The costs of dementia subtypes to California Medicare fee-for-service, 2015

Yingjia Chen, Leslie Wilson, John Kornak, R. Adams Dudley, Jennifer Merrilees, Stephen J. Bonasera, Christie M. Byrne, Kirby Lee, Winston Chiong, Bruce L. Miller, Katherine L. Possin

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Introduction: Dementia is among the costliest of medical conditions, but it is not known how these costs vary by dementia subtype. Methods: The effect of dementia diagnosis subtype on direct health care costs and utilization was estimated using 2015 California Medicare fee-for-service data. Potential drivers of increased costs in Lewy body dementia (LBD), in comparison to Alzheimer's disease, were tested. Results: 3,001,987 Medicare beneficiaries were identified, of which 8.2% had a dementia diagnosis. Unspecified dementia was the most common diagnostic category (59.6%), followed by Alzheimer's disease (23.2%). LBD was the costliest subtype to Medicare, on average, followed by vascular dementia. The higher costs in LBD were explained in part by falls, urinary incontinence or infection, depression, anxiety, dehydration, and delirium. Discussion: Dementia subtype is an important predictor of health care costs. Earlier identification and targeted treatment might mitigate the costs associated with co-occurring conditions in LBD.

Original languageEnglish (US)
Pages (from-to)899-906
Number of pages8
JournalAlzheimer's and Dementia
Issue number7
StatePublished - Jul 2019


  • Alzheimer's disease
  • Falls
  • Health care costs
  • Lewy body dementia
  • Medicare
  • Vascular dementia

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Health Policy
  • Developmental Neuroscience
  • Epidemiology


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