The most rigorous study to date of how much it costs to care for Americans with dementia found that the financial burden is at least as high as that for either heart disease or cancer, and is probably higher. And both the costs and the number of people with dementia will more than double in 25 years, skyrocketing at a rate that rarely, if ever, occurs with a chronic disease.
The research, led by an economist at the RAND Corp., financed by the federal government and published Wednesday in The New England Journal of Medicine, provides the most reliable basis yet for measuring the scale of this devastating problem. Until now, the most-cited estimates of the cost and prevalence of the condition came from an advocacy group, the Alzheimer's Association.
Although some figures from the new research are lower than the association's projections, they are nonetheless staggering and carry new gravity because they come from a dispassionate, academic research effort. Behind the numbers is the striking sense that the country, facing the aging of the baby boomer generation, is unprepared for the coming surge in the cost and cases of dementia.
"It's going to swamp the system," said Ronald C. Petersen, chairman of the advisory panel to the federal government's recently created National Alzheimer's Plan, who was not involved in the RAND study.
In fact, Dr. Petersen, who as director of the Alzheimer's Disease Research Center at the Mayo Clinic is part of another team collecting data on dementia costs, said of the RAND numbers, "I think they're kind of lowballing things; they're being somewhat conservative."
The results show that dementia currently afflicts nearly 15 percent of people ages 71 or older, or about 3.8 million people. By 2040, the authors said, that number will balloon to 9.1 million people.
The study found that direct health care expenses for dementia, including nursing home care, were $109 billion in 2010. For heart disease, those costs totaled $102 billion; for cancer, $77 billion.
Beyond that, the study quantified the value of the sizable amount of informal care for dementia, usually provided by family members at home. That number ranged from $50 billion to $106 billion, depending on whether economists valued it by the income the family member was giving up or by what the family would have paid for a professional caregiver.
Without a way to prevent, cure or effectively treat these conditions yet, the bulk of the costs -- 75 to 84 percent, the study found -- involves helping patients in nursing homes or at home manage the most basic activities of life as they become increasingly impaired cognitively and then physically.
Each case of dementia costs $41,000-$56,000 a year, the study said. Researchers project the total costs of dementia care will more than double by 2040.