the problem even more.”
The RAND cost estimates for current dementia care are similar to the Alzheimer’s Association’s, but the association’s future cost projections are significantly higher, an estimated $1.2 trillion in 2050. This is because the Alzheimer’s Association bases its forecast using people 65 and older with earlier stages of memory loss and Alzheimer’s – the most common type of dementia.
[Image via Shutterstock]