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 Cholesterol-lowering drugs may fight infectious disease
22.08.2017 | Duke University

nachricht Once invincible superbug squashed by 'superteam' of antibiotics
22.08.2017 | University at Buffalo

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: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

What the world's tiniest 'monster truck' reveals

23.08.2017 | Life Sciences

Treating arthritis with algae

23.08.2017 | Life Sciences

Witnessing turbulent motion in the atmosphere of a distant star

23.08.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>