Conference Presentation, Panel
Reducing the Cost and Risk of Dementia
Milken InstituteNora Super, Michael Belleville, Jennie Chin Hansen, Kevin Crain, Jeff Huber, Shari Ling, Sarah Locke, Ian Cramer, Orion, Alan Stevens, Jill Lesser
- Global dementia prevalence is projected to become overwhelming without a cure, necessitating new payment rules, billing codes, and quality measurement vehicles to enable earlier detection and management of cognitive impairment regardless of specific diagnosis.
- Emergency Triage, Treat, and Transport (ET3) demonstrations are expected to improve patient outcomes and experiences for older adults with multiple competing medical problems by offering alternatives to current emergency transport models.
- A national initiative for dementia-friendly communities will embrace the "nothing about us without us" principle, while the U.S. Preventive Services Task Force requires sufficient evidence to confirm that cognitive screening translates to better health outcomes.
- Early integration of cognitive testing into healthcare plans at ages 30 or 40 is anticipated to establish baselines for future detection, with 90% of current diagnoses expected to occur too late, analogous to stage four cancer, requiring systemic disruption for early intervention.
- The number of accredited geriatric emergency departments is expected to grow quickly from a baseline of 105, with approximately 90% able to maintain accreditation without major funding, potentially leading to lower costs and reduced fall rates within a month of discharge.
- A significant workforce shortage of geriatricians is expected due to payment policies that make geriatric training less financially attractive than primary care, though systems like accountable care organizations are projected to show higher uptake of preventive health services.
- Home Instead projects providing over 80 million hours of care by the end of the year, the majority related to dementia, with high-quality home care anticipated to reduce healthcare system access including fewer doctor visits, emergency room visits, and hospital readmissions.
- Future workforce challenges will impact productivity as the average American caregiver spends at least 12 hours monthly on duties, prompting expectations that the HR community will view caregiving as a robust benefit for multigenerational workers, not just mid-stage career individuals.
- Financial advisors and wealth management firms are expected to shift focus toward life-stage asset management and detect cognitive decline by recognizing financial mismanagement patterns, as the average Merrill Lynch client is 65 and the longevity economy for those over 60 is projected to accelerate spending.
- Next-generation drugs are anticipated to allow for intervention at very early dementia stages, while paid service programs and community engagement platforms aim to create personalized care experiences and bring the concept of aging support to national political discourse.