of Alzheimer's Symptoms Drives Cost of Care
In one of the largest national studies of its kind, UCLA researchers
found that both caregiver and patient health care costs dramatically
rise as symptoms worsen in patients with Alzheimer's disease.
The study, published in the February 2002 issue of the Journal
of the American Geriatrics Society, showed that for a six-month
period costs could rise to over $30,000 per patient, depending
on severity of symptoms.
"As Alzheimer's disease progresses, the costs to society
in terms of direct health care costs and loss of productivity
of caregivers are astronomical," said Dr. Gary Small,
lead investigator and Parlow-Soloman Professor on Aging, professor
of psychiatry and bio-behavioral sciences at UCLA, and director
of the Center on Aging at UCLA.
The study found that as symptoms progressed, costs rose.
For the six-month study period, costs approximated $20,000
for a typical high functioning patient compared with $35,000
for a patient with severe dementia. For example, the days
of work caregivers missed to care for a patient with mild
symptoms was 2.6 compared with 8.7 days to care for a patient
with severe symptoms. Hospitalizations increased from 1.8
to 3.4 days depending on the severity of symptoms. "The
study provides an impetus for earlier treatment to help keep
Alzheimer's disease at a less severe stage for longer,"
Costs to caregivers studied
According to Small, most Alzheimer's disease patients live
at home and are not institutionalized. Relatives, such as
a spouse, son or daughter, usually provide care. Most of the
cost of caring for such patients-almost 90 percent, according
to the study-is paid by the caregivers in terms of missed
days of work and hours per week spent caring for loved ones.
Researchers sent a survey to 1,700 non-institutionalized
patients and their caregivers in households throughout the
country. Patients represented all stages of disease. Disease
severity was measured using a scale of symptom frequency-such
as prevalence of memory loss and depression. Activity and
physical functioning were also gauged-such as the ability
to dress, prepare food and shop.
Costs totaled an average of $29,209 per patient over a six-month
period. Direct costs of care averaged $3,129 and included
hospital stays, physician visits and emergency room visits.
Caregiver costs averaged $26,080, calculated by missed days
of work and hours spent per week caring for patients.
Small adds that most Alzheimer's disease patients are not
taking available medications that could help slow down the
progression of the disease. Studies have shown that these
medications may be cost-effective; however, more studies need
to be completed.
Lack of recognition and education about Alzheimer's disease
may be keeping patients from receiving optimum treatment.
Patients and caregivers often mistake early symptoms of Alzheimer's
disease for normal aging changes, believing that early signs
of dementia may be "just senility." Physicians need
more training in recognizing early signs, perhaps by incorporating
more effective tests for cognitive functioning in routine
medical exams. Small adds that medications are often stopped
too early as well.
More help for caregivers may also control costs, says Small.
According to the study, caregivers spent an average of 85
hours a week providing care to patients. "Over $100 billion
is spent annually on Alzheimer's disease, making it the third
most costly disease in the United States after heart disease
and cancer. At least half of these costs are related to caregiving,"
said Dr. Howard Fillit, Executive Director of the Institute
for the Study of Aging in New York City. "Dr. Small's
study will help increase our understanding of the magnitude
and sources of caregivers costs as Alzheimer's disease progresses."
Fillit adds that the data may be especially critical to employers
of caregivers and to health insurance companies seeking better
systems to improve quality and manage costs.
For more information about Alzheimer's disease, please contact
the Alzheimer's Association at 1-800-272-3900 or www.alz.org.
The study was funded by Janssen Pharmaceutica Products, LLP.
The data was collected by the Alzheimer's Disease Caregiver
Project, conducted by Consumer Health Sciences, Princeton,