Monetary costs of dementia in the United States.

TitleMonetary costs of dementia in the United States.
Publication TypeJournal Article
Year of Publication2013
AuthorsHurd, MD, Martorell, P, Delavande, A, Mullen, KJ, Langa, KM
JournalN Engl J Med
Date Published2013 Apr 04
ISSN Number1533-4406
KeywordsAged, Aged, 80 and over, Cost of Illness, Dementia, Female, Health Care Costs, Home Care Services, Home Nursing, Humans, Longitudinal Studies, Male, Medicare, Middle Aged, Nursing homes, United States

BACKGROUND: Dementia affects a large and growing number of older adults in the United States. The monetary costs attributable to dementia are likely to be similarly large and to continue to increase.

METHODS: In a subsample (856 persons) of the population in the Health and Retirement Study (HRS), a nationally representative longitudinal study of older adults, the diagnosis of dementia was determined with the use of a detailed in-home cognitive assessment that was 3 to 4 hours in duration and a review by an expert panel. We then imputed cognitive status to the full HRS sample (10,903 persons, 31,936 person-years) on the basis of measures of cognitive and functional status available for all HRS respondents, thereby identifying persons in the larger sample with a high probability of dementia. The market costs associated with care for persons with dementia were determined on the basis of self-reported out-of-pocket spending and the utilization of nursing home care; Medicare claims data were used to identify costs paid by Medicare. Hours of informal (unpaid) care were valued either as the cost of equivalent formal (paid) care or as the estimated wages forgone by informal caregivers.

RESULTS: The estimated prevalence of dementia among persons older than 70 years of age in the United States in 2010 was 14.7%. The yearly monetary cost per person that was attributable to dementia was either $56,290 (95% confidence interval [CI], $42,746 to $69,834) or $41,689 (95% CI, $31,017 to $52,362), depending on the method used to value informal care. These individual costs suggest that the total monetary cost of dementia in 2010 was between $157 billion and $215 billion. Medicare paid approximately $11 billion of this cost.

CONCLUSIONS: Dementia represents a substantial financial burden on society, one that is similar to the financial burden of heart disease and cancer. (Funded by the National Institute on Aging.).

User Guide Notes

Endnote Keywords

ADAMS/Dementia/Cognitive Impairment/cognitive assessment/PREVALENCE/Medicare/Out of pocket costs/nursing homes/Informal care/public policy

Endnote ID


Alternate JournalN Engl J Med
Citation Key7798
PubMed ID23550670
PubMed Central IDPMC3959992
Grant ListR01 AG030155 / AG / NIA NIH HHS / United States
U01 AG009740 / AG / NIA NIH HHS / United States
R01AG030155 / AG / NIA NIH HHS / United States
U01 AG09740 / AG / NIA NIH HHS / United States