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Cost of Care for Vascular Dementia Higher Than
Alzheimer’s
Caused by strokes, vascular dementia second to
Alzheimer's as most common form of dementia
Sept. 12, 2005 - The most comprehensive health
economics study of vascular dementia in the U.S. has found that patients
with vascular dementia living in the community have substantially higher
healthcare utilization and costs than patients with Alzheimer's disease.
Vascular dementia is the second most common cause of dementia after
neurodegenerative Alzheimer's disease.
Vascular dementia (VaD) is a decline in
intellectual abilities as a result of a stroke. It occurs when brain
tissue is damaged because of reduced blood flow to the brain, most
commonly by a stroke or series of strokes. The brain cells, in effect,
have difficulty working together to process information. This can lead
to memory loss, confusion, and decreased attention span, in addition to
problems with activities of daily living.
It is estimated that nearly a fifth of people who
suffer a stroke will develop problems involving their mental abilities.
Approximately 10 to 20 percent of America's senior
citizens over age 65 experiencing dementia have VaD, making it second
only to Alzheimer's disease as a leading cause of dementia.
(To learn more about Vascular Dementia read the report
by National Stroke Association below this news report.)
The new findings demonstrate the unique clinical,
societal and economic importance of vascular dementia, and indicate that
improving ambulatory care for vascular dementia patients could prevent
unnecessary hospitalizations.
"This study reinforces the value of early
recognition and control of cardiovascular risks associated with vascular
dementia," said Howard Fillit, MD, executive director of the Institute
for the Study of Aging.
"It is critical that the health community recognize
that dementia is a common and clinically important consequence of
stroke. By managing risk factors, early recognition and diagnosis, and
better care management, much can be done to reduce the incidence of
vascular dementia, improve quality of care and reduce the costs
associated with it," he said.
The study included 20,098 community-dwelling
Medicare members of HIP Health Plan of New York.
Key findings were that annual costs per patient for
vascular dementia at $14,387 were substantially higher than persons with
stroke and no dementia at $8,254, Alzheimer's disease at $7,839, or
non-demented patients without stroke at $5,494.
While the study reports that total health care
costs for vascular dementia patients were higher primarily due to higher
hospital costs, it also reports that their costs for physician visits
and prescription drugs were lower than other study groups.
An article on this new study can be found in the
Journal of Alzheimer's Disease, Volume 8, Issue 1, published by ISO
Press on September 7, 2005. This project was a collaborative effort of
the Institute for the Study of Aging, Pfizer, Inc. and HIP Health Plan
of New York. For more information regarding this study, contact ISOA
Executive Director Howard Fillit, MD at 212-935-2402 or
hfillit@aging-institute.org.
About the Institute for the Study of Aging (ISOA)
The Institute for the Study of Aging (ISOA) is a
biomedical venture philanthropy whose sole mission is to accelerate the
discovery and development of new drugs to prevent, treat and cure
Alzheimer's disease. For more information,
call 212-935-2402 or visit
http://www.aging-institute.org.
About HIP Health Plan of New York
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HIP Health Plan of New York provides its members
access to quality, affordable health care from conveniently located,
leading hospitals and doctors. Including its subsidiaries, Vytra Health
Plans and ConnectiCare, there are approximately 1.4 million HIP members
who have access to 41,000 providers in over 61,000 locations in New
York, Connecticut and Massachusetts.
About the Journal of Alzheimer's Disease
The Journal of Alzheimer's Disease (www.j-alz.com)
is an international multidisciplinary journal to facilitate progress in
understanding the etiology, pathogenesis, epidemiology, genetics,
behavior, treatment and psychology of Alzheimer's disease. The journal
publishes research reports, reviews, short communications, book reviews,
and letters-to-the-editor. The journal is dedicated to providing an open
forum for original research that will expedite our fundamental
understanding of Alzheimer's disease.
Vascular Dementia and Stroke
Every year, more than 750,000 Americans experience
a stroke, or brain attack. A stroke occurs when a blood clot blocks a
blood vessel or artery, or when a blood vessel breaks, interrupting
blood flow to an area of the brain and cutting off vital supplies of
oxygen. This lack of blood can cause damage to areas of the brain that
control important functions such as thinking, speaking and breathing. A
common complication resulting from stroke is loss of cognitive function,
or intellectual abilities, often called vascular dementia.
What is Vascular Dementia?
Vascular dementia (VaD) is a decline in
intellectual abilities as a result of a stroke. It occurs when brain
tissue is damaged because of reduced blood flow to the brain, most
commonly by a stroke or series of strokes. The brain cells, in effect,
have difficulty working together to process information. This can lead
to memory loss, confusion, and decreased attention span, in addition to
problems with activities of daily living.
It is estimated that nearly a fifth of people who
suffer a stroke will develop problems involving their mental abilities.
Approximately 10 to 20 percent of Americans over
age 65 experiencing dementia have VaD, making it second only to
Alzheimer's disease as a leading cause of dementia.
The occurrence of VaD increases with age, and the
number of Americans age 65 and older is expected to increase to nearly
70 million by 2030.
Some of the risk factors for VaD are the same as
for stroke, including high blood pressure, history of previous stroke,
diabetes, heart disease, and high cholesterol levels.
Symptoms of Vascular Dementia
-
Memory loss
-
Confusion
-
Mood swings and personality changes
-
Language problems
-
Difficulty paying attention or following a
conversation
-
Impaired motor skills
-
Difficulty planning and organizing tasks
-
Visual orientation problems
-
Difficulty with calculations, making decisions,
solving problems
-
Depression-like behavior
Patients with VaD often deteriorate in a step-wise
manner, with symptoms becoming greater with each new stroke. Sometimes,
however, dementia can come on abruptly as the result of a single stroke,
depending on the location and size of damaged brain area.
In some instances, the onset of VaD is so gradual
that healthcare providers have difficulty distinguishing it from
Alzheimer's disease. The dementia in these cases is likely the result of
chronic inadequate blood circulation in the brain that can cause small,
silent strokes, or TIAs.
Patients with VaD may become more dependent upon
family members or caregivers for assistance with activities of daily
living due to physical and behavioral changes.
Diagnosing Vascular Dementia
Your healthcare provider should conduct a complete
medical and patient history evaluation in order to determine the
presence of VaD. Diagnostic tests may be used to exclude other possible
causes of cognitive decline. Clinical tools are available to assist
healthcare professionals in diagnosing VaD, including brain imaging
techniques (CT or MRI) and tests of congnitive functioning.
Treating Vascular Dementia
There are currently no therapies or drugs approved
by the U.S. Food and Drug Administration (FDA) available for the
treatment of VaD. Recently, an existing drug was submitted to the FDA
for review as a potential treatment for VaD.
The current treatment strategies focus on reducing
the risk of additional strokes, or prevention of stroke.
Other clinical trials are currently underway to
test drugs that may treat patients with VaD.
About Stroke
Stroke is the leading cause of disability and the
third leading cause of death among adults. The most common type of
stroke is ischemic stroke, which occurs when blood clots block arteries
and cut off blood flow to the brain. The most common stroke symptoms
are: numbness in the body, dizziness or confusion. Risk factors for
stroke include: previous stroke, previous mini- stroke or transient
ischemic attack, high cholesterol, high blood pressure, heart disease,
atrial fibrillation and carotid artery disease as well as being
overweight, smoking and consuming too much alcohol.
About National Stroke Association
Based in Englewood, CO, the National Stroke
Association (NSA) is a leading, independent national nonprofit
organization devoting 100 percent of its efforts and resources to
stroke. Currently, NSA is launching a comprehensive program to educate
emergency medical technicians about the logistics of recognizing and
handling the needs of a person suffering from a stroke.
www.stroke.org
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