Alzheimer Dementia: How do patients with cognitive impairment make decisions about medical and nursing costs?

Dementia is characterized by decreased function, increased dependence, and a greater likelihood of being admitted to a nursing home
.
The cost of nursing homes, that is, the cost of nursing homes, has to a large extent caused the huge economic burden that accompanies dementia

With the aging of the population, the incidence of dementia and the economic burden on individuals and society will increase dramatically
.
The results of drug intervention to delay the progression of the disease in patients with dementia have been disappointing

Non-pharmacological treatments that have been proposed, that is, enhanced caregiver support and primary care-based interventions, have been shown to delay permanent NH placement and reduce the hospitalization rate of patients with dementia

In this way, Kirsten Hall Long and others at the Mayo Clinic provide baseline direct medical and NH cost estimates to help fill in the cost-benefit model and possibly provide information for modeling assumptions
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Provides an objective estimate from the perspective of the health system, including all payers, for people who are described as cognitively accessible, or with mild cognitive impairment (MCI), or dementia

They conducted a stratified random sampling survey (N=3545) of 70-89-year-old residents in Olmsted County, Minnesota, which were characterized by cognitive accessibility, mild cognitive impairment (MCI) or dementia.
The agency-linked billing data and the NH assessment of the Centers for Medicare and Medicaid Services are tracked forward for ≤1 year

Costs are stratified by vital status and intensity of NH use (NH days/days of follow-up [0%, 1% to 24%, 25% to 99%, and 100%])
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The average annual cost difference between the categories was adjusted based on patient characteristics and the number of follow-up days

They found that the distribution of costs/days of follow-up for different cognitive categories was significantly different
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The average cost/days of follow-up for the deceased is 2.
5 to 18 times that of the survivors

Among all MCI patients, <9% use any NH, accounting for 18% of all annual medical +NH total expenses
.
The adjusted comparison between categories shows that compared with cognitively impaired people, MCI has significantly higher medical and medical+NH costs
.

The important significance of this study is that it has found that the cost-effectiveness of managing /changing MCI and dementia should be considered at the end of life and the intensity of NH use
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The results of the research help provide information for cost-benefit models, predict future care needs, and help individuals/providers/payers/policy makers make decisions
.

Original source:
Long KH, Smith C, Petersen R, et al.
Medical and nursing home costs: From cognitively unimpaired through dementia .
Alzheimer's Dementia.
Published online September 5, 2021:alz.
12400.
doi:10.
1002/alz.
12400