The impact of dementia in Germany: prevalence and direct costs in 2002

Uta Ziegler, Max Planck Institute for Demographic Research

Within the context of the aging of the populations all over the world mental illnesses come to the foreground of societal, political and medical interest. In industrialized countries dementia is the fourth most common cause of death after heart diseases, malignant growth and cerebrovascular diseases. For Germany we analyse an exceptional data set with a very large sample of over 2 Million people from the public sick funds (GKV) for the year 2002. We find age specific prevalence rates of dementia from 1.13% at the age of 60-64 increasing to 47% for people above age 100. The results are similar to those of meta analysis. Rates are higher for women than for men. Further differentiation reveals slightly higher rates for East Germans than for West Germans. Usually, Alzheimer’s disease (AD) is the most frequent form of dementia. We find lower rates for Alzheimer’s disease than for Vascular Dementia (VaD), however, this might be a diagnosis problem. AD can only be diagnosed with certainty with brain scans after death, thus many people are diagnosed as ‘dementia, not clearly specified’. In a next step we are going to look at the costs of dementia, which is one of the most expensive illnesses. Care need for mentally ill persons is especially high and thus causes very high indirect costs for familial care, but also treatment costs increase with the severity of the disease. For the year 2005 the total worldwide costs of dementia are estimated to US $ 315.4 billion. For Germany costs add up to about € 28 to 38 billion. With the data set we are going to estimate direct costs such as treatment costs and hospitalization. Age, sex, region, type of dementia and co-morbidity are taken into account.