Screening for Dementia Cuts Health Costs for Elderly, Researchers Show

Patients diagnosed with dementia through screening ran up 13 percent less in health costs in the first year of treatment than before, according to a study suggesting wider detection could reduce U.S. medical expenses.

The one-year cost for 345 patients who were screened, found to have dementia and treated at U.S. Department of Veterans Affairs clinics with specially trained nurses fell to $11,636 each on average, from $13,378 in the 12 months before diagnosis, said J. Riley McCarten, the lead researcher.

Patients with Alzheimer’s, the most common form of dementia and the seventh-leading cause of death in the U.S., are becoming more numerous and cost three times as much to treat as elderly patients without the disease. While screening for Alzheimer’s runs about $800 a person, it may more than pay for itself, as people diagnosed with the malady may be less likely to be treated for other illnesses, researchers said.

“Our study showed reduced costs in the short run, but we also anticipate that screening would save money in the long-run as well, since we would no longer sink costs into aggressive treatments for other conditions during end-of-life treatment when the patients already have an invariably terminal disease,” McCarten, a University of Minnesota physician, said in an interview yesterday.

The median decrease was 29 percent, according to a statement released today in Honolulu at the International Conference on Alzheimer’s Disease. That number reflects the savings for the study patient in the middle of the cost curve in the group whose treatment included the services of nurses trained in dementia, according to the statement.

Early Diagnosis

The difficulties of diagnosing Alzheimer’s patients have been widely discussed at this year’s conference, and new guidelines have been proposed to help address the challenges.

Despite such hurdles, for patients whose dementia is properly diagnosed, health care may become more efficient, McCarten said in the interview. That’s because they can receive chronic care such as phone checkups with nurses, he said. Before diagnosis, patients may be “lurching from crisis to crisis,” undergoing tests and treatment for many possible maladies, after coming to the hospital repeatedly with vague complaints, he said.

An estimated 5.3 million Americans have Alzheimer’s. That figure will grow as the population aged 65 and older more than doubles to 89 million in 2050 because of longer life expectancy and the aging of baby boomers, according to the Alzheimer’s Association, an advocacy group based in Chicago.

Proponents of screening said more is at stake than saving money.

‘Slower Progression’

“If you can detect and diagnose the disease earlier, then one can implement care sooner, so that the hope would be that the individual would have a slower progression of the disease and therefore extend the time before they would need institutionalized care,” said Molly V. Wagster, chief of the behavioral and systems neuroscience branch at the National Institute on Aging, in Bethesda, Maryland, in an interview yesterday. Wagster wasn’t involved in the study.

For the research, a three-item memory test was added to regular checkups by doctors for people over 70 who weren’t already diagnosed with memory loss. Nurses trained in dementia were employed at seven clinics used in the research, which was part of the Dementia Demonstration Project at the Minneapolis Veterans Medical Center, overseen by the U.S. Department of Veterans Affairs.

“We would like to see screening become a vital sign, just like taking your weight or blood pressure,” McCarten said. “Right now the health-care system cares about every other organ system, but almost completely ignores the brain.”

Running Up Bills

Health-care payments for dementia patients 65 and older are expected to total $172 billion in the U.S. this year, according to the Alzheimer’s Association. Hospital and nursing-home bills and other health expenses associated with Alzheimer’s average $33,007 annually for the patients compared with $10,603 for elderly people without the disease, the association said in a March report.

Alzheimer’s, which has no cure, destroys brain cells. Over the course of the three stages of the disease, which afflicts mostly people 65 and older, memory and cognition worsen until a person is unable to communicate.

To contact the reporter on this story: Arielle Fridson in New York at afridson@bloomberg.net.