2000 Medicare spending for Alzheimer's was $31.9 billion. By 2010, that could increase to $49.3 billion.

In 2000, Medicare spending for beneficiaries with Alzheimer's was pegged at $31.9 billion. A Lewin Group study funded by the Alzheimer's Assn. last year warned that by 2010, Medicare spending would have to increase 54.5%, to $49.3 billion, for the treatment of the disease.

"The most alarming thing about these findings is that the estimated cost increases come even before the baby boomers reach the age of highest risk and the number of people with Alzheimer's disease explodes," the group said.

Currently, about 4 million Americans have been diagnosed with Alzheimer's disease. Nearly one in 10 Americans over the age of 65 and nearly half of those over 85 are affected. That number could peak at 14 million by the middle of the century, the study said.

Most of the Medicare spending for Alzheimer's care, however, does not address the underlying disease, but other age-related problems that tend to be worse in patients with dementia. About 28% of Alzheimer's patients also have congestive heart failure, 27% have chronic obstructive pulmonary disease, 22% have diabetes, and 20% have cancer.

According to the Alzheimer's Assn., patients with dementia stay an average of four days longer in the hospital than other patients of the same age, at an average added cost of $4,000 per patient.

Alzheimer's patients also have preventable medical crises brought on by impaired memory and the inability to manage their own care. Their health often declines because they cannot follow medical instructions and do not recognize signs of health problems.

But Medicare does not cover the two greatest expenses incurred by Medicare beneficiaries with Alzheimer's disease: long-term care and prescription drugs. Congress is now voting on adding a prescription drug benefit [11/24/03], but funding for long-term-care services is provided only through Medicaid once patients spend their remaining assets (i.e., becomes "poverty-stricken”)

Medicare officials and consumer advocates hope some of the new expenditures that result from the clarification of Medicare Alzheimer's coverage will be offset by savings in other spending areas. Delays in the onset of the disease, or maintenance of the senior's mobility and independence, could potentially save millions in nursing home and hospital costs.