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Calculating the Burden of Dementia in Dollars and Cents

The burden of dementia is heavy. Not only are there physical and emotional challenges that come with cognitive decline, medical costs soar.

Dementia takes a devastating toll on people’s ability to organize, learn or even manage ordinary activities of daily life. It often places a huge strain on family members, both physically and emotionally. Now researchers have calculated the financial burden of dementia, which is only likely to rise with pricey new prescriptions like Leqembi.

What Is the Financial Burden of Dementia?

A new study documents the financial burden associated with dementia (JAMA Internal Medicine, Oct. 16, 2023). The researchers analyzed data, including economic status, availability of family to help a person manage, health conditions and medical care use among Americans at least 55 years old. In the following two years, physicians diagnosed 2,387 of these individuals with dementia. The researchers compared their need for family care hours, in-home medical services and hospitalization with those for people with similar characteristics but no dementia. Participants were 75 years old, on average, and provided information on medical costs and net wealth for 8 years.

Out-of-pocket medical costs were substantially greater, increasing from $4,000 to $10,000. In addition, median wealth dropped precipitously for people diagnosed with dementia. At the outset, they had $79,000 in assets, on average. By the end of the study, assets came to only about $30,500. Participants were also far more more likely to enroll in Medicaid. Usually this result from depletion of resources, so it is not surprising in this context. The investigators note that people without family nearby to help them manage day to day were far more likely to need a nursing facility.

Consequently, they conclude:

“Family care availability should be accounted for in a comprehensive assessment of predicting the effects of dementia.”

Can You Reduce the Burden of Dementia?

A member of a family with a history of Alzheimer disease or other type of dementia may experience a sense of dread about their own future. We recommend this article from Judith Graham of Kaiser Health News for perspective on how some people cope with this knowledge.

We also suggest avoiding multiple anticholinergic drugs, as a high anticholinergic burden can affect cognitive function. Long-term use may even predispose someone to develop dementia.

Maintaining a good regimen of exercise and healthful diet does not guarantee freedom from dementia. However, studies show that people embracing healthful lifestyles may be somewhat less vulnerable.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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