@article {7798, title = {Monetary costs of dementia in the United States.}, journal = {N Engl J Med}, volume = {368}, year = {2013}, month = {2013 Apr 04}, pages = {1326-34}, publisher = {386}, abstract = {

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.).

}, keywords = {Aged, 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}, issn = {1533-4406}, doi = {10.1056/NEJMsa1204629}, url = {http://www.nejm.org/doi/full/10.1056/NEJMsa1204629}, author = {Michael D Hurd and Martorell, Paco and Delavande, Adeline and Kathleen J Mullen and Kenneth M. Langa} } @article {5691, title = {Managing the Risk of Life}, number = {UM WP 2007-167}, year = {2007}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {This study analyzes the role of individual s and spouse s survival expectations and knowledge about Social Security rules on the expected Social Security claiming age, taking into account the various incentives single and married individuals face. There is substantial heterogeneity in the level of knowledge about SS rules according to demographic characteristics. We find that single men and women who expect to be longlived plan on delaying Social Security claiming. When we allow for differential effects of survival on knowledge about Social Security rules, subjective survivals matter only for single women who are knowledgeable. For single men, knowledge is not so important in their decisions. The claiming decision of married individuals is more complicated, because they are entitled to spouse s and survivor s benefits. Consistent with the incentives provided by Social Security rules, we find that married men base their expected claiming age on their spouse s survival expectations but not on their own survival. For married women, both own and spouse s subjective survivals positively influence the timing of claiming. Knowledge about Social Security rules affects the expected claiming age of both married men and women.}, keywords = {Expectations, Social Security}, url = {https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1082051}, author = {Delavande, Adeline and Robert J. Willis} }