Study: Addressing Alzheimer's Risk Factors Could Lead to Medicare, Medicaid Savings

Treating certain chronic conditions that increase the risk of developing Alzheimer's disease and related dementia could have "unintended benefits" in the form of reduced Medicare and Medicaid spending, according to a Health Affairs study.

The researchers analyzed Medicare beneficiary data and used a simulation model to study the relationship between the reduction of possible risk factors for dementia (obesity, diabetes, hypertension and cardiovascular disease), the onset and duration of dementia, and Medicare and Medicaid spending. Estimated per capita lifetime costs related to Alzheimer's disease and related dementias are $11,105 for Medicaid and $12,366 for Medicare, according to the study.

The researchers concluded reducing body mass index by 10 percent among overweight or obese beneficiaries would save Medicare $6 billion and Medicaid $35 billion in lower dementia costs over the lifetimes of an estimated 76 million baby boomers in the U.S. The same reduction in cardiovascular diseases would save Medicare $20 billion and Medicaid $17 billion, while lowering the incidence of diabetes would reduce Medicare spending by approximately $7 billion and Medicaid spending by $1 billion. Furthermore, a 10 percent reduction in hypertension would save Medicare and Medicaid about $12 billion each, according to the study. These savings would come primarily from delayed onset and reduced duration of Alzheimer's and related forms of dementia.

"More research is needed to establish the relationship between other chronic diseases and dementia," the researchers wrote. "However, our study suggests that by delaying the onset of dementia and reducing its duration, the mitigation of certain modifiable risk factors could increase dementia-free life expectancy and reduce dementia costs for Medicare and Medicaid."

Lead Study author Pei-Jung Lin, PhD —an assistant professor at the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center's Institute for Clinical Research and Health Policy Studies in Boston — says the study's results could be used along with other research to ultimately determine the most cost-effective strategies for addressing Alzheimer's. She stresses the study only looks at "unintended" benefits of treating chronic conditions identified as risk factors for Alzheimer's, not using treatments designed for those chronic conditions to remedy or prevent dementia directly.

"We're not advocating off-label use or anything," she says. "Right now there's not enough evidence to suggest, for example, you should take diabetes medication to prevent Alzheimer's disease. The purpose of our study was to explore the added benefits of addressing risk factors."

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