Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

The Long Reach of Alzheimer’s

09.04.2014

To address the burgeoning demands of Alzheimer’s disease that will affect generations, new policies will have to be adopted to acknowledge the complex and unique needs of people with dementia.

The aging of the U.S. population has turned the prism to focus on the increasing number of families facing the challenge of providing care for people with dementia, said Julie P.W. Bynum, associate professor at The Dartmouth Institute for Health Policy & Clinical Practice.  Writing in the April issue of Health Affairs, she says the “long reach” of Alzheimer’s will have an affect on broad-based national policies that must be addressed sooner rather than later.

In one important way, Alzheimer’s disease is unlike the four chronic conditions that cause more deaths – heart disease, cancer, stroke and chronic pulmonary disease, Bynum says. With Alzheimer’s, there is no way to prevent or slow the disease’s progression. It is estimated that cases will increase from 3 million in 2011 to more than 10 million in 2050.

The most striking implications have to do with cost. Because the majority of the cases involve people over 65, Medicare bears the brunt of the costs. And, because patients often require long-term care and outlive their assets, Medicaid ends up paying for a large part of needed nursing home care.

The annual cost of providing care for all people over the age of 70 in the U.S. is estimated at $157-$215 billion in 2010. The direct cost is estimated to be $109 billion, higher than similar costs for heart disease or cancer ($102 billion and $77 billion respectively). By 2040, spending on dementia patients is estimated to be $1.2-$1.6 trillion, if no breakthrough therapies emerge.

Additional costs are borne by informal (unpaid) caregivers, such as spouses or family members, who provide basic daily care and a safe environment. But these caregivers present their own set of policy challenges with associated loss of work productivity and declines in their own health.

Alzheimer’s carries far-reaching implications for the policy community, as the impact of dementia reaches well beyond the individual patient and his or her caregivers, Bynum says.

The Policy Implications:

  • Science and technology. Funding policies are critical for research to close gaps in scientific knowledge about pathophysiological cause of the disease, how to prevent it, detect it early and accurately, and how to slow it, if not cure it.
  • Health care. Payment policy and regulatory functions in Medicare have direct implications for people living with dementia who are heavy users of hospital-based care.
  • Long-term services and supports. Payment policy for nursing homes and strategies to support community living are fundamental for people with late disease. About 75 percent of people with dementia will spend time in a nursing home at some point in their disease. Medicaid is the primary payer for two-thirds’ nursing home expenditures, which cause budgetary issues, especially for states.
  • Public health. Addressing healthy lifestyle and risk factors as well as community readiness are important for a population approach to managing the growing burden of dementia.
  • Housing and community services. Critically important to support for those who wish to remain in their homes, are services such as those related to the rights of the elderly, Meals on Wheels, caregiver support, adult day care and senior centers. These community services are less costly than nursing home care, but less visible to federal policy makers because they are organized on the local level.
  • Labor.  New policies may be required to address the challenge of ensuring a competent and adequate workforce, especially for hands-on caregivers, such as personal care assistants, home health aides, and nursing assistants.
  • Justice and law enforcement. Relevant policies in the legal and law enforcement arena address issues that arise with substituted judgment and the need to provide protection from exploitation, abuse and neglect.

“Patients’ complex and expensive care needs and increasing numbers of people with dementia underscore the need to pay greater attention to how society protects and provides services for this vulnerable population at a cost that is sustainable, all while continuing to pursue treatments and cures.” Bynum said.

To view the abstract of the Viewpoint in Health Affairs, please go to http://content.healthaffairs.org/content/33/4/534.abstract

The Dartmouth Institute for Health Policy & Clinical Practice was founded in 1988 by Dr. John E. Wennberg as the Center for the Evaluative Clinical Sciences (CECS). Among its 25 years of accomplishments, it has established a new discipline and educational focus in the Evaluative Clinical Sciences, introduced and advanced the concept of shared decision-making for patients, demonstrated unwarranted variation in the practice and outcomes of medical treatment, developed the first comprehensive examination of US health care variations (The Dartmouth Atlas), and has shown that more health care is not necessarily better care. 

Contact:

Annmarie Christensen
Annmarie.Christensen@dartmouth.edu
603-653-0897
802-249-8795 (cell)

Annmarie Christensen | EurekAlert!
Further information:
http://tdi.dartmouth.edu/press/press-releases/the-long-reach-of-alzheimers

Further reports about: Alzheimer’s Dartmouth Medicare dementia implications pulmonary regulatory

More articles from Health and Medicine:

nachricht Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences

nachricht What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Argon is not the 'dope' for metallic hydrogen

24.03.2017 | Materials Sciences

Astronomers find unexpected, dust-obscured star formation in distant galaxy

24.03.2017 | Physics and Astronomy

Gravitational wave kicks monster black hole out of galactic core

24.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>