The US economic and social costs of Alzheimer's disease revisited.
R L Ernst and
J W Hay
Department of Pharmaceutical Economics and Policy University of Southern California, Los Angeles 90033.
OBJECTIVEs. An earlier paper estimated the per-case and nationalincidence costs of Alzheimer's disease for 1983. This paperupdates the estimates of costs per case to 1991 and presentsnew national prevalence estimates of the economic and socialcosts of the disease. METHODS. All data for the cost estimateswere taken from published sources or provided by other researchers.RESULTS. At midrange values of the estimated cost and epidemiologicalparameters, the discounted (at 4%) direct and total costs ofAlzheimer's disease were $47,581 and $173,932 per case, respectively.The estimated 1991 national direct and total prevalence costswere $20.6 billion and $67.3 billion, respectively. Assumingconservatively that the prevalence of the disease remains constant,the estimated discounted present values of the direct and totalcosts of all current and future generations of Alzheimer's patientsare $536 billion and $1.75 trillion, respectively. CONCLUSIONS.The $536 billion and $1.75 trillion figures are minimum estimatesof the long-term dollar losses to the US economy in 1991 causedby Alzheimer's disease.
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46(suppl_1):
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45(4):
505 - 515.
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1283 - 1289.
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449 - 456.
[Abstract][PDF]
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[Abstract][PDF]
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July 1, 2004;
19(4):
226 - 232.
[Abstract][PDF]
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J Geriatr Psychiatry Neurol,
September 1, 2003;
16(3):
140 - 145.
[Abstract][PDF]
P. M. McMahon, S. S. Araki, E. A. Sandberg, P. J. Neumann, and G. S. Gazelle Cost-Effectiveness of PET in the Diagnosis of Alzheimer Disease
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228(2):
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[Abstract][Full Text][PDF]
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June 3, 2003;
138(11):
927 - 937.
[Abstract][Full Text][PDF]
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289(20):
2651 - 2662.
[Abstract][Full Text][PDF]
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43(2):
158 - 164.
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February 1, 2003;
43(1):
86 - 91.
[Abstract][Full Text][PDF]
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January 1, 2003;
58(1):
S38 - 49.
[Abstract][Full Text][PDF]
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17(6):
338 - 344.
[Abstract][PDF]
J. W. Hay and B. Druss Expensive Conditions
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November 1, 2002;
21(6):
271 - 272.
[Full Text][PDF]
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American Journal of Alzheimer's Disease and Other Dementias,
July 1, 2002;
17(4):
213 - 226.
[Abstract][PDF]
N. Yamamoto-Mitani, C. S. Aneshensel, and L. Levy-Storms Patterns of Family Visiting With Institutionalized Elders: The Case of Dementia
J. Gerontol. B. Psychol. Sci. Soc. Sci.,
July 1, 2002;
57(4):
S234 - 246.
[Abstract][Full Text][PDF]
D. J. Foley and L. R. White Dietary Intake of Antioxidants and Risk of Alzheimer Disease: Food for Thought
JAMA,
June 26, 2002;
287(24):
3261 - 3263.
[Full Text][PDF]
D. J. Lanska Time is money--or is it?: Estimating the costs of informal caregiving
Neurology,
June 25, 2002;
58(12):
1718 - 1719.
[Full Text][PDF]
S. L. Hickenbottom, A. M. Fendrick, J. S. Kutcher, M. U. Kabeto, S. J. Katz, and K. M. Langa A national study of the quantity and cost of informal caregiving for the elderly with stroke
Neurology,
June 25, 2002;
58(12):
1754 - 1759.
[Abstract][Full Text][PDF]
J. L. Cummings and G. Cole Alzheimer Disease
JAMA,
May 8, 2002;
287(18):
2335 - 2338.
[Full Text][PDF]
K. M. Langa, S. Vijan, R. A. Hayward, M. E. Chernew, C. S. Blaum, M. U. Kabeto, D. R. Weir, S. J. Katz, R. J. Willis, and A. M. Fendrick Informal Caregiving for Diabetes and Diabetic Complications Among Elderly Americans
J. Gerontol. B. Psychol. Sci. Soc. Sci.,
May 1, 2002;
57(3):
S177 - 186.
[Abstract][Full Text][PDF]
D. H.S. Silverman, S. S. Gambhir, H.-W. C. Huang, J. Schwimmer, S. Kim, G. W. Small, J. Chodosh, J. Czernin, and M. E. Phelps Evaluating Early Dementia With and Without Assessment of Regional Cerebral Metabolism by PET: A Comparison of Predicted Costs and Benefits
J. Nucl. Med.,
February 1, 2002;
43(2):
253 - 266.
[Abstract][Full Text][PDF]
J. W. Hill, R. Futterman, S. Duttagupta, V. Mastey, J. R. Lloyd, and H. Fillit Alzheimer's disease and related dementias increase costs of comorbidities in managed Medicare
Neurology,
January 8, 2002;
58(1):
62 - 70.
[Abstract][Full Text][PDF]
D. L. Murman The Costs of Caring: Medical Costs of Alzheimer's Disease and The Managed Care Environment
J Geriatr Psychiatry Neurol,
December 1, 2001;
14(4):
168 - 178.
[Abstract][PDF]
J. H. T. Karlawish and D. Casarett Addressing the Ethical Challenges of Clinical Trials That Involve Patients with Dementia
J Geriatr Psychiatry Neurol,
December 1, 2001;
14(4):
222 - 228.
[Abstract][PDF]
F. W. Unverzagt, S. Gao, O. Baiyewu, A. O. Ogunniyi, O. Gureje, A. Perkins, C. L. Emsley, J. Dickens, R. Evans, B. Musick, et al. Prevalence of cognitive impairment: Data from the Indianapolis Study of Health and Aging
Neurology,
November 13, 2001;
57(9):
1655 - 1662.
[Abstract][Full Text][PDF]
D. H. S. Silverman, G. W. Small, C. Y. Chang, C. S. Lu, M. A. K. de Aburto, W. Chen, J. Czernin, S. I. Rapoport, P. Pietrini, G. E. Alexander, et al. Positron Emission Tomography in Evaluation of Dementia: Regional Brain Metabolism and Long-term Outcome
JAMA,
November 7, 2001;
286(17):
2120 - 2127.
[Abstract][Full Text][PDF]
K. E. Covinsky, C. Eng, L.-Y. Lui, L. P. Sands, A. R. Sehgal, L. C. Walter, D. Wieland, G. P. Eleazer, and K. Yaffe Reduced Employment in Caregivers of Frail Elders: Impact of Ethnicity, Patient Clinical Characteristics, and Caregiver Characteristics
J. Gerontol. A Biol. Sci. Med. Sci.,
November 1, 2001;
56(11):
M707 - 713.
[Abstract][Full Text][PDF]
D. H. Taylor Jr., M. Schenkman, J. Zhou, and F. A. Sloan The Relative Effect of Alzheimer's Disease and Related Dementias, Disability, and Comorbidities on Cost of Care for Elderly Persons
J. Gerontol. B. Psychol. Sci. Soc. Sci.,
September 1, 2001;
56(5):
S285 - 293.
[Abstract][Full Text]
J. A. Hayman, K. M. Langa, M. U. Kabeto, S. J. Katz, S. M. DeMonner, M. E. Chernew, M. B. Slavin, and A. M. Fendrick Estimating the Cost of Informal Caregiving for Elderly Patients With Cancer
J. Clin. Oncol.,
July 1, 2001;
19(13):
3219 - 3225.
[Abstract][Full Text][PDF]
M. J. Moore, C. W. Zhu, and E. C. Clipp Informal Costs of Dementia Care: Estimates From the National Longitudinal Caregiver Study
J. Gerontol. B. Psychol. Sci. Soc. Sci.,
July 1, 2001;
56(4):
S219 - 228.
[Abstract][Full Text][PDF]
G. Fillenbaum, A. Heyman, B.L. Peterson, C.F. Pieper, and A.L. Weiman Use and cost of outpatient visits of AD patients: CERAD XXII
Neurology,
June 26, 2001;
56(12):
1706 - 1711.
[Abstract][Full Text][PDF]
S. L Tyas, J. Manfreda, L. A Strain, and P. R Montgomery Risk factors for Alzheimer's disease: a population-based, longitudinal study in Manitoba, Canada
Int. J. Epidemiol.,
June 1, 2001;
30(3):
590 - 597.
[Abstract][Full Text][PDF]
H. C. Hendrie, A. Ogunniyi, K. S. Hall, O. Baiyewu, F. W. Unverzagt, O. Gureje, S. Gao, R. M. Evans, A. O. Ogunseyinde, A. O. Adeyinka, et al. Incidence of Dementia and Alzheimer Disease in 2 Communities: Yoruba Residing in Ibadan, Nigeria, and African Americans Residing in Indianapolis, Indiana
JAMA,
February 14, 2001;
285(6):
739 - 747.
[Abstract][Full Text][PDF]
D. H.S. Silverman and M. E. Phelps Evaluating Dementia Using PET: How Do We Put into Clinical Perspective What We Know to Date?
J. Nucl. Med.,
November 1, 2000;
41(11):
1929 - 1932.
[Full Text][PDF]
V. G. Valcour, K. H. Masaki, J. D. Curb, and P. L. Blanchette The Detection of Dementia in the Primary Care Setting
Arch Intern Med,
October 23, 2000;
160(19):
2964 - 2968.
[Abstract][Full Text][PDF]
D. R. Gifford, R. G. Holloway, and B. G. Vickrey Systematic Review of Clinical Prediction Rules for Neuroimaging in the Evaluation of Dementia
Arch Intern Med,
October 9, 2000;
160(18):
2855 - 2862.
[Abstract][Full Text][PDF]
J. M. Lipton, A. Catania, and T. Ichiyama Marshaling the Anti-Inflammatory Influence of the Neuroimmunomodulator {alpha}-MSH
Physiology,
August 1, 2000;
15(4):
192 - 195.
[Abstract][Full Text][PDF]
D. C. Marson, S. M. Sawrie, S. Snyder, B. McInturff, T. Stalvey, A. Boothe, T. Aldridge, A. Chatterjee, and L. E. Harrell Assessing Financial Capacity in Patients With Alzheimer Disease: A Conceptual Model and Prototype Instrument
Arch Neurol,
June 1, 2000;
57(6):
877 - 884.
[Abstract][Full Text][PDF]
G. Fillenbaum, A. Heyman, B. Peterson, C. Pieper, and A. L. Weiman Frequency and duration of hospitalization of patients with AD based on Medicare data: CERAD XX
Neurology,
February 8, 2000;
54(3):
740 - 740.
[Abstract][Full Text][PDF]
C. H. van Dyck, P. Newhouse, W. E. Falk, J. A. Mattes, and for the Physostigmine Study Group Extended-Release Physostigmine in Alzheimer Disease: A Multicenter, Double-blind, 12-Week Study With Dose Enrichment
Arch Gen Psychiatry,
February 1, 2000;
57(2):
157 - 164.
[Abstract][Full Text][PDF]
R. Guttman, R. D. Altman, N. H. Nielsen, and for the Council on Scientific Affairs, American Me Alzheimer Disease: Report of the Council on Scientific Affairs
Arch Fam Med,
July 1, 1999;
8(4):
347 - 353.
[Abstract][Full Text][PDF]
S. S. Richards and H. C. Hendrie Diagnosis, Management, and Treatment of Alzheimer Disease: A Guide for the Internist
Arch Intern Med,
April 26, 1999;
159(8):
789 - 798.
[Abstract][Full Text][PDF]
S. S. Bassuk, L. F. Berkman, and D. Wypij Depressive Symptomatology and Incident Cognitive Decline in an Elderly Community Sample
Arch Gen Psychiatry,
December 1, 1998;
55(12):
1073 - 1081.
[Abstract][Full Text][PDF]
K. Yaffe, G. Sawaya, I. Lieberburg, and D. Grady Estrogen Therapy in Postmenopausal Women: Effects on Cognitive Function and Dementia
JAMA,
March 4, 1998;
279(9):
688 - 695.
[Abstract][Full Text][PDF]
G. W. Small, P. V. Rabins, P. P. Barry, N. S. Buckholtz, S. T. DeKosky, S. H. Ferris, S. I. Finkel, L. P. Gwyther, Z. S. Khachaturian, B. D. Lebowitz, et al. Diagnosis and Treatment of Alzheimer Disease and Related Disorders: Consensus Statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society
JAMA,
October 22, 1997;
278(16):
1363 - 1371.
[Abstract][PDF]
J. P. Leigh, S. B. Markowitz, M. Fahs, C. Shin, and P. J. Landrigan Occupational Injury and Illness in the United States: Estimates of Costs, Morbidity, and Mortality
Arch Intern Med,
July 28, 1997;
157(14):
1557 - 1568.
[Abstract][PDF]
R. S. Henry and B. V. Reifler Coverage of Adult Day Services in Long Term Care Insurance Policies
Journal of Applied Gerontology,
June 1, 1997;
16(2):
221 - 234.
[Abstract][PDF]
R. L. Ernst, J. W. Hay, C. Fenn, J. Tinklenberg, and J. A. Yesavage Cognitive Function and the Costs of Alzheimer Disease: An Exploratory Study
Arch Neurol,
June 1, 1997;
54(6):
687 - 693.
[Abstract][PDF]
A. Paganini-Hill and V. W. Henderson Estrogen Replacement Therapy and Risk of Alzheimer Disease
Arch Intern Med,
October 28, 1996;
156(19):
2213 - 2217.
[Abstract][PDF]
E. J Norman Screening for Cobalamin Deficiency
Arch Fam Med,
April 1, 1995;
4(4):
304 - 305.
[Abstract][PDF]
G. W. Small, L. M. Ercoli, D. H. S. Silverman, S.-C. Huang, S. Komo, S. Y. Bookheimer, H. Lavretsky, K. Miller, P. Siddarth, N. L. Rasgon, et al. From the Cover: Cerebral metabolic and cognitive decline in persons at genetic risk for Alzheimer's disease
PNAS,
May 23, 2000;
97(11):
6037 - 6042.
[Abstract][Full Text][PDF]