Improving early diagnosis of Alzheimer’s disease could significantly reduce healthcare costs in the United States, according to a new report from the Alzheimer’s Association. Up to $7.9 trillion could be saved in both health and long-term care expenditure in the United States if more patients with the chronic neurodegenerative condition are diagnosed in the earliest stages of the disease, it suggested.
Alzheimer’s disease is the most common cause of dementia, affecting as many as 5.7 million Americans, a figure expected to rise to 7.1 million in 2025. It is the sixth leading cause of death in the United States, behind heart disease, cancer, chronic lower respiratory diseases, accidents, and strokes. The condition generally manifests after the age of 60, but changes in the brain can start years before the first symptoms appear. One of the most common early signs of Alzheimer’s is mild cognitive impairment (MCI), which is the earliest stage at which clinical symptoms may be diagnosed.
Over the last 15 years, death rates from Alzheimer’s have more than doubled, increasing the financial strain on patients, their family and caregivers, and the nation, said Keith Fargo, director of scientific programs and outreach at the Alzheimer’s Association, who claimed the growing cost of the disease is becoming “unsustainable”.
Diagnosis of Alzheimer’s during the earliest MCI stage of the disease rather than the dementia stage could result in average savings in excess of $14,000 per individual, according to the report. It suggested that even improving diagnosis of the condition to an earlier stage than dementia could yield significant financial benefits, saving an average of $8,000 per individual.
The projected health and long-term care costs of a patient with Alzheimer’s diagnosed in the dementia stage was calculated at $424,000. However, the average per-person cost for those diagnosed during the MCI stage of the disease was only $360,000. Identifying Alzheimer’s at an earlier stage mitigates the risk of mismanagement of comorbidities, such as diabetes, which often increase the risk of hospitalization and lead to higher medical costs, the report suggested.
Fargo revealed the potential for cost-savings was so high because a diagnosis of Alzheimer’s in the later dementia stage “tends to occur during some kind of medical crisis”.
“For example, a person is found wandering and confused; this can lead to hospitalization and testing to determine what is causing the problem. By the time a diagnosis of Alzheimer's is made, a lot of money has been spent, in contrast to a diagnosis during the MCI stage which can commonly be done in the outpatient setting, and which is much less expensive,” he explained.
The Alzheimer’s Association representative advocated a “multidimensional approach” to tackling Alzheimer’s disease, suggesting greater focus should be placed on advancing research and improving support for patients and caregivers.
Over the last 20 years, the US Food and Drug Administration (FDA) has approved five drugs for the treatment of Alzheimer’s, the most recent being Namenda (memantine), which gained FDA approval in 2003. Other medication used to treat the condition include Aricept (donepezil) and Exelon (rivastigmine), cholinesterase inhibitors that work by helping restore the balance of neurotransmitters in the brain.
