How can Alzheimer's disease and dementia delay your retirement?

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A diagnosis of dementia can disrupt retirement plans and affect families. It also results in higher costs, estimated to be 22% higher than those of a person without dementia over the five years following diagnosis, based on a study of Medicare data co-authored by Norma Coe, associate professor of medical ethics and health policy at the Perelman School of Medicine the University of Pennsylvania.

The study used a sample of approximately 4,000 elderly people with dementia and reviewed Medicare Part A and B expenditures between 1991 and 2012. Not included: Potential costs related to the care of susceptible individuals to be necessary for a person with a cognitive decline. A diagnosis of dementia resulted in additional costs of $ 15,700 for the traditional Medicare system over a five-year period, of which about half in the first year. Patients with dementia used more hospital care, specialized nursing care and palliative care – all covered by Part A – than those without a diagnosis of dementia. Although their use of outpatient care was higher in the first year, it did not differ much in the following years from that used by people without dementia.

The diagnosis of dementia did not change the survival time of the women in the study, but they resulted in additional costs of approximately $ 7,850 higher than those of men with dementia. The main reason: a diagnosis of dementia reduced the survival of men, which meant that their greater use of services was offset by a shorter life span.

With respect to health care expenses in retirement, Fidelity estimates that an average age of 65 who is retiring needs $ 285,000 before taking into account the costs of long-term care. But in an aging population, the numbers add up quickly. About 5.5 million older adults live with dementia, and this number is expected to increase with the aging of the population. The study used the 480,000 newly diagnosed patients with Alzheimer's disease, the most common type of dementia, in 2017, to show that these diagnoses would add more than $ 3 billion to Medicare spending over the last five years. coming years.

Earlier detection could potentially reduce costs. About 40% of the study sample was diagnosed in a hospital setting, which contributed to higher costs. By year five, there was little difference in the costs incurred for those with and without dementia.

A separate report by UsAgainstAlzheimer, a nonprofit disease-focused organization, described some of the barriers to early detection, including the reluctance of physicians to rate or discuss the disease because of the wrong idea that there would be no treatment or medical intervention if cognitive decline is detected. Conversations about brain health are also not part of routine examinations. Financial incentives do not match either. "Private insurers are subject to an annual risk related to health care costs. As a result, it is harder for them to take advantage of dementia prevention initiatives that generate long-term savings for the health system, "says Anne Tumlinson, head of the research and counseling service focused on health care. the elderly.

But prevention and early attention can reduce risk or delay cognitive delays, according to the report, citing research from the American Heart Association and the American Stroke Association that show a link between risk factors Vascular and cognitive dysfunction and a report from the Institute of Medicine that discovered that brain health earlier in life can enhance brain resistance to brain disorders later in life.

Write to Reshma Kapadia at [email protected]