The Cost of Dementia

描述(由申请人提供)：这项拟议的研究将估计美国人口中痴呆症的经济成本。这些成本是市场交易产生的实际美元成本和未付护理造成的隐性成本。该项目将估计认知衰退会导致轻度认知障碍，痴呆症是导致美国老年人残疾和生活质量下降的越来越常见和重要的原因。认知障碍和痴呆症老年人数量的预期增长也将给家庭、医疗保健系统和社会项目(如联邦医疗保险)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。这项拟议的研究将：1)使用老龄化、人口统计和记忆研究(ADAMS)的临床评估和健康和退休研究(HRS)每一波中可用的预测因子，建立痴呆症状态的统计模型；2)计算每个HRS受访者患痴呆症的可能性；3)估计痴呆症状态对卫生保健利用的数量和类型的影响，条件是使用65岁或以上受访者的自我报告数据和与HRS相关的医疗保险数据；4)使用与HRS挂钩的医疗保险数据、医疗支出小组调查以及疗养院成本地理数据来评估不同类型医疗服务的财务成本，并计算由于医疗保健利用而导致的痴呆症的直接财务成本；5)开发非正规医疗保健提供的经济模型，并使用该框架估计非正式照顾者用于帮助痴呆症患者的时间的美元价值；以及6)开发和实施调查项目，以解决护理质量和痴呆症照顾者的多任务问题；使用这些措施来提供非正规护理成本的替代估计。这项研究将在具有全国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，从而允许更知情的卫生保健规划和政策制定。此外，更好地了解作为认知下降和痴呆风险的医疗、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针对高危群体，实施干预措施以防止或减缓认知能力下降，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.