Early diagnosis can cut Alzheimer's costs: study

HONOLULU, 16 july 2010-- Identifying dementia early can cut the cost of care by nearly 30 percent, U.S. researchers said on Wednesday, a finding that may reduce the heavy financial burden of the disease on the health care system.

They said routine screening that identified patients with early signs of dementia helped cut average healthcare costs by nearly $2,000 per patient in the first year, often by eliminating money spent on unnecessary tests and treatments.

"That runs into billions of dollars we could potentially save," Dr. Riley McCarten of the Minneapolis Veterans Medical Center told reporters at the Alzheimer's Association meeting in Honolulu.

On Tuesday experts at the National Institute on Aging and the Alzheimer's Association proposed new guidelines for diagnosing the fatal and incurable brain disease even before patients have symptoms.

The U.S. government, private insurance and individuals spend $172 billion a year to treat people with Alzheimer's disease, a fatal and incurable deterioration of the brain that affects more than 26 million people globally. It is the most common form of dementia.

By 2050, the cost of Alzheimer's care will reach $1.08 trillion a year in the United States, according to the Alzheimer's Association.

McCarten said most people in the United States with dementia are never diagnosed, and they often turn up in the emergency room with an acute problem when what they really have is a fatal brain disease.

"People lurch from one crisis to another," he said. "There is a tremendous amount of healthcare resources dedicated to acutely managing a chronic disease."

HAVING A SAY

McCarten and colleagues at seven Veterans Administration medical centers looked to see how much they could save by routinely screening patients with a two-minute memory test.

More than 8,000 people over age 70 took the test and 26 percent failed. Those who failed were offered a 90-minute work-up to diagnose dementia, and about a third of those who failed the initial screening were tested. Of these, 97 percent had some form of cognitive impairment and 76 percent had dementia.

People who got a diagnosis and their families met with case managers to devise a care plan, and the team tracked their health costs for a year.

After subtracting the cost of the evaluation, patients saved an average of $1,700 annually, McCarten said.

"We found cost savings in the short run -- within one year," he said. McCarten said early diagnosis gives patients the chance to have a say in their own care, and it gives families time to come to grips with the disease.

A separate study by researchers at Johnson & Johnson and Pfizer found that a large portion of the financial burden of caring for Alzheimer's patients falls on families and caregivers.

Their Internet survey of nearly 1,000 families of Alzheimer's patients found they spend an average of $1,000 per month out of pocket to care for a family member in a nursing home, and $375 a month to care for them at home.

The team also found that families spend nearly 70 hours a week caring for an Alzheimer's patient at home, and close to 30 hours a week when their family member is in a nursing home.