The macroeconomics of dementia-will the world economy get Alzheimer's disease?

BACKGROUND: Health is firmly on the economic radar. It is big business. In 2009, the proportion of the Gross Domestic Product spent on health care varied between 6.4% in Mexico and 17.4% in the U.S., with the UK at 9.8% and Germany, Switzerland and Canada ~11%. These are considerable amounts of money and they are growing. With all projections pointing to a growth in the numbers of older people, the pressure on budgets will only increase. In this paper we will consider the role of dementia in this. METHODS: Demographic and economic data were combined and policy implications developed. RESULTS: The costs of dementia dwarf those of the illnesses that are currently prioritized at a national and international level such as HIV, cancer, heart disease, stroke and diabetes. Based on simple demographics, the costs of dementia are set to increase by 85% by 2030, with developing countries bearing an increasing share of the economic burden. CONCLUSIONS: The data suggest that dementia is a clear and present economic challenge for the world from the macro level down to the individual. Before the crisis, governmental structural primary deficits were generally improving and this would have given time and resource to meet the challenges of ageing in general and dementia in particular. However, increasing government debt over the past 3 years has had the effect of our needing to implement reforms to contain the risks to sovereign budgets sooner rather than later. This is not an issue that can be ignored. Inaction will only lead to further debt accumulation in the medium term and the death of systems of care in the long term. Across the developed world, the main long-term fiscal challenges come from health care costs, and dementia is a major driver of those costs. There is a need for budgetary consolidation and pension reform more generally. But, given that dementia is the highest ticket health and social care item that we have, making up 60% of long term care spending according to some estimates, then targeted investment in early intervention and in research (into causes, cure and care) are likely to be of major value in personal, societal, political, and economic terms.