Zooming Medicare and Medicaid costs to care for a surge of Alzheimer's disease patients in the next 10 to 20 years threaten survival of America's health care system, a nationwide study shows. Rising costs of
By Helen Altonn
Alzheimer’s care
threaten health system,
study finds
Star-BulletinHawaii's patients are expected to grow to 65,010 by 2025, from 19,500 now.
Medicare costs for island residents with Alzheimer's are expected to increase to $171 million in 2010 from $96 million now, according to the Lewin Group study.
Medicaid costs will increase to $124 million from $69 million in that period.
Hawaii will be hard hit because it has the fastest-growing aging population in the United States, said Janet Bender, executive director of the Alzheimer's Association's Aloha Chapter.
"We've got a lot of people coming here to retire," she said.
Age is not the direct cause of Alzheimer's, but it is the highest risk factor, she said.
Nationally, the number of people with Alzheimer's will increase to 14 million between 2010 and 2050 from an estimated 5.5 million as baby boomers reach the high-risk age, the study reported.
"This imminent epidemic of Alzheimer's disease threatens to bankrupt Medicare and Medicaid," said Dr. Patricia Lanoie Blanchette, director of the University of Hawaii's Geriatric Medicine Program and president of the Alzheimer's Association-Aloha Chapter.
She met recently with Hawaii's congressional delegation in Washington and urged Congress and President Bush to make conquering Alzheimer's disease a top federal health priority.
"Scientists now know that the process that destroys the brain cells begins in the brain at least 10 years before the symptoms of Alzheimer's appear," Blanchette said.
"If we haven't found a way to slow down or stop that process before the baby boomers start turning 65, it may be too late to save most of them from the disease."
Blanchette said Congress must boost funding to the National Institutes of Health to $1 billion for Alzheimer's research, with at least an additional $200 million this year.
The NIH now spends about $515 million on Alzheimer's research.
The 50-state study shows the Medicare cost of treating people with the disease will soar to $49.3 billion in 2010 from $31.9 billion in 2000.
Medicaid costs for nursing-home care for people with Alzheimer's will leap to about $33 billion in 10 years from $18.2 billion.
The most common form of dementia, Alzheimer's is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking and behavior. There is currently no cure.
Statistics show one in 10 people over age 65 have Alzheimer's, and nearly half of those are older than 85, Bender said. A small percentage of victims are as young as the 30s and 40s, she said.
The average life span for someone with Alzheimer's is about eight years from its onset, although many live 20 years or more, she said.
"More than seven out of 10 people with Alzheimer's live at home, and about 75 percent of the care is provided by family and friends," Bender said.
That is encouraged when possible, she added, since nursing-home care can cost as much as $5,000 or more per month.
Blanchette, citing enormous benefits of increased research, said delaying the onset of Alzheimer's for even five years could keep half of the at-risk baby boomers from suffering the devastating effects of the disease.
Medicare and Medicaid savings would be dramatic, she said, noting even a one-month delay in putting someone in a nursing home would amount to an estimated $1 billion savings per year. Bender pointed out that Alzheimer's is the third most expensive disease in the United States, after heart disease and cancer.
"So it's something we can't be complacent about," she said. "People have to start planning now. The best way is to become aware of what it is, what are the symptoms and how it can impact the family and community."
Among the symptoms are gradual memory loss, declining ability to do routine tasks, disorientation, difficulty in learning, loss of language skills, impaired judgment and planning, and personality changes. Bender urged residents to call the Alzheimer's Association if they suspect something is wrong with a family member.
However, people often do not call for help because they are embarrassed and afraid, Bender said. "There is still a stigma with a disease of the brain and Alzheimer's, and people are afraid to learn about it. When they contact us, they can get connected to services and learn steps to plan as they progress through the disease."
The Alzheimer's Association has committed more than $100 million toward research into the causes, treatment, prevention and cure of the disease, and Bender urges residents to ask Congress for more Alzheimer's research money.
"People who say it won't happen in their lifetime are not being realistic," she said. "We would be a nation of iron lungs if not for polio vaccine."
But they should not look to the government or an agency to solve the Alzheimer's plight, she said, stressing, "The community needs to become partners in the fight against the disease and how to support families."
She said plans should be made for the possibility of long-term care so it does not become a burden on families and eat up life savings. Respite care and other services also must be available to address needs of caregivers, she said.
Also, all Alzheimer's patients should be registered in the association's nationwide Safe Return program to help identify and locate those who wander off, she said, noting only 450 are registered in Hawaii.
"People (with the disease) go to Las Vegas with their family, and they go to the bathroom and are gone four or five hours. It's very frightening and people become complacent," saying, "My mom won't wander," she said.
"On Maui, two people wandered and were never found."
To register someone in Safe Return or
obtain further information about Alzheimer's, call
the Aloha Chapter at 591-2771 or, on the
neighbor islands, 877-43ALOHA.