Falling significantly increases healthcare costs linked to dementia, primarily because individuals with dementia are at higher risk of falls, which often lead to injuries requiring medical attention, hospitalization, and long-term care. These fall-related incidents exacerbate the already substantial financial burden associated with dementia care.
Dementia, including Alzheimer’s disease, is characterized by progressive cognitive and functional decline, which impairs balance, judgment, and mobility, making falls more frequent and severe among this population. The consequences of falls in people with dementia often include fractures, head injuries, and other trauma that necessitate emergency care, inpatient treatment, rehabilitation, and sometimes permanent placement in long-term care facilities. These medical events drive up direct healthcare costs substantially.
The global societal cost of dementia was estimated at $1.3 trillion in 2019, with direct medical and non-medical care costs constituting a large portion of this figure. Hospitalizations and emergency care related to falls contribute notably to these expenses. For example, in the United States alone, direct costs related to healthcare, long-term care, and hospice care for dementia patients reached $154 billion in 2015, and these costs are expected to rise as dementia prevalence increases[1]. Falls among older adults, especially those aged 75 and above, have been identified as a primary contributor to the doubling of inpatient trauma care costs over the past decade, with annual inpatient trauma costs rising from $27 billion in 2012 to $42 billion in 2021[6]. Since many dementia patients fall within this age group, falls directly escalate dementia-related healthcare expenditures.
Moreover, individuals with severe dementia experience significantly higher out-of-pocket (OOP) healthcare costs, with 21% facing catastrophic expenditures and 12% falling below the poverty line due to medical expenses[4][8]. Falls often precipitate these financial crises because they lead to costly hospital stays, surgeries, and rehabilitation services. The financial burden extends beyond direct medical costs to include long-term care needs, as falls can accelerate functional decline and increase dependency, necessitating more intensive caregiving and support services.
Home care costs for people with dementia are also substantial, as many require assistance with activities of daily living (ADLs) following a fall. Since Medicare does not cover long-term care and Medicaid coverage varies by state, many families pay out of pocket for home care, which can be a prolonged and expensive necessity after fall-related injuries[3]. This ongoing care demand adds to the indirect costs of dementia, including lost productivity and unpaid caregiving hours.
The interplay between falls and dementia creates a vicious cycle: cognitive impairment increases fall risk, and falls worsen health outcomes and accelerate cognitive and functional decline, thereby increasing healthcare utilization and costs. Preventing falls in dementia patients is therefore critical not only for improving quality of life but also for mitigating the escalating economic burden on healthcare systems and families.
Efforts to address this issue include improving dementia care models to better manage fall risks, enhancing early diagnosis and intervention to slow disease progression, and supporting caregivers to reduce injury risks at home[5]. However, current healthcare reimbursement models often do not fully account for the complexity of dementia-related care needs, including fall prevention and post-fall management, which limits the effectiveness of cost containment strategies[3].
In summary, falls are a major driver of increased healthcare costs in dementia due to the high incidence of injury, hospitalization, and long-term care needs they cause. These costs compound the already enormous financial and societal burden of dementia, highlighting the importance of integrated care approaches that address both cognitive decline and fall prevention.
—
[1] Global Societal Burden of Alzheimer’s Disease by Severity, Neurol Ther. 2025
[3] As Dementia Rises, More Older Americans Are Getting Care at Home, PRB
[4] Characterizing financial risk from out‐of‐pocket expenditures across dementia severity, Alzheimers Dement. 2023
[5] Can W
