Early Dementia Diagnosis Cuts Costs

By Care For You •

“Earlier diagnosis of cognitive impairment can yield substantial savings in medical costs for Alzheimer’s patients, according to a study unveiled Wednesday.” Writing in The Wall Street Journal (July 15, 2010), Shirley S. Wang notes, the cost of medical care is increasing every day. Yet, with dementia as with other conditions early diagnosis can save the patient money.

“Simple techniques exist to screen for memory problems, but many doctors don’t routinely use them. Increasingly, however, efforts are being made to diagnose patients’ cognitive impairment earlier.

“To examine the cost-effectiveness of screening and earlier diagnosis, researchers from the Department of Veterans Affairs in the Midwest conducted a standard memory screen on over 8,000 patients aged 70 and older. More than a quarter failed the two-minute screen and were referred for further evaluation. Of the 700 veterans who were more extensively evaluated, nearly all were found to have significant cognitive impairment.

“In clinics that were trained to recognize dementia, the researchers found, the average cost of all medical care for those patients identified with dementia dropped $1,700 in the year after diagnosis from the year before, according to Riley McCarten, medical director of the geriatric research education and clinical center at the Minneapolis Veterans Affairs Medical Center, who presented the research. The savings didn’t reflect the cost of the evaluation, which averaged $800, Dr. McCarten said.

“The cost savings are probably due to reduced hospitalizations and visits to urgent-care centers because families no longer bring their loved ones to these facilities as frequently as when they didn’t understand what was going on, according to Dr. McCarten. The reduced costs may also be related to having a caregiver step in to help the patient better manage chronic health conditions, he said.

“Patients often aren’t diagnosed until later stages, when day-to-day functioning is affected. As they try to manage on their own, many fail to take medications for such chronic conditions as diabetes, or experience falls and accidents leading to costly hospitalizations.

“The results of the large study were presented at the International Conference on Alzheimer’s Disease in Honolulu. It is the biggest study so far to examine the reduction of costs by identifying cognitive dysfunction early, according to William Thies, chief medical and scientific officer for the Alzheimer’s Association. He said the data show the program is “clearly cost-effective.”

“But it isn’t yet clear whether these “really important” findings would apply to patients who aren’t part of the Veterans Affairs system, or who go to clinics without specialty training in Alzheimer’s disease, according to Howard Fillit, executive director of the Alzheimer’s Drug Discovery Foundation, who wasn’t involved in the study.”