The Value of Delaying Alzheimer’s Disease Onset

Abstract Alzheimer’s disease (AD) extracts a heavy societal toll. The value of medical advances that delay onset of AD could be significant. Using data from nationally representative samples from the Health and Retirement Study (1998–2008) and Aging Demographics and Memory Study (2001–2009), we estimate the prevalence and incidence of AD and the formal and informal health care costs associated with it. We use microsimulation to project future prevalence and costs of AD under different treatment scenarios. We find from 2010 to 2050, the number of individuals ages 70+ with AD increases 153%, from 3.6 to 9.1 million, and annual costs increase from $307 billion ($181B formal, $126B informal costs) to $1.5 trillion. 2010 annual per person costs were $71,303 and double by 2050. Medicare and Medicaid are paying 75% of formal costs. Medical advances that delay onset of AD for 5 years result in 41% lower prevalence and 40% lower cost of AD in 2050. For one cohort of older individuals, who would go on to acquire AD, a 5-year delay leads to 2.7 additional life years (about 5 AD-free), slightly higher formal care costs due to longer life but lower informal care costs for a total value of $511,208 per person. We find Medical advances delaying onset of AD generate significant economic and longevity benefits. The findings inform clinicians, policymakers, businesses and the public about the value of prevention, diagnosis, and treatment of AD.

[1]  J. Weuve,et al.  Alzheimer disease in the United States (2010–2050) estimated using the 2010 census , 2013, Neurology.

[2]  E. Clipp,et al.  Identification of dementia: agreement among national survey data, medicare claims, and death certificates. , 2007, Health services research.

[3]  K. Langa,et al.  Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study , 2007, Neuroepidemiology.

[4]  Jacob A. Brody,et al.  Delaying the Onset of Late-Life Dysfunction , 1995 .

[5]  Paul G Shekelle,et al.  Consequences of health trends and medical innovation for the future elderly. , 2005, Health affairs.

[6]  P. Greengard,et al.  Inhibitor of the Tyrosine Phosphatase STEP Reverses Cognitive Deficits in a Mouse Model of Alzheimer's Disease , 2014, PLoS biology.

[7]  S. Leurgans,et al.  Sources of variability in estimates of the prevalence of Alzheimer’s disease in the United States , 2011, Alzheimer's & Dementia.

[8]  Truls Østbye,et al.  The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited. , 2009, Journal of Alzheimer's disease : JAD.

[9]  B. Bloom,et al.  Cost of illness of Alzheimer's disease: how useful are current estimates? , 2003, The Gerontologist.

[10]  Medical Expenditure Measures in the Health and Retirement Study , 2011, Forum for health economics & policy.

[11]  Steven G Heeringa,et al.  Prevalence of Cognitive Impairment without Dementia in the United States , 2008, Annals of Internal Medicine.

[12]  R. Brookmeyer,et al.  National estimates of the prevalence of Alzheimer’s disease in the United States , 2011, Alzheimer's & Dementia.

[13]  P. Neumann,et al.  The economics of mild cognitive impairment , 2013, Alzheimer's & Dementia.

[14]  K. Langa,et al.  The Aging, Demographics, and Memory Study: Study Design and Methods , 2005, Neuroepidemiology.

[15]  A. Caspi,et al.  Influence of Life Stress on Depression: Moderation by a Polymorphism in the 5-HTT Gene , 2003, Science.

[16]  Paco Martorell,et al.  Monetary costs of dementia in the United States. , 2013, The New England journal of medicine.

[17]  R. Schulz,et al.  Family caregiving of persons with dementia: prevalence, health effects, and support strategies. , 2004, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[18]  Paco Martorell,et al.  Monetary costs of dementia in the United States. , 2013, The New England journal of medicine.