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Natalia Loskutova, The Annual Wellness Visit: Assessment of Cognitive Impairment, Public Policy & Aging Report, Volume 29, Issue 1, 2019, Pages 20–25, https://doi.org/10.1093/ppar/pry047
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Dementia is a Major Health Problem
Dementia is a general term describing a serious loss in at least two cognitive functions—such as memory, attention, thinking, or language—caused by brain disease. Alzheimer’s disease (AD), which accounts for 60–80% of all dementia cases, is the most common cause (Alzheimer’s Association, 2015). Many studies predict that, with the rapidly-aging population, the number of people with dementia will increase dramatically, and 6.7 million people will have AD by 2025. Dementia places an enormous burden on individuals, their families, caregivers, and society. Medical, long-term, and end-of-life care costs per patient are estimated to be substantially higher, on average, for a person with AD, compared with a person of the same age without dementia, totaling a cost of $200 billion a year for all people with AD (Suehs et al., 2013). Medicare and Medicaid cover most of these costs, placing a strain on federal and state budgets. Many studies have found that the average, total Medicare cost for a person with dementia is much higher than for many other health conditions (McCarthy, 2013; Yang, Zhang, Lin, Clevenger, & Atherly, 2012). The individual financial burden is also substantial; out-of-pocket expenses for all individuals with AD are estimated at $33.8 billion (Hurd, Martorell, Delavande, Mullen, & Langa, 2013). As recently demonstrated by the National Institutes of Health, Medicaid paid for 43% of long-term care in 2006, and almost two-thirds of older people cannot afford even one year of nursing-home costs (U.S. Census Bureau, 2014). This financial burden is particularly relevant in AD, given that more than half the nursing home residents have AD or other related dementia whose length of stay in skilled nursing facilities is significantly longer compared to persons without dementia (Hoffmann, Kaduszkiewicz, Glaeske, van den Bussche, & Koller, 2014; Magaziner et al., 2000; Sabbagh et al., 2003).
