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 Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University

nachricht Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München

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: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

From rocks in Colorado, evidence of a 'chaotic solar system'

23.02.2017 | Physics and Astronomy

'Quartz' crystals at the Earth's core power its magnetic field

23.02.2017 | Earth Sciences

Antimicrobial substances identified in Komodo dragon blood

23.02.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>