Alzheimer's, other dementias, most costly malady in US; tops cancer, heart disease, study says

Cancer and heart disease are bigger killers, but Alzheimer's is the most expensive malady in the U.S., costing families and society $157 billion to $215 billion a year, according to a new study that looked at this in unprecedented detail.

The biggest cost of Alzheimer's and other types of dementia isn't drugs or other medical treatments, but the care that's needed just to get mentally impaired people through daily life, the nonprofit RAND Corp.'s study found.

It also gives what experts say is the most reliable estimate for how many Americans have dementia — around 4.1 million. That's less than the widely cited 5.2 million estimate from the Alzheimer's Association, which comes from a study that included people with less severe impairment.

"The bottom line here is the same: Dementia is among the most costly diseases to society, and we need to address this if we're going to come to terms with the cost to the Medicare and Medicaid system," said Matthew Baumgart, senior director of public policy at the Alzheimer's Association.

Dementia's direct costs, from medicines to nursing homes, are $109 billion a year in 2010 dollars, the new RAND report found. That compares to $102 billion for heart disease and $77 billion for cancer. Informal care by family members and others pushes dementia's total even higher, depending on how that care and lost wages are valued.

"The informal care costs are substantially higher for dementia than for cancer or heart conditions," said Michael Hurd, a RAND economist who led the study. It was sponsored by the government's National Institute on Aging and will be published in Thursday's New England Journal of Medicine.

Alzheimer's is the most common form of dementia and the sixth leading cause of death in the United States. Dementia also can result from a stroke or other diseases. It is rapidly growing in prevalence as the population ages. Current treatments only temporarily ease symptoms and don't slow the disease. Patients live four to eight years on average after an Alzheimer's diagnosis, but some live 20 years. By age 80, about 75 percent of people with Alzheimer's will be in a nursing home compared with only 4 percent of the general population, the Alzheimer's group says.

"Most people have understood the enormous toll in terms of human suffering and cost," but the new comparisons to heart disease and cancer may surprise some, said Dr. Richard Hodes, director of the Institute on Aging.

"Alzheimer's disease has a burden that exceeds many of these other illnesses," especially because of how long people live with it and need care, he said.

For the new study, researchers started with about 11,000 people in a long-running government health survey of a nationally representative sample of the population. They gave 856 of these people extensive tests to determine how many had dementia, and projected that to the larger group to determine a prevalence rate — nearly 15 percent of people over age 70.

Using Medicare and other records, they tallied the cost of purchased care — nursing homes, medicines, other treatments — including out-of-pocket expenses for dementia in 2010. Next, they subtracted spending for other health conditions such as high blood pressure, diabetes or depression so they could isolate the true cost of dementia alone.

"This is an important difference" from other studies that could not determine how much health care cost was attributable just to dementia, said Dr. Kenneth Langa, a University of Michigan researcher who helped lead the work.

Even with that adjustment, dementia topped heart disease and cancer in cost, according to data on spending for those conditions from the federal Agency for Healthcare Research and Quality.

Finally, researchers factored in unpaid care using two different ways to estimate its value — foregone wages for caregivers and what the care would have cost if bought from a provider such as a home health aide. That gave a total annual cost of $41,000 to $56,000 per year for each dementia case, depending on which valuation method was used.

"They did a very careful job," and the new estimate that dementia affects about 4.1 million Americans seems the most solidly based than any before, Hodes said. The government doesn't have an official estimate but more recently has been saying "up to 5 million" cases, he said.

The most worrisome part of the report is the trend it portends, with an aging population and fewer younger people "able to take on the informal caregiving role," Hodes said. "The best hope to change this apparent future is to find a way to intervene" and prevent Alzheimer's or change its course once it develops, he said.

___

Online:

Alzheimer's information: http://www.Alzheimers.gov

National Institute on Aging: http://www.nia.nih.gov

View the original article here

Pew's social media study pushes all the wrong buttons

• 

  HOLD FOR RELEASE UNTIL 12:01 A.M. EDT. THIS STORY MAY NOT BE PUBLISHED, BROADCAST OR POSTED ONLINE BEFORE 12:01 A.M. EDT - Donald Conkey, 15, checks his smartphone while doing homework in his bedroom on Monday, March 11, 2013, in Wilmette, Ill. A new report from the Pew Internet & American Life Project says more teens are using smartphones as a main means of accessing the Internet -- moreso than adults. (AP Photo/Martha Irvine)

Most Americans like to poke fun of just how tech savvy Asian-Americans are. The stereotypical assumption is often accurate when it comes to finding the coolest social app or digital designer. 

Experienced business travelers know that if you want to find the latest generation gadget, go to Seoul or Hong Kong or Tokyo. This fact, however, seems to be lost on the well-respected Pew Research Center.  How else can you explain their latest work, “The State of Social Media Users,” which remarkably excludes Asian-Americans from the study?

The February 2013 report of social media users has either forgot about Asian-Americans, lumped them in with their white counterparts or refused to score them. Why would Pew publish a comparison of social media users that doesn’t track Asian-Americans?  Perhaps it might be that Asians’ social media habits score so high against other races that it might not be an interesting or alarming comparison.

Why wouldn’t Pew want to compare Asians to the other minority groups?

Demographic research shows the rapid growth of Asian-Americans – an increase of 46 percent between the 2000 and 2010 Census. And even though Asian-Americans comprise a smaller part of the population than other groups, their growth rate is four times that of the general population. So why wouldn’t Pew want to compare Asians to the other minority groups?

It’s not the first time policy makers, the mainstream media, advertisers, think tanks or influential research groups have forgotten about Asian-Americans.  Sadly, it probably won’t be the last.

The studies that ignore the rise of Asian-Americans and the Asian impact on American culture not only deprive Asians a seat at the table, but it denies our society as a whole valuable information.  Dismissing Asian-Americans when it comes to social media is a particularly bad idea.  According to the most recent Nielsen Social Media Report, Asian-Americans are the most likely group to have visited a social network, interacted with social media advertising and made purchases through social media.  So why are we ignoring the leaders’ habits?

There are far greater consequences for those minorities left behind in studies like Pew’s latest.  Government and non-profit funding for social, health and economic programs use these studies to make grant decisions. While national organizations like Pew marginalize Asian-Americans in their studies, critical research is left to smaller, regional groups and universities that don’t have the same clout. If an audience isn’t counted, it doesn’t get any attention, funding or support for pressing issues. Consequently, myths about Asian-Americans as the “model minority” prevail.  In the U.S., the common perception holds that Asians are harder working, more educated, higher earning and more successful than other ethnic groups.

Stereotypes like this, however positive they may seem, are detrimental in that they gloss over the serious problems facing Asian-Americans.  Pew’s refusal to include Asians in their social media study creates an over-hyped distraction that diverts attention from the threats and problems facing Asian-Americans.  Every ethnic group has unique and inherent problems that should not be overlooked by false narratives.  For example, black Americans have diabetes at nearly twice the rate of whites and nearly half the Hispanic population considers access to affordable health care a “very serious” problem. The successful Asian stereotype also means less than 1-in-3 Asian-American children receive mental health care treatment when parents determine there’s a need, but fear the stigma attached to seeking treatment.

Are Asian-Americans perceived as non-existent, unimportant or maybe just honorary Caucasian? The problems facing researchers in counting smaller groups is understandably an inconvenience.  Asian-Americans are frequently undercounted because of linguistic and cultural barriers -- the result of grouping together dozens of peoples from diverse ancestries that sometimes share little more than a common region of the world. But the invisibility created by being left out also creates countless problems.  Health needs are not met.  Funds for social services are unfairly distributed. Politicians and policy makers ignore the problems they don’t even know exist.  Entrepreneurs, particularly social entrepreneurs, miss opportunities to generate business, jobs and tax revenues.

Studies that omit key groups are a waste of time and lack credibility because their conclusions are based on only part of the picture.  It seems to me, Pew should want to study the social media habits of those leading the digital revolution.

Julia Y. Huang, CEO of interTrend Communications - a national advertising agency connecting FORTUNE 500 companies with Asian-American audiences.

View the original article here

Study: Health care overhaul to increase claims costs by 32 percent

Medical claims costs -- the biggest driver of health insurance premiums -- will jump an average 32 percent for Americans' individual policies under President Obama's overhaul, according to a study by the nation's leading group of financial risk analysts. 

The report could turn into a big headache for the Obama administration at a time when many parts of the country remain skeptical about the Affordable Care Act. The estimates were recently released by the Society of Actuaries to its members. 

While some states will see medical claims costs per person decline, the report concluded the overwhelming majority will see double-digit increases in their individual health insurance markets, where people purchase coverage directly from insurers. 

The disparities are striking. By 2017, the estimated increase would be 62 percent for California, about 80 percent for Ohio, more than 20 percent for Florida and 67 percent for Maryland. Much of the reason for the higher claims costs is that sicker people are expected to join the pool, the report said. 

The report did not make similar estimates for employer plans, the mainstay for workers and their families. That's because the primary impact of Obama's law is on people who don't have coverage through their jobs. 

The administration questions the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick. The study also doesn't take into account the potential price-cutting effect of competition in new state insurance markets that will go live on Oct. 1, administration officials said. 

"It's misleading to look at only some of the provisions of the law because, taken together, the law will reduce costs," said Health and Human Services spokeswoman Erin Shields Britt. 

But a prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does "a credible job" of estimating potential enrollment and costs under the law, "without trying to tilt the answers in any particular direction." 

"Having said that," Foster added, "actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully." Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago. 

Kristi Bohn, an actuary who worked on the study, acknowledged it did not attempt to estimate the effect of subsidies, insurer competition and other factors that could mitigate cost increases. She said the goal was to look at the underlying cost of medical care. 

"Claims cost is the most important driver of health care premiums," she said. 

"We don't see ourselves as a political organization," Bohn added. "We are trying to figure out what the situation at hand is." 

On the plus side, the report found the law will cover more than 32 million currently uninsured Americans when fully phased in. And some states -- including New York and Massachusetts -- will see double-digit declines in costs for claims in the individual market. 

Uncertainty over costs has been a major issue since the law passed three years ago, and remains so just months before a big push to cover the uninsured gets rolling Oct. 1. Middle-class households will be able to purchase subsidized private insurance in new marketplaces, while low-income people will be steered to Medicaid and other safety net programs. States are free to accept or reject a Medicaid expansion also offered under the law. 

Obama has promised that the new law will bring costs down. That seems a stretch now. While the nation has been enjoying a lull in health care inflation the past few years, even some former administration advisers say a new round of cost-curbing legislation will be needed. 

Bohn said the study overall presents a mixed picture. 

Millions of now-uninsured people will be covered as the market for directly purchased insurance more than doubles with the help of government subsidies. The study found that market will grow to more than 25 million people. But costs will rise because spending on sicker people and other high-cost groups will overwhelm an influx of younger, healthier people into the program. 

Some of the higher-cost cases will come from existing state high-risk insurance pools. Those people will now be able to get coverage in the individual insurance market, since insurance companies will no longer be able to turn them down. Other people will end up buying their own plans because their employers cancel coverage. While some of these individuals might save money for themselves, they will end up raising costs for others. 

Part the reason for the wide disparities in the study is that states have different populations and insurance rules. In the relatively small number of states where insurers were already restricted from charging higher rates to older, sicker people, the cost impact is less. 

"States are starting from different starting points, and they are all getting closer to one another," said Bohn. 

The study also did not model the likely patchwork results from some states accepting the law's Medicaid expansion while others reject it. It presented estimates for two hypothetical scenarios in which all states either accept or reject the expansion. 

Larry Levitt, an insurance expert with the nonpartisan Kaiser Family Foundation, reviewed the report and said the actuaries need to answer more questions. 

"I'd generally characterize it as providing useful background information, but I don't think it's complete enough to be treated as a projection," Levitt said. The conclusion that employers with sicker workers would drop coverage is "speculative," he said. 

Another caveat: The Society of Actuaries contracted Optum, a subsidiary of UnitedHealth Group, to do the number-crunching that drives the report. United also owns the nation's largest health insurance company. Bohn said the study reflects the professional conclusions of the society, not Optum or its parent company.

View the original article here

Was duck penis study an appropriate use of taxpayer money?

By You Decide

Published March 25, 2013

FoxNews.com

The National Science Foundation has been criticized for spending $384,949 on a Yale University study that examined, among other things, the particulars of male duck penises. Do you believe the study was a proper use of taxpayer funding?

View the original article here

Study says new moms among the most distracted drivers

New mothers aren't immune to the dangers of distracted driving. In fact, with the demands of driving with a newborn baby on board, new moms may be among the most distracted drivers on the road.

A recent survey of new moms that was conducted by American Baby and Safe Kids Worldwide  points out how prevalent distracted driving is among new moms. The key evidence is that while the majority of moms surveyed said they are being more cautious in their driving habits since the birth of their child, their answers to other survey questions implies the direct opposite.

In short, new moms are driving while fatigued (sleeping an average of 5 hours, 20 minutes per night), not paying attention to the speed limit, turning around to tend to the baby, three out of four moms are using their phones to text or call or read messages or emails, and doing other kinds of distracted behavior – all with baby on board.

Worse yet is the statistic that almost 10 percent of new moms surveyed had an accident with their baby while driving. That’s nearly three times the rate in the general population.

How to get around this problem is a complex matter, but a variety of experts, including the National Highway Traffic Safety Administration (NHTSA), Parents Magazine, and the AAA Foundation for Traffic Safety, recommend these tips to help new moms avoid dangerous driving behavior:

Keep eyes on the road. The cardinal rule while driving is that you keep your eyes on the road at all times. When driving, that’s the activity that has to claim the driver's full attention and focus.

No texting, taking calls, checking email. The survey results showed that 78 percent of new moms talk on the phone while driving with baby on board and that 26 percent check email or text. Keep in mind that no message, text or call is worth jeopardizing baby’s life, the driver's, or anyone else who is driving on the road or a pedestrian in and around the car's field of travel.

Multi-tasking is not your friend.  There is a time and a place for everything and driving in the car is not the place to juggle multiple tasks.

Pick the right time to do errands. The best way to avoid the dangerous behavior of being distracted by a crying baby is to pick the right time to do errands.

Enlist help. Obviously there will be times when it is absolutely necessary to go out and do something that requires driving to get there. If possible, ask a friend or neighbor to watch the baby.

Eliminate distractions. Besides having baby in the car, there are numerous other distractions that can and will seek to grab the driver's attention. Succumbing to distraction increases the danger quotient. As much as possible, eliminate all the distractions that take concentration away from the road and driving safely.

No eating or drinking behind the wheel. Keep hands on the wheel and concentration on the task at-hand: driving. Save eating and drinking for at home, destination or when safely parked.

No turning around to tend to baby. The tendency to immediately turn to tend to a crying child may only take a few seconds, but can result in tragedy. Instead of risking disaster, pull off the road, where and when it is safe to do so, and tend to baby then. 

Get some more shut-eye. Many new moms have a serious lack of sleep, winding up feeling exhausted most of the time. Take frequent naps, when possible, but don’t get behind the wheel without sufficient sleep the night before.

Watch speed. It’s hard to be observant and adhere to speed limits and other traffic signs and signals when distracted by thoughts of what needs to be done and places yet to go. That few extra seconds saved by speeding won’t make that much of a difference in the time at home, but it can make the difference between life and death on the road.

Bottom line: Having a new baby is an exciting time, an opportunity for new mom and baby to grow together and share love and meaningful experiences. Part of the responsibility of a new parent to this child is to exercise caution and use good judgment when driving with baby in the car.

More from The Car Connection

View the original article here