{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:46:30Z","timestamp":1791726390812,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2009,4,13]],"date-time":"2009-04-13T00:00:00Z","timestamp":1239580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005902","name":"Institute for Clinical and Translational Research, University of Wisconsin, Madison","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005902","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Alzheimer's disease (AD) is a progressive neurodegenerative disease that places substantial burdens on those who provide support for family members with declining cognitive and functional abilities. Many AD patients eventually require formal long\u2010term care services because of the absence, exhaustion, or inability of family members to provide care. The costs of long\u2010term care, and especially nursing home care, often deplete private financial resources, placing a substantial burden on state Medicaid programs. Current evidence suggests that pharmacological treatments and caregiver interventions can delay entry into nursing homes and potentially reduce Medicaid costs. However, these cost savings are not being realized because many patients with AD are either not diagnosed or diagnosed at late stages of the disease, and have no access to Medicare\u2010funded caregiver support programs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>A Monte Carlo cost\u2010benefit analysis, based on estimates of parameters available in the medical literature, suggests that the early identification and treatment of AD have the potential to result in large, positive net social benefits as well as positive net savings for states and the federal government.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings indicate that the early diagnosis and treatment of AD are not only socially desirable in terms of increasing economic efficiency, but also fiscally attractive from both state and federal perspectives. These findings also suggest that failure to fund effective caregiver interventions may be fiscally unsound.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jalz.2009.01.028","type":"journal-article","created":{"date-parts":[[2009,4,13]],"date-time":"2009-04-13T02:05:57Z","timestamp":1239588357000},"page":"215-226","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":198,"title":["Early identification and treatment of Alzheimer's disease: Social and fiscal outcomes"],"prefix":"10.1002","volume":"5","author":[{"given":"David L.","family":"Weimer","sequence":"first","affiliation":[{"name":"Robert M. La Follette School of Public Affairs University of Wisconsin-Madison Madison WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Sager","sequence":"additional","affiliation":[{"name":"Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,4,13]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002093-200110000-00002"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/43.2.158"},{"key":"e_1_2_9_4_2","volume-title":"Dementia UK: the full report","author":"Knapp M","year":"2007"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2000.tb04721.x"},{"key":"e_1_2_9_6_2","unstructured":"Kaiser Family Foundation.State health facts2006 Available atwww.statehealthfacts.org"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53015.x"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000242727.81172.91"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.19.2964"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/59.6.M621"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53117.x"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/39.4.457"},{"key":"e_1_2_9_13_2","volume-title":"United States Preventive Services Task Force. The guide to clinical preventive services","year":"2005"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e318161103c"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00852.x"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.0126.x"},{"key":"e_1_2_9_17_2","first-page":"113","article-title":"Treatment guidelines for Alzheimer's disease: redefining perceptions of primary care. Primary care companion","volume":"9","author":"Geldmacher DS","year":"2007","journal-title":"J Clin Psychiatry."},{"key":"e_1_2_9_18_2","first-page":"1","article-title":"United States life tables, 2003","volume":"54","author":"Arias E","year":"2006","journal-title":"Natl Vital Stat Rep."},{"key":"e_1_2_9_19_2","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.jns.2004.11.022","article-title":"Survival following dementia onset: Alzheimer's disease and vascular dementia","volume":"229","author":"Fitzpatrick AL","year":"2005","journal-title":"J Neurol Sci."},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2005.02.001"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afj083"},{"key":"e_1_2_9_22_2","volume-title":"Estimates of Medicare beneficiaries\u2014out-of-pocket drug spending in 2006","author":"Mays J","year":"2004"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200017040-00005"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002093-200107000-00004"},{"key":"e_1_2_9_25_2","volume-title":"Wisconsin Department of Health and Family Services. Wisconsin nursing homes and residents","year":"2006"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.6.1138"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.7.645"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2003.30103.x"},{"key":"e_1_2_9_29_2","volume-title":"Cost-benefit analysis: concepts and practice","author":"Boardman AE","year":"2006"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1368-5031.2005.00562.x"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2006.02.001"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/1099-1166(200008)15:8<713::AID-GPS187>3.0.CO;2-I"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1368-5031.2005.00524.x"},{"key":"e_1_2_9_34_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.7.1008"},{"key":"e_1_2_9_35_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.5.850"},{"key":"e_1_2_9_36_2","first-page":"645","article-title":"Effects of the Medicare Alzheimer's disease demonstration on the use of community-based services","volume":"34","author":"Newcomer R","year":"1999","journal-title":"Health Serv Res."},{"key":"e_1_2_9_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.wad.0000155380.63231.68"},{"key":"e_1_2_9_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01387.x"},{"key":"e_1_2_9_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.18.2148"},{"key":"e_1_2_9_40_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-145-10-200611210-00005"},{"key":"e_1_2_9_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0202-8"},{"key":"e_1_2_9_42_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.20.2409"},{"key":"e_1_2_9_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01600.x"},{"key":"e_1_2_9_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2007.10.001"}],"container-title":["Alzheimer's &amp; Dementia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1552526009000296?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1552526009000296?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.jalz.2009.01.028","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.jalz.2009.01.028","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.jalz.2009.01.028","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.jalz.2009.01.028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T19:32:33Z","timestamp":1759951953000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1016\/j.jalz.2009.01.028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,4,13]]},"references-count":43,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2009,5]]}},"alternative-id":["10.1016\/j.jalz.2009.01.028"],"URL":"https:\/\/doi.org\/10.1016\/j.jalz.2009.01.028","archive":["Portico"],"relation":{},"ISSN":["1552-5260","1552-5279"],"issn-type":[{"value":"1552-5260","type":"print"},{"value":"1552-5279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,4,13]]},"assertion":[{"value":"2009-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}