The Cost of Dementia

描述（由申请人提供）：这项拟议的研究将估算美国人口中痴呆症的经济成本。这些成本包括市场交易产生的实际美元成本和无偿护理产生的隐性成本。该项目将估计导致轻度认知障碍和痴呆的认知能力下降是美国老年人残疾和生活质量下降的一个日益常见和重要的原因。患有认知障碍和痴呆症的老年人数量的预期增长也将给家庭、医疗保健系统和医疗保险等社会项目带来越来越大的负担。鉴于这种广泛的影响，了解美国老年人认知能力下降和痴呆症的全部社会成本是很重要的。本研究将：1)利用Aging， demographic, and Memory study （ADAMS）的临床评估和Health and Retirement study （HRS）的每一波预测因子，建立痴呆状态的统计模型；2)为每个HRS应答者计算痴呆的概率；3)在其他合并症的条件下，使用65岁及以上受访者的自我报告数据和与hr相关的医疗保险数据，估计痴呆状况对医疗保健利用数量和类型的影响；4)利用hrs关联医疗保险数据、医疗支出小组调查和养老院成本的地理数据，评估不同类型医疗保健服务的财务成本，并计算因医疗保健利用而导致痴呆的直接财务成本；5)开发非正式医疗保健提供的经济模型，并使用该框架来估计非正式护理人员用于帮助痴呆症患者的时间的美元价值；6)制定和实施调查项目，以解决痴呆症护理人员的护理质量和多任务处理问题；使用这些措施提供非正式护理费用的替代估计。这项研究将在全国具有代表性的老年人样本中更好地了解认知能力下降和痴呆症的全部社会成本，因此，允许更明智的卫生保健规划和决策。此外，更好地了解认知能力下降和痴呆风险的医学、行为和社会经济因素的相对重要性，将有助于临床医生和政策制定者瞄准高危人群，实施预防或减缓认知能力下降的干预措施，并更好地评估当前和未来干预措施的成本效益。

DESCRIPTION (provided by applicant): This proposed research will estimate the economic costs of dementia in the U.S. population. These costs are actual dollar costs resulting from market transactions and implicit costs resulting from unpaid care. This project will estimate both cognitive decline leading to mild cognitive impairments and dementia is an increasingly common and important cause of disability and decreased quality of life for older Americans. The expected growth in the number of older adults with cognitive impairment and dementia will also place an increasing burden on families, the health care system, and social programs, such as Medicare. Given this wide-ranging impact, it is important to understand the full societal costs of cognitive decline and dementia in older Americans. This proposed study will: 1) Develop a statistical model of dementia status using the clinical assessment from the Aging, Demographics, and Memory Study (ADAMS) and predictors available in each wave of the Health and Retirement Study (HRS); 2) Impute the probability of dementia for each HRS respondent; 3) Estimate the effect of dementia status on the amount and type of health care utilization, conditional on other co-morbidities using self-reported data and HRS-linked Medicare data for respondents age 65 or older; 4) Use information from the HRS-linked Medicare data, the Medical Expenditure Panel Survey, and geographical data on nursing home costs to evaluate the financial cost of different types of health care services, and calculate the direct financial cost of dementia due to health care utilization; 5) Develop an economic model of informal health care provision, and use this framework to estimate the dollar value of time informal caregivers spend assisting demented individuals; and 6) Develop and implement survey items to address the issues of quality of care and multi-tasking among dementia caregivers; use these measures to provide alternative estimates of costs of informal care. This study will provide a better understanding of the full societal costs of cognitive decline and dementia in a nationally representative sample of older adults and, therefore, allow more informed health care planning and policy-making. In addition, a better understanding of the relative importance of medical, behavioral, and socioeconomic factors that are risks for cognitive decline and dementia will help clinicians and policy-makers target high-risk groups, implement interventions to prevent or slow cognitive decline, and better assess the cost-effectiveness of current and future interventions.