The Global Economic Impact of Dementia, the first study of such scope to examine the macroeconomics of all types of dementias, released by the non-profit group Alzheimer’s Disease International 2010 includes some hard-to-ignore data. About 35.6 million people worldwide live with some type of dementia — about four times the population of Sweden. That caseload will increase to 65.7 million by 2030 and 115.4 by 2050. It seems that with each new study, the numbers get bigger and scarier.
The report estimates that the annual cost of care for patients with dementia at more than $600 billion or about 1% of the world’s gross domestic product. Astoundingly that figure is dwarfed by the projected rise in costs over the next few decades. In fact, the report estimates that costs could reach nearly $2 trillion by the year 2050.
While a cure is the goal that everyone seeks, a cold economic look at the disease makes it clear that the crippling expense of care comes primarily from patients in the moderate to severe stages of illness, when they cannot administer their own lives. While simply delaying progression to those stages might seem to be an uninspiring health care goal, it is a very attractive economic goal. Simply delaying progression by two years would have a tremendous impact in costs.
In the UK, the national body that reviews drugs for the National Health Service in terms of effectiveness and value for money (NICE) decides if a drug should be recommended. NICE has completed a re-assessment of the cholinesterase inhibitors and decided they should now be prescribed more routinely than under the fairly restricted clinical circumstances they proposed in 2007.
Global figures don’t mean much if you or a loved one is battling dementia — nor should they. But governments and policymakers are paid to take the longer view, and this report should be a wake-up call. To that end, earlier intervention and robust treatment, including a balanced diet, physical exercise, pharmaceutical therapy, and tight control of diabetes and any present cardiovascular risks, should be a high priority in the primary care setting.