THE INCREMENTAL EFFECTS OF DEMENTIA ON HEALTHCARE USE AND ECONOMIC STATUS IN THE US: A QUASI-EXPERIMENTAL APPROACH

Abstract

Abstract This research is to assess the impact of dementia on healthcare use and economic status over the course of dementia. We used a nationally representative, longitudinal study of older adults, specifying two propensity-score matched samples: 1) 3,476 adults aged 55+ at baseline who would have dementia in two years (hereafter “dementia group”), and 2) 3,476 adults who had never transitioned to dementia but had similar baseline sociodemographic and health status (hereafter “control group”). In two-year follow-up, the total care hours from unpaid helpers (44 hours per month vs. 20) and other in-home medical care (24% vs. 15%) were substantially higher with vs. without dementia. In the dementia group, the percentage of using nursing homes increased from 4% at the baseline to 27% at 8-year follow-up, compared to the increase from 3% to 10% in the control group. There was little change in OOP costs in the control group but a substantial increase in the dementia group over time (from $4,443 at baseline to $11,806 in an 8-year follow-up). The percent having Medicaid increased from 17% at baseline to 33% in 8-year follow-up in the dementia group. By using a quasi-experimental approach with longitudinal data, the study clarifies the incremental effects of dementia on health care and economic status. The effects of dementia on both home-based and facility-based care are substantial, with major changes occurring at the onset. Dementia exacerbated financial resources with increasing OOP medical costs, which may have profound impacts on families and society.