Dementia places a much larger financial burden on families in the last 5 years of life than cancer, heart disease, and other conditions, especially among the social groups least prepared to cope, according to a study published in Annals of Internal Medicine.

Not enough is known about the cost of end-of-life care for persons with different medical conditions. Researchers used data from the Health and Retirement Study (HRS) to examine the social costs and financial risks faced by Medicare beneficiaries 5 years before death. They considered various social costs associated with disease, such as government spending (Medicare), private insurance, out-of-pocket expenditures, and informal care. They also examined how these spending components varied across four disease groups: dementia, cancer, heart disease, and other conditions.

The researchers found that total social costs for Medicare patients with dementia was $250,000 per person in the last 5 years of life, which is 57 percent greater than social costs associated with death from other conditions. Families of patients with dementia also had to pay a greater proportion of family assets for end-of-life care than families of patients without dementia. Those who were unmarried, were black, and had less than a high school education were disproportionately affected. The authors suggest that these findings could inform discussions on Medicare policy.