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The following is a summary of “Changes in Care Use and Financial Status Associated With Dementia in Older Adults,” published in the October 2023 issue of Neurology by Choi, et al.

Since the dementia population will more than quadruple in the next several decades, estimating its implications on care utilization and financial outcomes is crucial. For a study, researchers sought to examine dementia-related incremental changes in older people’s care needs and cost impacts on individuals, families, and society. The population-based cohort study used propensity score matching on national, longitudinal data to match sociodemographic characteristics, economic status, family availability, health conditions, disability status, and outpatient care use in two groups of 55-year-old US adults without dementia. 

During the 2-year follow-up, 2,387 people developed dementia, and 2387 did not. Participants were tracked for 8 years after baseline. Data were analyzed from February 2021 to August 2023. Key Results and Measures  Care outcomes included monthly family and unpaid helper care hours, in-home medical services, hospital stay, and nursing facility stay. Wealth, Medicaid, and out-of-pocket medical expenses were financial consequences. The sample mean (SD) age was 75.4 [10.4] years, and 59.7% were female. At baseline, the dementia group used 45 vs 13 monthly care hours from family and unpaid helpers, 548 of 2,370 participants (23.1%) vs 342 of 2,383 (14.4%) using in-home medical care, 1,104 of 2,369 (46.6%) vs 821 of 2,377 (34.5%) with a hospital stay, and 489 of 2,375 (20.6%) vs 104 of 2,384 (4.4%) using a nursing facility. 

If family care was scarce, nursing home utilization increased. Over an 8-year follow-up, the dementia group had a rise in 2-year out-of-pocket medical expenses from $4005 to $10 006, a decrease in median wealth from $79 339 to $30 490, and a rise in Medicaid enrollment from 16.1% to 29.7%. Financial results did not vary significantly in the control group. The cohort research showed that dementia significantly affects older persons’ long-term care and financial burden. A complete dementia prediction evaluation should include family care availability.

Source: jamanetwork.com/journals/jamainternalmedicine/article-abstract/2810859