The costs of vascular dementia: a comparison with Alzheimer's disease.

OBJECTIVES: To estimate the costs of Medicare patients with vascular dementia (VaD). To compare the costs of VaD to Alzheimer's disease (AD) and controls without dementia.

METHODS: The study samples were drawn from community-dwelling patients in a large Medicare managed care organization (MCO) operating in the Northeast region of the USA. Costs for three study groups were contrasted in the study: 240 cases with vascular dementia (VaD), 1,366 cases with Alzheimer's disease (AD), and 19,300 controls without dementia. Costs were estimated from medical and pharmacy claims data. Estimated cost differences are controlled for age, gender, and comorbid conditions using regression analysis.

RESULTS: VaD patients accounted for 6% of all dementia patients identified in the health plan. VaD patients had substantially higher prevalence rates for 10 cardiovascular conditions compared with AD patients and controls. Annual costs for VaD patients were US$6,797 greater than AD patients. Compared with controls, costs were US$10,545 higher for VaD patients and US$3,748 higher for AD patients. Higher costs for VaD and AD patients relative to controls were largely attributable to higher inpatient costs.

CONCLUSIONS: Annual medical costs for VaD patients were substantially higher than costs for patients with AD and control patients without dementia. The high cost of VaD patients suggests a need to improve medical management and treatment of these patients to optimize patient outcomes and medical costs.