Dementia Costs Exceed Heart Disease, Cancer

Caring for Americans with dementia costs more than heart or cancer care, a new study finds. Direct costs were estimated at $109 billion a year. This includes medical care and nursing homes. The total exceeds the estimated $102 billion a year for heart disease and $77 billion for cancer. Informal care by family and friends boosts dementia costs even more. In all, costs add up to $157 billion to $215 billion a year. The study calculated these two figures using different ways to estimate the costs of informal care. Researchers based their study on 10,903 people in a long-running government study of aging. Of that group, 856 were given detailed exams to determine if they had dementia. Researchers then estimated that 15% of the total group over age 70 had dementia. Costs of care were based on Medicare and other records. The New England Journal of Medicine published the study. The Associated Press wrote about it April 4.

By Howard LeWine, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

Americans and people from many other countries take pride in the dramatic improvement in life expectancy during the last 100 years. But with this success, we now have a rapidly rising rate of Alzheimer's disease and other types of dementia. And society is paying a huge price.

This new study shows just how much it costs -- an estimated $157 billion to $215 billion a year in the United States. The medical costs to care for the estimated 4.1 million Americans with dementia are about $11 billion. That's just a small percentage of the total costs.

What runs up the tab is the cost of helping people with dementia make it through the day. Almost all of them will need someone with them 24 hours a day. When the family can't provide that care, it means moving to a nursing home.

A century ago, dementia was a rare disease. It remained uncommon for another 50 years. With better sanitation, vaccines, antibiotics and advances in medical care, life expectancy has been on a tear. In 1930, average life expectancy in the United States was less than 60. It didn't reach age 70 until 1970. That's just 43 years ago.

The risk of Alzheimer's disease and other types of dementia is quite small before age 70. But after that the risk rises quickly. Today, with people living longer than ever, an estimated 14% of Americans over age 70 live with dementia. The number may be as high as 14 million by 2050.

The authors only looked at the financial burden of dementia. Their study was not designed to look at the emotional and physical toll on family members. The authors acknowledged that these costs to family quality of life may be even greater than the financial burdens.

What Changes Can I Make Now?

There are no specific treatments to prevent Alzheimer's disease and other types of dementia. Scientists will keep looking for answers. Meanwhile, you can reduce your risk or at least delay when dementia occurs.

• Don't smoke or use other tobacco products.
• Use alcohol in moderation. That means no more than one drink per day for women, and no more than two per day for men.
• Maintain a healthy body weight. In particular, try not to let your waist expand. People with more fat in the middle have a higher risk of developing dementia, even if their body weight is normal.
• Exercise regularly. Make it your goal to get at least 150 minutes of moderate-intensity exercise per week.
• Keep your blood pressure in the normal range. To do this, get regular exercise, eat lots of fruits and vegetables, and cut down on salt. Your doctor can prescribe medicines if needed.
• Stay socially engaged with family and friends.

There is some evidence that a Mediterranean-style diet may be especially good for the brain.

These suggestions should look familiar. They are the same ones that will help keep your heart healthy and decrease your risk of stroke.

What Can I Expect Looking to the Future?

Progress in prevention and treatment of dementia has been slower than we hoped. Government support of medical research is being cut. However, the relative amounts of money that will go toward Alzheimer's and other dementias will likely be affected the least. Everyone recognizes how great the burden to society will be in the near future if we don't have some major discoveries soon.