Care Use, Financial Burden Increase Over Time for Elders With Dementia

MONDAY, Oct. 16, 2023 (HealthDay News) -- For older adults, care use and financial burden increase substantially over time for those with dementia versus those without, according to a study published online Oct. 16 in JAMA Internal Medicine.

HwaJung Choi, Ph.D., from the University of Michigan in Ann Arbor, and colleagues examined the incremental changes associated with dementia with regard to older adults' care use and assessed the associated financial consequences in a population-based cohort study that included propensity score matching. A total of 2,387 adults experienced dementia onset during the two-year follow-up and 2,387 did not.

The researchers found that between the matched groups, care use was similar at baseline, but in subsequent years, care use was substantially greater for the dementia versus control group, especially during the two-year follow-up: 45 versus 13 monthly care hours from family and unpaid helpers; 23.1 versus 14.4 percent using in-home medical care; 46.6 versus 34.5 percent with hospital stay; and 20.6 versus 4.4 percent using a nursing facility. If baseline family care availability was low, the increase in use of a nursing facility was especially high. In the dementia group, the two-year out-of-pocket medical costs increased from $4,005 to $10,006; there was a reduction in median wealth from $79,339 to $30,490; and those enrolling in Medicaid increased from 16.1 to 29.7 percent of participants during the eight-year follow-up. In the control group, there were no significant changes noted in financial outcomes.

"We found that the broad influences of dementia onset are profound, even for a short period (less than two years of the onset), which exacerbates over the course of dementia," the authors write.

One author served as an expert witness for a legal case regarding the decisional capacity for an adult with dementia.

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