The Economic Burden of Memory Loss

Contributed by: Dennis Fortier, President, Medical Care Corporation

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Memory loss is costing our nation billions of dollars annually.  This is an easy argument to build and the widely published data are compelling from every conceivable perspective.  But today, I am citing a new publication in the Archives of Internal Medicine, because it has been broadly covered in the general press.

According to a study conducted by the VA Medical Center in White River Junction, Vt., more than 600 primary care physicians were surveyed and the results confirmed much of what was strongly suspected.  About 42% of the physicians admitted that their patients receive "too much care" and 28% indicated that they order too many tests and too many expensive referrals to specialists.

The key driver of these expensive habits?  Fear of malpractice lawsuits was indicated by an alarming 76% of physicians.

This is an important concept in the brain health space because the early boomers are now reaching the age of risk for Alzheimer's disease and are well into the risk-prone years for stroke.  Combine that demographic trend with rising awareness about Alzheimer's disease, and we see the number of memory and cognition related complaints climbing steeply in primary care settings.

A standard work-up for such complaints involves blood work and an MRI scan of the brain, which can cost between $1500 and $2000. However, because subtle declines in working memory and processing speed are common in a healthy aging brain, the vast majority of brain scans ordered due to a memory complaint are negative. This means primary care physicians are aggressively ordering unnecessary tests in this space.

Some simple math shows that this could become a devastating economic problem for our healthcare system.  With 120 million people aged 65+, performing a work-up on even 1% of them would cost the nation about $2.4 billion. Given that about 80% of people aged 65+ have concerns about their memory, this is a scenario that could get out of control quickly.

The challenge is that, not working up a memory complaint on a patient in the early stages of Alzheimer's disease is akin to letting the disease progress without treatment.  That approach is obviously costly in both economic and emotional terms.

The solution is expand the adoption of better "memory assessment tools" in primary care so that physicians can effectively discern normal aging from cognitive decline caused by an underlying medical condition.  A review of the medical literature shows that new cognitive assessment tools with sophisticated computer scoring are pragmatic and cost-effective in a clinical setting.  More importantly, they can greatly improve healthcare in a fiscally prudent manner.