Early Alzheimer’s diagnoses could prevent huge money mistakes
by Charles Sauer · The Washington TimesOPINION:
Shortly before his Alzheimer’s diagnosis, Jay Reinstein walked into a car dealership and bought a brand-new BMW that he couldn’t afford.
His wife was as upset as she was mystified, but Jay’s impulsivity was not the result of a newfound reckless streak. It was related to the thinking and judgment issues that come with Alzheimer’s disease.
Fascinating research from Georgetown University and the New York Federal Reserve shows that Jay’s story is not unique.
People who develop Alzheimer’s or related dementias show measurable financial decline in the five years before diagnosis. This means that by the time many patients receive a diagnosis, their money missteps have already been compounding for years, threatening their long-term financial stability.
Diagnosing Alzheimer’s early is key to protecting finances. Identifying the disease earlier gives patients and families the opportunity to set up guardrails and plan for the future: monitoring accounts, adjusting spending and assigning financial power of attorney.
Those guardrails can mean the difference between having the financial stability to focus on family and seeing every new medical bill as a life destabilizer.
Lifetime medical and caregiving costs for an Alzheimer’s patient are around $400,000, and families shoulder 70% of that cost. That is a lot of money for most Americans, and the financial mistakes in the years leading up to diagnosis put these families at greater financial risk.
New research shows that credit scores fall steadily as cognitive function declines. One year before diagnosis, people are about 17% more likely to be delinquent on their mortgage payments and about 34% more likely to miss credit card bills.
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Meanwhile, the incidence of Alzheimer’s is on track to double by 2060, which could bankrupt not only families but also the federal budget. Total U.S. dementia spending is projected to reach $1.6 trillion by 2050. The healthcare system’s late-stage crisis care is far costlier than early-stage prevention.
That is why early diagnosis of Alzheimer’s would help address both family finances and federal spending.
The good news is that diagnostic advances enable doctors to detect Alzheimer’s before severe symptoms set in. New blood-based biomarker tests can identify the disease with about 90% accuracy.
Yet even with new technologies, our healthcare system needs key adjustments to make Alzheimer’s screening and diagnosis a routine part of primary care. We already understand the value of early detection in other diseases. We screen for cancer and monitor for heart disease because doing so improves outcomes and reduces long-term costs.
Alzheimer’s care should be no different.
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Primary care physicians, the providers patients see the most, should anchor care to keep track of memory and thinking changes. For early diagnosis to become a consistent reality, primary care should be adequately reimbursed for cognitive assessments and for time spent counseling patients on next steps, including financial planning and lifestyle changes that may help slow decline.
These fixes are simple and could give millions of families the time they need to ensure their finances are on track.
Jay Reinstein says he was fortunate. He received the diagnosis shortly after the uncharacteristic BMW purchase, and he had a government pension and a spouse who could take part in the planning process.
Many others do not have that support. These are the patients whose financial futures could be saved by their primary care physician administering a simple cognitive test early.
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If we want to protect Americans as they age, then we need to look for Alzheimer’s earlier — not only to give them more time with their families but also to prevent avoidable financial damage.
Without that shift, families will continue to absorb the consequences of a system that waits too long to act.
• Charles Sauer is president of the Market Institute.