According to researchers, early diagnosis and treatment of Alzheimer's disease could save millions or even billions of dollars while simultaneously improving care.

Much of the fiscal burden is borne by state and federal governments, and thus taxpayers, through the Medicaid and Medicare programs. For example, the Wisconsin Medicaid program spends almost half a billion dollars each year on nursing home care for just 11,000 dementia patients, a tiny fraction of the estimated 160,000 affected people in the state, says Mark Sager, director of the Wisconsin Alzheimer's Institute of the UW-Madison School of Medicine and Public Health.

These costs could be greatly reduced by earlier diagnosis and treatment, Sager says. The research, a cost-benefit analysis of the social and fiscal impacts of early identification and treatment of Alzheimer's, uses Wisconsin as a model.

In addition to substantial financial savings, on average $10,000 net savings to the state alone per Alzheimer's patient diagnosed in Wisconsin, early Alzheimer's diagnosis and intervention would lead to positive social outcomes, including slower disease progression and improved quality of life for the patients' families and caregivers.

A major challenge to reaping these potential savings is the current lack of mechanisms for screening and early Alzheimer's diagnosis, allowing the vast majority of affected people to go unrecognized, Sager says. "We will have to develop systems of cognitive screening if we are going to eventually identify people at early stages when future treatment and caregiver interventions are most likely to be helpful."

"There are many physical, emotional and social benefits of early detection, diagnosis and intervention for people with Alzheimer's and their caregivers," says Shelley Morrison Bluethmann, director of early stage initiatives at the Alzheimer's Association, a health advocacy organization. "Early Alzheimer's detection empowers people with the disease to participate in decisions about their treatment and future care, as well as consider clinical trial opportunities. Being diagnosed early is vital to receiving the best help and care possible."

Patients with Alzheimer's and other dementias are heavy users of long-term care services, especially nursing home care, with estimated annual costs upward of tens of billions of dollars nationwide.

"The future of this disease is to intervene decades before someone becomes symptomatic. This analysis says you can save literally billions of dollars in long-term care costs if you can intervene at an earlier stage," Sager says. "What you don't know costs a lot of money when it comes to this disease."

The issue is becoming more pressing as the population ages, with some estimates placing the incidence of Alzheimer's in the U.S. around 1 million cases by 2050, the authors say.

"We need to begin now to make the public-policy changes that will allow and encourage early recognition and intervention," says Sager. "This article says to all the legislators facing deficits, 'here's a way to save money, and you can do it by providing better care.' It's a win for legislators, it's a win for patients, it's a win for families."
References:
1. Mark Sager, David Weimer. Early identification and treatment of Alzheimer's disease: Social and fiscal outcomes. Alzheimer's & Dementia: The Journal of the Alzheimer's Association. doi:10.1016/j.jalz.2009.01.028.