title: Direct medical expenditures associated with Alzheimer's and related dementias (ADRD) in a nationally representative sample of older adults - an excess cost approach.
abstract: To estimate the excess direct annual healthcare expenditures associated with Alzheimer's and related dementias(ADRD) among community-dwelling older adults in the United States.
  
  
  
  This retrospective cross-sectional study compared the annual healthcare expenditures between elderly individuals aged 65 years and older with ADRD (n = 662) and without ADRD (n = 13,398) using data from the Medical Expenditure Panel Survey (MEPS) for the years 2007, 2009, 2011 and 2013. Adjusted total annual medical expenditures was estimated using generalized linear model with gamma distribution and log link in 2013 U.S. dollars. Adjusted inpatient, outpatient, emergency, home healthcare and prescription drug expenditures, were estimated using two-part logit-generalized linear regression models.
  
  
  
  The adjusted mean total healthcare expenditures were higher for the ADRD group as compared to the no ADRD group($14,508 vs. $10,096). Among those with ADRD, 34.3% of the expenditures were for home healthcare as compared to 4.4% among those without ADRD. Among users, the ADRD group had significantly higher home healthcare ($3,240 vs. $566) and prescription drug expenditures($3,471 vs. $2,471). There were no statistically significant differences in inpatient, emergency room and outpatient expenditures between the ADRD and no ADRD group.
  
  
  
  ADRD in U.S. community-dwelling elders is associated with significant financial burden, primarily driven by increased home healthcare use.
authors.affiliation: a Department of Pharmaceutical Systems and Policy, School of Pharmacy , West Virginia University , Morgantown , WV , United States.
authors.forename: Arijita
authors.identifier: 0000-0002-4570-0364
authors.initials: A
authors.lastname: Deb
authors.affiliation: a Department of Pharmaceutical Systems and Policy, School of Pharmacy , West Virginia University , Morgantown , WV , United States.
authors.forename: Usha
authors.identifier: 0000-0001-8311-1360
authors.initials: U
authors.lastname: Sambamoorthi
authors.affiliation: a Department of Pharmaceutical Systems and Policy, School of Pharmacy , West Virginia University , Morgantown , WV , United States.
authors.forename: James Douglas
authors.identifier: 0000-0001-6017-7500
authors.initials: JD
authors.lastname: Thornton
authors.affiliation: b Department of Physiology and Pharmacology , School of Medicine, West Virginia University , Morgantown , WV , United States.
authors.forename: Bernard
authors.initials: B
authors.lastname: Schreurs
authors.affiliation: c Department of Epidemiology , School of Public Health, West Virginia University , Morgantown , WV , United States.
authors.forename: Kim
authors.identifier: 0000-0002-6395-7972
authors.initials: K
authors.lastname: Innes
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000191:economics / Q000628:therapy; D003430:Cross-Sectional Studies; D003704:Dementia / Q000191:economics* / Q000628:therapy*; D011307:Drug Prescriptions / Q000191:economics*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D012189:Retrospective Studies; D014481:United States
keywords: Alzheimer's; Medical Expenditure Panel Survey; dementia; direct medical expenditures