75 The American Heart Association also estimated an overall stroke prevalence of 6.8 million Americans ≥20 years of age, accounting for 2.8% of the population, based on NHANES data from 2007 to 2010.37 Among older survivors of ischemic stroke who were followed up in the Framingham Study, 26% were dependent in activities of daily living 6 months poststroke. Half had reduced mobility or hemiparesis, including 30% who were unable to walk without assistance. In addition, a significant number had associated aphasia (19%), symptoms of depression (35%), and other impairments that contributed to a 26% rate of nursing home placement.41 The economic burden of stroke is

impacted by initial hospitalization, medications, continuing medical care, and work limitations.

The average cost of a stroke Obeticholic Acid hospitalization in 2005 was $9500.76 Over a lifetime, the cost of an ischemic stroke in the United Selleck LY2109761 States is more than $140,000 including inpatient care, rehabilitation, and long-term care for lasting deficits.77 A 2011 estimate divided the total cost of stroke in the United States into $28.3 billion ($33.0 billion in 2013 dollars) for direct costs and $25.6 billion ($27.3 billion in 2013 dollars) in indirect costs.38 Estimates for the total costs for strokes in the United States range from $34.3 billion ($36.6 billion in 2013 dollars)78 to $65.5 billion ($72.7 billion in 2013 dollars).40 A 2010 report from the Centers for Disease Control and Prevention estimated that TBI requiring a physician visit occurs with an incidence of 1.74 million per year in the United States, based on calculations from NHIS data by Waxweiler et al79 in 1995. The severity of TBI ranges from mild

(80%) to severe (10%), with most long-term disability caused by moderate to severe injury.80 The prevalence of long-term disability resulting from TBI has been estimated at 3.32 million43 oxyclozanide to 5.3 million81 in the United States. Survivors of TBI often have limitations in activities of daily living, instrumental activities of daily living, social integration, and financial independence.82 and 83 About 43% of people discharged with TBI after acute hospitalization develop TBI-related long-term disability.45 Individuals with a history of TBI are 66% more likely to receive welfare or disability payments.83 In addition, a history of TBI is strongly associated with subsequent neurologic disorders that are disabling in their own right, including Alzheimer disease and Parkinson’s disease.84 The direct costs of TBI have been estimated at $9.2 billion per year ($13.1 billion in 2013 dollars). An additional $51.2 billion ($64.7 billion in 2013) dollars is lost through missed work and lost productivity.45 Total medical costs range from $48.3 billion to $76.5 billion ($63.4–$79.1 billion in 2013 dollars).