Dementia and Medicare at life's end.

Objective: To determine the effect of a diagnosis of Alzheimer's disease or related dementias (ADRD), and the timing of first ADRD diagnosis, on Medicare expenditures at end of life.

Data Sources: Monthly Medicare payment data for the 5 years before death linked to the National Long-Term Care Survey (NLTCS) for decedents between 1996 and 2000 (N=4,899).

Data Extraction Methods: Medicare payment data for the 5 years before death were used to compare 5-year and 6-month intervals of expenditures (total and six subcategories of services) for persons with and without a diagnosis of ADRD during the last 5 years of life, controlling for age, gender, race, education, comorbidities, and nursing home status.

Medicare cost effects of recent U.S. disability trends in the elderly: future implications.

Objective: The authors examine how trends in disability prevalence and in inflation-adjusted per capita, per annum Medicare costs, 1982 to 1999 and 1989 to 1999, affected total Medicare costs projected to 2004 and 2009.

Method: To describe disability trends, the authors applied grade of membership analyses to 27 measures of disability from the 1982 to 1999 National Long Term Care Surveys (NLTCS). This identified seven disability profiles for which individual scores were calculated.

Change in chronic disability from 1982 to 2004/2005 as measured by long-term changes in function and health in the U.S. elderly population.

Changes in the health and functioning of the Medicare-enrolled population aged 65+ are tracked by using the 1982-2004/2005 National Long-Term Care Surveys. We found a significant rate of decline in the prevalence of chronic disability that accelerated from 1982 to 2004. These declines are significant for both persons with less severe chronic disability, which might be compensated by modifying the built environment and providing assistive devices, and for persons with more serious disability, which may be affected by reductions in the incidence and severity of disease through biomedical interventions.