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无酬照护产生的隐性成本。该项目将估计导致轻度认知障碍的认知下降和痴呆症是美国老年人残疾和生活质量下降的一个越来越常见和重要的原因。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，重要的是要了解美国老年人认知能力下降和痴呆症的全部社会成本。这项拟议的研究将：1）使用来自老龄化、人口统计学和记忆研究（亚当斯）的临床评估以及健康和退休研究（HRS）的每个波中可用的预测因子来开发痴呆状态的统计模型; 2）估算每个HRS应答者的痴呆概率; 3）估计痴呆状态对医疗保健利用的数量和类型的影响，对于65岁或以上的受访者，使用自我报告的数据和与HRS相关的Medicare数据，以其他合并症为条件; 4）使用来自与HRS相关的医疗保险数据、医疗支出小组调查的信息，以及疗养院成本的地理数据，以评估不同类型医疗保健服务的财务成本，并计算痴呆症因医疗保健利用而产生的直接财务成本; 5）开发一个非正式的医疗保健提供的经济模型，并使用这个框架来估计非正式的照顾者花在帮助痴呆症患者上的时间的美元价值;和6）开发和实施调查项目，以解决痴呆症照顾者的护理质量和多任务处理问题;使用这些措施来提供非正式护理成本的替代估计。这项研究将提供一个更好的理解认知能力下降和痴呆症的全部社会成本在全国代表性样本的老年人，因此，允许更明智的医疗保健规划和决策。此外，更好地了解认知能力下降和痴呆症风险的医疗，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瞄准高危人群，实施干预措施以预防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.