Prevalence and Cost of Dementia

阿尔茨海默氏病和相关痴呆症（ADRD）对有多少老年人得到照顾，这种照顾对公共计划（医疗保险，医疗补助）和家庭的成本有重大影响。认知功能差是功能下降、机构化和死亡率的一个重要风险因素。随着其他原因导致的死亡率推迟和人口老龄化，ADRD患者人数正在上升。目前尚不清楚经人口统计学调整的流行率是否正在发生变化。ADRD的成本是惊人的，从小方便的样本和横截面设计。有很多东西可以从纵向分析的全国代表性的数据库，最近已经成为可用的，国家长期护理调查（NLTCS）。本研究的具体目标是：（1）通过对1984年、1989年、1994年和1999年的ADRD诊断与使用NLTCS调查工具确定的患者进行协调，测量ADRD的年龄和性别调整患病率;（2）确定长期流行的重要决定因素，包括降低心血管疾病的死亡率和接受挽救生命的干预;（3）确定ADRD患者是否接受了除ADRD以外的主要疾病的较低强化治疗（例如，某些癌症、冠心病）与其他类似残疾老年人相比;（4）衡量ADRD对医疗保险和医疗补助其他政府机构、私人支付者和自付费用的成本ADRD对医疗保险和医疗补助其他政府机构、私人支付者和自付费用的成本ADRD的个人健康服务，1984年，1994年和1999年m和项目成本的趋势，这些公共计划的基础上，这些估计。为了计算这样的成本估计，我们将考虑在这样的预测中经常被忽视的两个因素：（1）ADRD对其他健康状况治疗的影响，以及（2）如果ADRD被消除，医疗保险等公共项目将产生其他疾病的其他成本。NLTCS将使该项目能够提供迄今为止关于ADRD调整后患病率的最佳信息，影响ADRD的因素，ADRD患者是否因急性和慢性健康状况而受到不同治疗，以及ADRD将如何影响未来的医疗费用。

Alzheimer's disease and related dementias (ADRD) has a major impact on how many elderly are cared for, the cost of such care to public programs (Medicare, Medicaid) and to families. Poor cognitive functioning is an important risk factor in functional decline, institutionalization and mortality. The number of persons with ADRD is rising as mortality from other causes is delayed and the population ages. It remains unclear whether demographically adjusted prevalence is changing. The cost of ADRD is staggering from small convenience samples and cross sectional designs. There is much to be learned from longitudinal analysis of a nationally representative data bases that has become available recently, the National Long Term Care Survey (NLTCS). The specific aims of the proposed work are: (1) Measure the age and gender adjusted prevalence of ADRD in 1984, 1989, 1994 and 1999 by reconciling Medicare claims based diagnosis of ADRD with patients identified using the survey instrument of NLTCS; (2) Ascertain the important determinants of prevalence over time, including decreasing mortality from cardiovascular diseases and receipt of life saving interventions; (3) Determine whether persons with ADRD receive less intensive treatment for major conditions other than ADRD (e.g., selected cancers, coronary heart disease) relative to otherwise similar disabled elderly persons; (4) Measure the cost of ADRD to Medicare and Medicaid other government agencies, private payers and out-of-pocket the cost of ADRD to Medicare and Medicaid other government agencies, private payers and out-of-pocket expenditures for personal health services for ADRD, in 1984, 1994 and 1999m and project cost trends for these public programs based on these estimates. To compute such cost estimates, we will account for two factors often overlooked in such projections: (1) the impact of ADRD on the treatment of other health conditions and (2) techniques that such public programs as Medicare would incur other costs from other diseases if ADRD were eliminated. The NLTCS will allow this project to provide the best information to date on the adjusted prevalence of ADRD, what factors are influencing same, whether persons with ADRD are treated differently given acute and chronic health conditions, and how ADRD will impact future medical costs.