Direct and indirect cost of managing alzheimer’s disease and related dementias in the United States

ABSTRACT

Introduction: Care of individuals with Alzheimer’s Disease and Related Dementias (ADRD) poses special challenges. As the disease progresses, individuals with ADRD require increasing levels of medical care, caregiver support, and long-term care which can lead to substantial economic burden.

Areas covered: In this expert review, we synthesized findings from studies of costs of ADRD in the United States that were published between January 2006 and February 2017, highlighted major sources of variation in costs, identified knowledge gaps and briefly outlined directions for future research and implications for policy and program planning.

Expert commentary: A consistent finding of all studies comparing individuals with and without ADRD is that the average medical, non-medical, and indirect costs of individuals with ADRD are higher than those without ADRD, despite the differences in the methods of identifying ADRD, duration of the study, payer type and settings of study population. The economic burden of ADRD may be underestimated because many components such as direct non-medical costs for home safety modifications and adult day care services and indirect costs due to the adverse impact of ADRD on caregivers’ health and productivity are not included in cost estimates.

KEYWORDS:

• Dementia
• alzheimer’s disease
• economic burden
• direct cost
• indirect cost

Declaration of interest

KE Innes disclosure: NIH/NIGMS U54GM104942, Alzheimer’s Research and Prevention Foundation. JD Thornton disclosure: NIH Research Training Program in Behavioral and Biomedical Sciences 5 BBS T32 GM 081741-08. U Sambamoorthi disclosure: NIH/NIGMS U54GM104942. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was funded by NIH/National Institute of General Medical Sciences (NIGMS) U54GM104942, Alzheimer’s Research and Prevention Foundation, and NIH Research Training Program in Behavioral and Biomedical Sciences 5 BBS T32 GM 081741-08.