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Costs of Caring for Old Folks Could Skyrocket

May 1, 1990

WASHINGTON (AP) _ The costs of caring for the elderly will soar in the coming decades without advances in the prevention and treatment of illnesses such as Alzheimer’s disease, researchers reported Tuesday.

As baby boomers age and medical advances increase their life span, a larger group of Americans will be at risk of developing the debilitating diseases that rob the elderly of their independence, the researchers said.

″This is where the challenge of aging (research) lies,″ said Dr. Jack M. Guralnik, an epidemiologist at the National Institute on Aging and co-author of a report in this week’s Journal of the American Medical Association.

″Unless we make substantial advances in the prevention and treatment of the diseases that cause the greatest disability, the aging of our oldest age groups will have a major impact on future health care costs,″ the report said.

Joseph Califano Jr., once secretary of the old Department of Health, Education and Welfare and a national spokesman for Project Independence for Older Americans, said the study findings show that ″the most cost-effective research the United States can put money into now is in aging″ research.

At a briefing on the study, Sen. Tom Harkin, D-Iowa and chairman of the Senate Appropriations subcommittee that deals with medical research, said he will introduce legislation that would increase federal financing of aging research from the current $400 million to $1 billion annually.

″We’re either going to invest now or pay later,″ Harkin said.

Applying Census Bureau population projections to inflation-adjusted 1987 Medicare spending figures, the researchers said costs of the program for those 65 and older could triple by 2040, reaching $212 billion. For those 85 and older, these costs could increase sixfold, they said.

Also, costs for nursing home care, now $3.1 billion for 1.3 million people 65 and older, could rise to $139 billion with as many as 5.9 million elderly Americans, most of them over 85, living out their years in these facilities.

Cost-containment strategies will not be enough to prevent these massive increases, said Dr. Edward L. Schneider, dean of the University of Southern California’s Andrus Gerontology Center and co-author of the report.

The greatest savings will come in preventing and delaying the onset of illnesses and conditions that make the elderly dependant on others for care, such as dementia, the most common form of which is Alzheimer’s disease, and hip fractures, he said.

″If we can prevent or delay the onset for people in their 80s, these people will die of other things″ that require less costly care, he said at a briefing on the study.

The study estimates that in 1985, the cost of caring for 2.4 million Americans with moderate to severe senile dementia was $35.8 billion. In 2040, when many baby boomers will be in their 80s, as many as 9.8 million Americans will need care for this dementia, costing as much as $149 billion.

A $1 billion annual investment in Alzheimer’s research would likely yield advances that could at least delay the onset of the disease by a minimum of five years, which would save $500 billion in care costs in the two decades from 2000-2020, Schneider said.

About 220,000 older Americans suffered hip fractures, mostly as a result of osteoporosis, in 1987, and their care cost $1.6 billion. In 2040, as many as 840,000 elderly could be expected to suffer hip fractures, at a cost of as much as $6 billion in inflation-adjusted 1987 dollars.

The researchers pointed to the search for ways to prevent and treat polio and tuberculosis as examples of cost-effective research because, once found, they reduced the incidence and costs of these conditions.

″If, instead of research, we had relied solely on cost containment or rationing, we might still have tuberculosis sanatariums and iron lungs,″ the researchers said.

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