Economic Analysis of Alzheimer’s Disease in Outpatients: Impact of Symptom Severity

Souêtre, E.; Qing, W.; Vigoureux, Isabel; Lozet, H.; Dartigues, Jean‐François; Lacomblez, L.; Derousené, C.

doi:10.1007/978-1-4615-8149-9_78

Cited by 18 publications

(22 citation statements)

References 14 publications

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“…In this process, precise knowledge of the health care costs of dementia is crucial. A number of studies of the cost of dementia have been published [2][3][4][5][6][7]. However, first, these studies differ methodologically with respect to the types of costs to be included.…”

Section: Introductionmentioning

confidence: 99%

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The Cost of Dementia in Denmark: The Odense Study

Andersen¹,

Søgaard²,

Hansen³

et al. 1999

Dement Geriatr Cogn Disord

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In a population-based study of dementia, the cost of care for 245 demented elderly and 490 controls matched by age and gender was estimated. Dementia of Alzheimer’s type was diagnosed according to the NINCDS-ADRDA criteria, and vascular dementia and other types of dementia were diagnosed according to the DSM-IIIR criteria. Severity of dementia was determined by the Clinical Dementia Rating scale. The annual cost of medical care, domestic care, home help, nursing home and special equipment for nondemented patients was DKK 22,000 per person while the cost for very mildly, mildly, moderately and severely demented patients was DKK 49,000, DKK 93,000, DKK 138,000 and DKK 206,000, respectively. Except for very mild dementia the cost did not differ between elderly who suffer from Alzheimer’s disease and those with other types of dementia. The net cost of dementia is the difference in cost between those with dementia and the matched controls and amounts on average to DKK 77,000 per person per year. However, priority setting cannot be based on the cost of dementia per se, but only on the cost of a specific dementia intervention compared to its health benefit.

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Section: Introductionmentioning

confidence: 99%

“…Second, diagnostic criteria and methods used to examine participants are rarely reported. Third, some studies only consider Alzheimer's disease [3,6]. Fourth, some studies only consider expenditures to the demented who live at home [7].…”

Section: Introductionmentioning

confidence: 99%

The Cost of Dementia in Denmark: The Odense Study

Andersen¹,

Søgaard²,

Hansen³

et al. 1999

Dement Geriatr Cogn Disord

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“…At the early stage of the disease, direct costs, linked to diagnostic consultations, neuropsychological evaluations and testing procedures, are predominant (1,23). The time interval between the first symptoms and the first medical consultation is approximately 1.5-years (23).…”

Section: Cost Analysis Of Various Care Strategies Of Demented Patientsmentioning

confidence: 99%

“…For example, the cost-effectiveness of the new anti-dementia drugs (such as acetylcholinesterase inhibitors) includes not only the price of the drug, but also its ability to stabilize and improve patients' (and caregivers') quality of life, and reduce caregiver burden (35). This kind of analysis appears complex because it includes data and costs that constantly vary such as delay in institutionalization and reduction in the number of hours of informal care required by the patient, as well as improvement in the patients' and caregivers' quality of life, and need to be compared with societal trends and progress (1).…”

Section: "Cost-minimization" Analysis (Cma)mentioning

confidence: 99%

Economic considerations of Alzheimer’s disease and related disorders

et al. 2001

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"Dementia is certainly one of the most dramatic medical and economic challenges that our society will face in the coming years"(1)This strong statement by Souêtre recognizes the interaction between world-wide demographic changes and the particular nature of dementing conditions. Population aging has resulted in a doubling of the population over 60 years of age over the past century in developed countries. This phenomenon is occurring at accelerated rates in developing countries, which will undergo a similar demographic change over less than 3 decades (2). In most countries, the prevalence of dementia varies between 6 and 8% for individuals aged 65 years or more, and rises dramatically with age. For each decade after the 6 th , the number of affected people doubles so that an estimated 30% of the 85+ population is affected by dementia (3, 4). In a recent prevalence study performed in Geneva, 5.6% of the population over the age of 65 suffered from dementia; however, the rate of the disease varied from 2.6% in women in the 65-70 years age group to 28.1% in men in the over 90 years group (5). In the United States, in 1994 dementia ranked 9 th in incidence (959,000 cases/year), and 8 th in prevalence (7,082,000 cases) (6). The number of individuals with dementia will double between 1990 and 2005 in many developing countries, such as Brazil, India, and Nigeria (7). These demographic and epidemiological considerations have major economic consequences. Until a few years ago, the economic impact of chronic conditions such as dementia suffered a lack of theoretical and empirical development (8). However, over 300 papers devoted to economic aspects of Alzheimer's disease (AD) have been published in peer reviewed journals within the last five years. In these papers, the chosen perspective (costs to society or to specific payers) is important to consider. The societal perspective includes global costs, while that of specific payers (e.g., patients, families, insurance companies, municipality, county, etc.) may stress costs for which they themselves are responsible (9).

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“…Dementia undoubtedly takes a major toll on both the patients and their carers, who are frequently family and friends. Moreover, a significant positive correlation has been demonstrated between the evolution of dementia and healthcare costs, even in out-patients [18]. As the population of the western world continues to age, the prevalence of dementia and other diseases associated with old age will almost certainly increase [19].…”

Section: Therapeutic Regimenmentioning

confidence: 99%

Study on COgnition and Prognosis in the Elderly (SCOPE): Baseline Characteristics

Hansson

Lithell²,

Skoog

et al. 2000

Blood Pressure

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The Study on COgnition and Prognosis in the Elderly (SCOPE) is a multi-centre, prospective, randomized, double-blind, parallel-group study. The primary objective of SCOPE is to assess the effect of the angiotensin II type 1 (AT 1 ) receptor blocker, candesartan cilexetil 8-16 mg once daily, on major cardiovascular events in elderly patients (70-89 years of age) with mild hypertension (DBP 90-99 and/or SBP 160-179 mmHg). The secondary objectives of the study are to test the hypothesis that antihypertensive therapy can prevent cognitive decline (as measured by the Mini Mental State Examination, MMSE) and dementia, and to assess the effect of therapy on total mortality, myocardial infarction (MI), stroke, renal function, and hospitalization. A total of 4964 patients from 15 participating countries were recruited during the randomization phase of SCOPE, exceeding the target population of 4000. The mean age of the patients at enrolment was 76 years, the ratio of male to female patients was approximately 1:2, and 52% of patients were already being treated with an antihypertensive agent at enrolment. The majority of patients (88%) were educated to at least primary school level. At randomization, mean sitting blood pressure values were SBP 166 mmHg and DBP 90 mmHg, and the mean MMSE score was 28. Previous cardiovascular disease in the study population included myocardial infarction (4%), stroke (4%) and atrial fibrillation (4%).Men, more often than women, had a history of previous MI, stroke and atrial fibrillation. A greater percentage of men were smokers (13% vs 6% in women) and had attended university (11% vs 3% of women). Of the randomized patients, 21% were 80 years of age. In this age group smoking was less common (4% vs 10% for 70-79-year-olds) and fewer had attended university (4% vs 7% for 70-79-yearolds). The incidence of MI was similar in both age groups. However, stroke and atrial fibrillation had occurred approximately twice as frequently in the older patients.The patients' mean age at baseline was similar in the participating countries, and most countries showed the approximate 1:2 ratio for male to female patients. There was also little inter-country variation in terms of mean SBP, DBP or MMSE score. However, there was considerable regional variation in the percentage of patients on therapy prior to enrolment.

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Economic Analysis of Alzheimer’s Disease in Outpatients: Impact of Symptom Severity

Cited by 18 publications

References 14 publications

The Cost of Dementia in Denmark: The Odense Study

The Cost of Dementia in Denmark: The Odense Study

Economic considerations of Alzheimer’s disease and related disorders

Study on COgnition and Prognosis in the Elderly (SCOPE): Baseline Characteristics

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